In cases where deep expression lines, scars, asymmetries or other depressions are present, a good solution is the use of fillers. There are many types of filler available including: Organic that are similar to naturally occurring elements in the skin, such as collagen, (Zyderm), hialuronic acid, (Restylane…) and inorganic such as polymethylmethacrylate, (Artefill.) As their name implies, they all add volume to smooth out depressed areas or enhance others like the lips. The specific filler to be used is decided jointly with the patient. Even though very small caliber needles are used to inject the filler just under the skin, in most areas there is slight discomfort with the application. .
For the lips local anesthesia is applied first. There is almost immediate slight swelling that doesn’t progress, and there can be some bruising. The effects last around 8 months since the material is eventually reabsorbed. With Artefill there are reports of a long lasting effect of several years. The most frequent complications are granulomas or firm localized nodules