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Facial Volume restoration

Hyaluronic acid injectable fillers are the most widely used soft tissue fillers to treat facial volume deficits, providing long-term facial aesthetic enhancement outcomes for the signs of aging and/or facial contouring.⁽¹⁾

Soft tissue fillers are a minimally invasive aesthetic medicine procedure used to improve or create volume, to remodel the contours of the face, and fill in wrinkles and deep folds.

Common areas to inject fillers are in the face, neck, and décolleté, resulting in a fuller, smoother and more youthful appearance. Fillers are among the most popular aesthetic medicine procedures because they carry immediate results, very few risks and little recovery time.⁽²⁾

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Origin and composition
Fillers may be classified depending on their source as:

  • autologous (e.g., fat, cultured human fibroblasts);
  • collagen (bovine-derived, human-derived from tissue culture);
  • hyaluronic acid (HA) (non-animal stabilised or viscoelastic HA from bacterial fermentation);
  • synthetic or pseudo-synthetic implants (silicone, polymethacrylate microspheres, poly-L-lactic acid, calcium hydroxylapatite microspheres suspended in aqueous polysaccharide gel, alkyl-imide gel polymer).⁽⁴⁾


Depending on their permanence in the body, fillers can be classified as temporary, semi-permanent, and permanent. The first two classes have a different time of duration in the tissue due to the reabsorption, while the permanent fillers are not absorbable.

  • Temporary fillers stay in the tissue for up to a year; they have a temporary effect because they contain materials that are absorbed by the body over time⁽³⁾. Examples are: fillers based on collagen or hyaluronic acid.
  • Semi-permanent fillers stay in the tissue for up to 1–2 years⁽⁾.
    Longer-lasting fillers typically contain substances such as the
    Biostimulators, for example, Calcium hydroxylapatite⁽²⁾ and polycaprolactone are semi permanent and less reabsorbable.
  • Permanent fillers are substances that remain in the tissue more than two years.⁽³⁾ Permanent fillers include silicone oils, polymethyl methacrylate (PMMA) microspheres, polyacrylamide, and several other materials either alone or formulated in various combinations with absorbable components.
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(1) Pierre S, Liew S, Bernardin A. Basics of dermal filler rheology. Dermatol Surg. 2015 Apr;41 Suppl 1: S120-6. doi: 10.1097/DSS.0000000000000334.

(2) The American Society for Aesthetic Plastic Surgery. Fillers. [online] Available at: [accessed March 2017].

(3) Vedamurthy al. Dermal fillers: tips to achieve successful outcomes. J Cutan Aesthet Surg 2008; 1(2): 64–67.

(4) Ganceviciene al. Skin anti-aging strategies. Dermatoendocrinol 2012 Jul 1; 4(3): 308–319.

(5) DeLorenzi C. Complications of injectable fillers, part I. Aesthet Surg J 2013 May; 33(4): 561-575.Resurface

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