Hyaluronic acid fillers
These fillers remain the most popular and safest variety of filler with the least potential side effects. Made of hyaluronic acid, which occurs naturally in our skin, these fillers are easily reversible by the injection of an enzyme.
There are many different types of hyaluronic acid fillers, even within the same brand. Variations in hardness and shaping between the different fillers are essential; precise filler selection is important in achieving excellent results across different facial regions.
Normal fillers are used to fill folds such as the nasolabial (smile) lines; stiffer and more durable fillers, which better maintain their shape, are used for nose and chin augmentation; firm and rounder fillers are used to address volume loss in the cheeks and forehead. There are even fillers specifically made for lip enhancement.
In trained and experienced hands, there is usually no downtime from fillers, as bruising and swelling are extremely rare. In general, hyaluronic acid fillers last from six to 24 months, depending on type and placement.
Skin boosters have become very popular over the last few years. The difference with these ‘fillers’ is that the hyaluronic acid retains more bioactivity while also being mixed with more antioxidants and other goodies for skin health.
Skin boosters offer more hydration and skin rejuvenation through collagen stimulation than normal fillers. The downside is that their volume effects are usually more short-lived, at a maximum of six months. The upside is that there is a longer-term benefit in terms of skin quality improvement
A little less popular now, collagen stimulators still have a place in areas where an improvement in skin quality and thickness is desired without too much volume enhancement. These injectables are good for ageing skin on the backs of hands, or cheeks with a lot of laugh lines.
Autologous fillers are made of substances extracted from the patient’s own body. The best autologous filler is fat, preferably extracted from the patient’s thighs or tummy. As the smallest fat cells retain stem cell properties, fat transfer rejuvenates ageing skin to a greater degree than artificial fillers.
Newer techniques have added flexibility and enhanced results to fat transfer: micrografting adds both volume and stimulates rejuvenation, whereas specialised nano grafting offers more rejuvenation without significantly affecting volume.
Common areas for fat transfer are hollowing eye sockets, temples, foreheads and cheeks. Platelet-rich plasma and Vampire Lifts are currently not allowed in Singapore.
A cautionary note about these products. There were some artificial fillers available for breast enhancement, but several of them had safety problems: infections, migration of the filler, and the formation of neck lumps. One of the manufacturers even released an advisory that breast fillers were not recommended as they could interfere with the detection of breast cancer. With patient health in mind, breast fillers are not recommended; safer options are fat transfer or implants.
With so many products on the market, it is most important to select both the filler and doctor wisely.