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Another good alternative in the second step (and with a different purpose) is the use of dermal fillers to restore lost volume and return the appearance of younger skin, fuller and with less wrinkles. An importance thing to notice is that in spite of not being a surgical procedure, involves the placement of them under the skin with very fine needles, so you should be aware that your treating doctor has the proper training and technical skills to administer these substances. Dermal fillers are non-allergenic and well tolerated by most patients, giving satisfying results.

Dermal fillers are directed to both women and men, though in men the areas to be treated are slightly different.

They are usually administered under local anesthesia or after the use of an anesthetic cream over the skin for 30 minutes.  In some cases an anesthetic block is preferred (like when going to the dentist), and then the dermal filler is applied under sterile technique. After finishing, the patient rests for a while with a cold pack on the treated area.  This procedure lasts from 20 to 30 minutes depending on the anesthesia, technique and extension of the treated area.

Hyaluronic acid gel (Restylane)











Currently there are many trademarks available, but you should know their main components, like:

- Hyaluronic acid: These are resorbable fillers made with stabilized hyaluronic acid, obtained through a biochemical process and without animal origin, between them we can find: Restylane (Q-Med), Juvéderm (Allergan), Fortelis, Esthelis, Mesolis (Anteis), Glytone (Pierre Fabre).










- Calcium hydroxilapatite: Contained in Radiesse (BioForm Medical Inc.) composed of synthetically produced smooth calcium hydroxylapatite (CaHA) micro-spheres suspended in a gel carrier. Hydroxylapatite is a natural component of human bones, and the synthetic form it's used in different biomedical applications like prosthetic implants. The form contained in dermal fillers is resorbable through time and can stimulate some degree of collagen production where was injected.

- Poly-L-lactic acid: Contained in Sculptra (Sanofi-Aventis), it's also contained in some suture materials for surgery, it's slowly reabsorbed and degraded by the body, being replaced in some degree by collagen.

- Polyacrylamide: This is a non resorbable filler contained in Aquamid (Contura Int.), consisting in a solution of water and 2,5% polyacrylamide. The effects are permanent and long lasting.

It is important to mention that every product has advantages and disadvantages and these can be discussed with the surgeons in Arcadia Clinic.

The duration of the effect is variable between patients, being from 6 months to 1 year for most, but up to 2 years with some dermal fillers.

Adverse reactions of dermal fillers are uncommon but reported time to time, being the most common local reddening and swelling that last up to a week. Less common is bruising and very rare are inflammatory reactions and skin discoloration (1 in 50.000 treatments as reported by the pharmaceutical companies).


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