Hyaluronic Acid-based dermal fillers

What are dermal fillers and what are their indications?

Dermal fillers are designed to correct facial ageing signs. By filling or giving volume where it is necessary, they allow recreating more harmonious contours on the face and effectively filling wrinkles, furrows and some depressions on the face.
They are resorbable injectable implants, made from hyaluronic acid and injected with a thin needle. The filling agents improve the skin’s radiance by rehydrating it with hyaluronic acid.
These include Jevederm®, Belotero® and Restylane®.


What Is Hyaluronic Acid?

Hyaluronic acid is a polysaccharide present in the intercellular space of all the tissues in all animal species. It forms a structure that is both supple and rigid for the purpose of providing elasticity and moisture. The proteoglycans contained in hyaluronic acid help link water molecules that are many times its weight. That is what imparts volume to tissues.
This acid comes from a non-animal source, it results from the biofermentation technology. It is stabilized through small chemical changes in order to prolong its life (from 7 to 12 months), which is a particularly interesting property. Actually, biodegradable implants usually lose their volume gradually. Hyaluronic acid maintains, so to speak, its volume during the degradation phase.

Thanks to its important water-conservation properties (up to 1000 times its weight), it will replace the progressive loss of its stabilization bridges during degradation with water molecules until there no longer remains sufficient matrix to support the correction.

What Can Be Treated with dermal fillers?

The possible corrections are numerous:

  • Wrinkles of the glabella, nasolabial fold and corners-of-the-mouth
  • Fine wrinkles of the lips and eyes
  • Increases in volume (cheeks, chin, lips)
  • Lip contour definition
  • Correction of the lacrimal fossae (dark circles under the eyes).

Other Surgery Options

Depending on the defect to correct, support requirement, fineness or depth of the wrinkle, desired volume, your cosmetic surgeon will choose a product with differing molecule sizes: Fine Lines™, Restylane™, Perlane™, Teosyal ™: global – kiss – deep. They share the same beneficial properties: transparency, non-animal origin, fluidity, identical concentration, but inserted in different depths of the skin.

Several types of injectable implants are available; Dr. Bernier will guide you through their pros and cons. Some conditions are better treated with surgery such as lifting or blepharoplasty, while sometimes complementary techniques such as subcision, thread lift, microdermabrasion or radiophotorejuvenation will enhance the expected results.

Studies show a rejuvenating of 6 to 9 years after only 2 to 4 weeks of the treatment.

Frequently Asked Questions about dermal fillers

Are there contraindications?

Treatments on pregnant women should be avoided since no study has been carried out with these patients. Hyaluronic acid should not be injected in an area in which a permanent implant has been set or if there is the occurrence of inflammation or infection.

Are there precautions to be taken?

In order to avoid the risk of inflammation, it is preferable to avoid exposure to cutaneous heat or extreme cold for a few days. The treated area can be covered with makeup after 1 to 2 hours.

Are there related effects?

Reactions usually linked to injections can occur redness of the skin, tissue swelling, sensitivity, itching, and sometimes discolouration. These reactions are usually spontaneously resolved within 48 to 72 hours, but can also take up to 7 days for the lips.

Are there unwanted effects?

In 1 case out of 2,000, there have been reports about hypersensitivity reaction consisting in the hardening and thickening of a tissue sometimes related to reddening and sensitivity in the implant area. Such induration can last sometimes up to 4 weeks following the injections. These reactions have been described as “light” and “moderate,” and are spontaneously resolved at the end of 2 weeks on average.

Although no case has been reported, injecting a hyaluronic acid implant in a blood vessel could jeopardize circulation and cause loss of tissue (necrosis with or without scarring).

Is it painful?

Some discomfort can be expected but it is tolerable. However, in the case of the lips-the most sensitive part of the body-these usually require local anaesthesia.

Are you interested in Hyaluronic Acid-based dermal fillers?

Feel free to contact us if you need more information or make an appointment with Dr Bernier in Montreal, Sherbrooke or Val-d’Or.


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