Dermal fillers and augmentation procedures

Author: Vanessa Ngan, Staff Writer, 2002.

Dermal fillers and other implants are used for facial augmentation. They can be chosen for reconstructive or cosmetic purposes. It has become increasingly popular for the ‘normal’ everyday person to seek dermal fillers to fill in acne scars and facial lines or to enhance a specific facial area. Dermal fillers are injected just below the skin surface. Other materials are implanted in the subcutaneous area to restore or replace fat.

Over the years many filling agents have been developed. However, the search is still on for the ideal facial implant material. The ideal product should have the following properties:

What are dermal fillers and other implants used for?

Dermal fillers and facial implants can be used in reconstructions for areas that may have been scarred or altered by trauma. This may be done in conjunction with minor or major plastic surgery. The other increasing use of dermal fillers is in cosmetic surgery where patients seek these treatments to improve their appearance.

They are mainly used for the removal or improvement of scars caused by acne, correction of facial (wrinkle) lines, and enhancement or filling in of certain specific facial features such as the lips or chin.

Facial lines and features that can be corrected using dermal fillers
  • Frown lines (glabellar lines)
  • Smoker's lines (perioral lines)
  • Marionette lines (oral commissures)
  • Worry lines (forehead lines)
  • Crow's feet (periorbital lines)
  • Deep smile lines (nasolabial furrows)
  • Smile lines (nasolabial lines)
  • Cheek depressions
  • Lip enhancement
  • Witch's chin (chin augmentation)
  • Acne scars
  • Facial scars

What products are available?

There are numerous substances that add bulk to tissue. The decision as to which you should use will depend on what you are trying to achieve and on the expert advice of your health practitioner. Each has their place and specific uses in facial augmentation. See individual implant types for specific details regarding use. The list below includes some older products that are no longer in general use.

Implant type Product names
Fat grafting  
Collagen Zyderm™, Zyplast™, Alloderm™, CosmoDerm™, CosmoPlast™
Hyaluronic acid Hylaform™, Restylane™, Captique™, Perlane™, Juvederm™, Prevelle™, Puragen™, Elevess™
Hydroxyapatite Hydroxyapatite (HA), Coralline Hydroxyapatite (CH), Radiesse™
Silicone Popular manufacturers include Implantech, Allied Biomedical, Advanced Bio-Technologies, Inamed Aesthetics
Expanded polytetrafluoroethylene (ePTFE) Gore-Tex™, SoftForm™
Polyethylene Medpor™
Polymethyl-methacrylate (PMMA) Artecoll™, MetaCrill™, Artefill™
Hydrophilic polyacrylamide Hydrogel™, HPG™, Argiform™, Bioformacryl™, DermaLive™, Aquamid™
Poly-L-lactic acid Sculptra™

Of the implant types described above, the following are injectable augmentation products:

These products provide facial augmentation with less downtime. Collagen and hyaluronic acid provide only a temporary solution as they are reabsorbed into the body over time (3 to 12 months); top-up treatments are necessary to maintain the desired correction. PMMA and hydrophilic polyacrylamide gel are recent additions of injectable augmentation products and give more long-lasting results (months to years).

Are there any side effects from using facial implants?

All dermal fillers and facial implants currently used have some side effects that preclude them from being the ideal agent. Some of the side effects and complications that may occur include:

See individual implant types for specific problems.

Prevention of side effects

Proper knowledge of facial anatomy, training in injection technique and supervision of new injectors will reduce the risks.

Related information

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