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What Do Dermal Fillers Do?


You’ve tried creams, serums, and facial exercises to diminish the lines and wrinkles you see on your face. But they haven’t worked, and now volume loss is contributing to your tired appearance. It feels like you’re stuck with these changes; like a more youthful appearance is simply no longer possible. The solution is not to despair but to choose dermal fillers from Artful Aesthetics in Oakland, CA.

What Do Dermal Fillers Do?

These multi-purpose treatments essentially help counter the effects of time. As we age, subcutaneous fat within the face naturally slides downward. Facial muscles then work closer to the skin’s surface, and without extra padding in places where we often emote, crow’s feet and smile lines become more apparent.

Facial skin also stretches as it loses elasticity. This, too, contributes to a loss of volume. Through targeted application, fillers can be used to:

  • Plump shallow contours
  • Improve facial symmetry
  • Smooth wrinkles and creases
  • Diminish the appearance of scars
  • Restore contours
  • Reduce or eliminate the shadow of the lower lids


Hyaluronic Acid

Most fillers contain hyaluronic acid (HA) as their active ingredient. This is a clear, gooey substance, and the body naturally produces HA to lubricate and moisturize. It is a carbohydrate that binds to other molecules or water, thereby giving it a slightly stiff consistency that resembles Jello. HA is remarkable for a number of reasons, including the fact that it can be several thousands of sugars long and can hold almost 1,000 times its weight in water.

As you might have guessed, HA is crucial to healthy joints, ligaments, and yes, skin. This sugar helps plump skin by keeping it hydrated, regulates water balance, and transports nutrients to ensure skin is properly nourished. Because it is so tissue-friendly, and one of the most water-loving molecules in nature, it only makes sense that it be featured in a variety of fillers, including common names like Juvederm and Restylane.

Skin Health

Collagen is a popular topic of conversation where skin health is concerned, and rightly so. One of its chief functions is to comprise the skin’s underlying constructive framework, known as the extracellular matrix (ECM). Many studies have focused on this network of molecules, trying to identify those that comprise it. These studies have revealed that in addition to providing a constructive framework, these molecules also impact cellular function.

ECM molecules form a highly organized structure that includes collagen, growth factors, and other proteins. But the predominant component of this network is hyaluronic acid. In addition, nearly 50 percent of the body’s HA levels are found in the skin and ECM. To say HA is crucial to skin’s appearance and health is an understatement, but with age, the body’s ability to produce this sugar wanes significantly.

HA Fillers

Fillers made with HA boosts skin’s hydration levels and instantly restores volume. The fillers themselves are soft so they can be easily injected below the skin’s surface. They are made with stabilized, non-animal hyaluronic acid that is biocompatible with the body and will not migrate beyond the treatment site.

With just one treatment, patients see results that can last for nearly a year, and those results are very natural-looking. They don’t affect your ability to make facial expressions, and they help you control the way in which you age. In other words, wrinkles and fine lines are no longer the inevitable side effects of growing older.

Additional Filler Ingredients

Not all fillers are made with HA. Other common ingredients include:

  • Calcium hydroxyapatite (CaHA)
  • Poly-L-lactic acid (PLLA)
  • Polymethylmethacrylate (PMMA)


Explaining CaHA

Injectables made with CaHA, like Radiesse, work in different ways from HA and thus have slightly different effects on the face. To illustrate, CaHA boosts collagen production. The injection itself immediately adds volume as collagen levels gradually increase. Keep in mind collagen is a protein that, in the face, resides in the skin’s middle layer. It is a primary component of the ECM and gives skin its firm but flexible properties.

By increasing collagen production, CaHA fillers tend to last a little longer than those made with HA. Results, therefore, continue developing over a span of several weeks. CaHA can also improve skin tone and texture with the uptick in collagen.

How PLLA Works

PLLA is a polymer recognized as biocompatible and absorbable. In layman’s terms, this means it is safe; it’s also effective, having shown in numerous studies to induce fibroblasts (cells) to produce collagen. In turn, the collagen lifts and volumizes skin in a very natural manner. After injections, patients often are instructed to follow the rule of 5-5-5: perform massage on the treatment site five times daily, five minutes per session, for five days.

PLLA does not produce immediate results because the filler itself does not volume. Instead, it relies on the increased production of collagen. Three to five sessions may be necessary to achieve your desired look. Each session is separated by four- or six-week intervals, but the results can last between two and four years. Again, the trade-off for longer results is a slower development time.

A Look at PMMA

Bellafill, the brand name of an injectable that contains PMMA, is approved by the FDA to treat smile lines and improve acne scars on the cheeks. This gel is made of microspheres, each of which holds PMMA, which again promotes collagen production. Results can last for five years, but patients don’t need to wait for effects to develop because the injectable also contains cow collagen that immediately plumps skin.

Because of the collagen component, patients must undergo skin tests two to four weeks before receiving treatment. The tests are necessary to detect an allergy to the collagen ingredient. Although less well-known than fillers like Radiesse, Bellafill is nonetheless popular because of its long-lasting results.

Fillers Versus Injectables

It’s important to distinguish dermal fillers from injectables because they are two very different treatments that often get mistaken for each other. It’s easy to see why – both get injected into the skin and help reduce the appearance of wrinkles and fine lines. But fillers achieve this effect by adding volume from below the skin’s surface. That volume helps support skin, like a building block, so it looks plumper and softer.

Injectables like Dysport and Botox, on the other hand, provide no volume. They fall under an umbrella category of neurotoxins, which means they relax targeted facial muscles to prevent wrinkles from showing. Kybella, another popular injectable, is approved for use under the chin – where extra padding often leads to a “double chin” – and works by killing fat cells.

Which Is Right for You?

The good news is that you rarely need to choose between these treatments because they can work together in complementary ways. We can, for example, craft a treatment plan that blends injectables and fillers to give you the most pleasing aesthetic possible. This plan will reflect your skin’s unique needs and the underlying cause of your wrinkles, but it is possible to address nearly all of your concerns by blending treatments.

The Art and Science of Fillers

We have had to develop a deep understanding of skin’s physiological and immunological conditions to reach the point we’re currently at with aesthetic technology. In particular, we’ve devoted much time to learning how and why the face ages as it does. This has led to a variety of topical treatments, like dermal fillers, that give us options outside of surgery.

But successfully using fillers requires equal parts art and science. This means skill must be used in choosing the right filler for the right patient, follow-up must be vigilant, and application of the filler itself must be skillful. All of these facets are subject to unique interactions between patients and our staff as we strive to:

  • Ensure correct tissue acceptance and reaction after the filler is injected
  • Measure treatment efficacy
  • Compare wrinkle-reduction outcomes in a before and after sense


Filler Properties

Each filler has a slightly different viscosity, elasticity, and cohesivity that dictates where it is best used on the face. Some fillers, for instance, are only approved for plumping lips, while others are better suited to deep nasolabial folds. Both viscosity and elasticity are measured by G prime. Fillers with high G prime have firmer consistencies, hold their shapes, and provide more lifting capacity.

In contrast, those with low G prime spread more easily and are thinner and more fluid. These products are ideal for correcting fine lines around the mouth.

Facial Structure

While a beautiful face can be recognized universally, it is distinctly difficult to define. Balance and symmetry are crucial points, but so are less definitive characteristics like facial movements and personality. From a treatment perspective, we focus on face shape, known to correlate to age, gender, and overall attractiveness. This also allows us to assess bone structure and skin health so that we capitalize on your natural beauty without altering your appearance.

Subtlety Is Best

The goal of cosmetic treatment is to provide subtle enhancements without immediately alerting others that you’ve had treatment. Fillers restore volume in an aging face and strengthen contours in a younger patient. And while all fillers are capable of delivering subtle, natural results, the effects you see will depend on factors like:

  • Your skin type
  • Location of injections
  • Number of treatments
  • Type of filler used

The theory with fillers is that less is more, meaning you should start with smaller results and then build from there. You can easily add in a slow and gradual manner to achieve the volume you want, but it’s more difficult to take away from fillers once they are injected.

Ways to Extend Your Results

By design, fillers get metabolized with time as their effects become less visible. Two key factors that play into your results are your natural metabolism and the treatment site; dermal fillers often last longer in spots with less movement. While we don’t recommend that you alter your facial movements or expressions to maintain results, you can take some simple steps that will help extend them.

Start by minimizing UV exposure; sun damage is responsible for most of the wrinkles and lines you see on your face. Consistently applying sunscreen can maintain your results and protect your skin from further damage. It’s also important to drink plenty of water to keep your skin and body hydrated. Water can enhance the effects of HA fillers and should be your go-to beverage in place of sugary, caffeinated drinks.

Skin Care and Stress

Your skin care routine can significantly impact your results, and for this reason, we recommend you wash and moisturize your face twice daily with products that match your skin type. If you need help, we can provide some guidance. Finally, manage your stress to reduce the effects of free radical damage. Activities like walking, reading, and yoga will help you decompress at the end of a long day.

Natural, Dependable Results

Dermal fillers combine the power of aesthetic technology with the art of subtle enhancements. They safely and effectively deliver results that can restore volume, improve contours, and smooth wrinkles throughout your face. Schedule your consultation today by calling Artful Aesthetics in Oakland, CA.

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