(i) SYNTHETIC SUBSTACES
There are numerous substances but without doubt,
Hyaluronic acid has become the most prominent and useful of these
substances because of its effectiveness and virtually total lack of
It is not taken from animals or humans but it is fully synthesizable.
It is a natural constituent of human skin. Unlike collagen which was
the original ‘filler’ substance it produces no allergic reactions.
It is an extremely effective means to extinguish wrinkles ranging
from those of shallow depth to those that are quite deep. It is most
frequently used for the wrinkles stretching from the nose to the
corners of the mouth (nasolabial folds), those between the eyebrows
and also in other locations on the face such as the upper lip,on the
chin and elsewhere. Often, old scars from acne or otherwise are
amenable to this treatment.
It is an office procedure requiring around 15 minutes. The first
treatment lasts an average of 5 months but each subsequent one
extends this interval so that after 3-4 treatments one can expect to
repeat it on a yearly or even longer basis.
The cost effectiveness is indisputably far superior to even the best
cosmetic cream in view of the radical and immediate effect on the
wrinkle.The patient leaves the doctor’s office with an already
dramatically improved wrinkle which continues to improve over the
next few days due to the absorption of water from the neighbouring
(ii) AUTOLOGOUS FAT
For very deep wrinkles or losses of subcutaneous
tissue e.g. from accidents, severe infections or tissue necrosis the
use of fat-cells taken from the patient herself is preferred. Since
they are harvested from the patient herself these cells are really
grafts which are placed in the areas where there is a need to build
them up.The principle is the same as when a skin-graft is taken from
a patient and placed elsewhere on he body.
The fat is taken with a small cannula (tube) with the aid of local
anaesthesia, from a suitable area of the patient, (often the hips or
waist). It is centrifuged to purify the fat by separating it from
the local anaesthetic and blood and is then inserted in the areas on
the face which need to be augmented.
The patient experiences swelling such that may require her to remain
at home for 5-7 days until it subsides. There is a moderate bruising
which resolves during the above period. Not all the transplanted
cells are expected to take but those which do stay for ever. If
necessary the procedure may be repeated after a few months for
further building up of the area. There is only minimal pain with