With the passage of time and the help of genetic factors, the sun, stress and eating habits, the skin begins to lose brightness, luminosity and elasticity; Fine wrinkles that will in a short time become fissures or furrows begin to appear.
Other factors such as subcutaneous fat loss due to its natural reabsorption causes the formation of dark circles and depressions on the cheeks. The volume of the lips may also be diminished or altered by the use of dental prostheses or by smoking. Some diseases, or pathologies experienced in adolescence, such as chickenpox or acne, can also leave marks on the face, back and/or neckline.
Wrinkles, furrows and fissures have an effective corrective treatment:
Fillers that will occupy the space that the medium or deep dermis lacks (second layer of the skin, where the fibers of Collagen and elastin).
The choice of the type of substance depends on the composition of the substance, the experience of the patient, the degree of aging of the patient and the general condition in general.
What to expect from the treatment?
The most important thing to remember is that skin fillers do not have permanent results, as part of the substance is reabsorbed.
The advantage is that the application of these products restructures the skin, returning hydration, elastin and collagen, an avoiding involution of the tissue. In the long run we observe that maintenance requires progressively less quantity of the product.
Mode of application
Small punctures or fine cannula are made.
Since the puncture can be painful, prior to treatment an anesthetic cream that lightens the pain a little can be applied, although depending on the area to be treated, it is sometimes not necessary since the pain is minimal, momentary and easily tolerated.
The application with a cannula prevents the possible appearance of superficial hematomas although it causes a little more inflammation (24 h).
Immediately after the procedure, redness can be seen, with minimal local swelling and edema. Both return to normal after between 24-48 hours at most. These effects can be disguised if desired with a little make-up.
Types of fillings
The fillers can be divided into 2 types: temporary or absorbable and permanent.
Permanent fillers are not used in the Trius Institute due to the large number of side effects that can be produce in the short and long term (inflammation, superinfection, encapsulation, migration, etc.)
In addition, a permanent and immobile filler does not conform to a constant evolutionary fabric. Absorbable or temporary fillers allow adaptation according to necessity and do not present side effects, if there are any, they are transient.
At the Trius Institute we use:
At present it is the best filling substance. A completely biocompatible substance, which is a natural component of the organism and has a great capacity for capturing water and restoring hydration to the skin, while maintaining its elasticity and creating volume.
Hyaluronic acid works by treating the matrix of the tissue itself, in addition to adding volume and reconstituting it, so that the application (maintenance) of this substance restructures the skin so that over time the amount of volume filling required will decrease.
It is presented in different densities and cross-links which, depending on the area, the condition of the skin, and the purpose of the treatment (hydration or filling, one or the other will be chosen.
It is an inducer of absorbable collagen that can also be used as a filling substance to correct grooves (rictus) or depressions (sunken cheeks) or volume deficit (cheekbones, chin, and nose).
It consists of processing the patient’s own fat to add volume or filling to the corporal areas that need it. There is always a percentage of short-term reabsorption and overcorrection.
This type of filling has the advantage that it does not produce any type of reaction to a foreign body when dealing with the patient’s own fat.
Not all wrinkles or furrows are treated in the same way, depending on the condition of the skin and the depth of the wrinkle or groove.
Two types of hyaluronic acid concentrations are sometimes required:
Denser at a deeper level, and one less dense to smooth the wrinkle which is more superficial. This is called sandwich technique.
In general it is preferable to perform the first filling session and have a second session 15 days later (maximum 1 month), if necessary, to finish correcting the wrinkle or defect.
When using ELLANSÉ® (PCL), if there are any superficial wrinkles, Ac. Hyaluronic can be used to smooth them, although it’s not usually necessary.
If the filling has been done with fat, you may need a “retouch” 2 months later, since we cannot control the degree of absorption of the implant. Usually 50% of what is injected is reabsorbed.
Lips are treated with hyaluronic acid. To improve hydration of the lips, low density hyaluronic acid will be used and as it does not increase the volume, the lip appears smoother, fresher and without dry skin. This type of treatment is very interesting during winter.
When volume increase is required, hyaluronic acid is especially designed for this purpose, reticulated and denser but allowing perfect mobility and without localized substance clusters forming.
In the treatment of dark circles, two factors must be considered: the existence of darker pigmentation (and in that case if it is brown or violaceous) or the presence of a depression. Each of them requires its own treatment.
In the case of an eye that has a depression, it can be improved with the injection of hyaluronic acid, platelet rich plasma. Characteristically in this zone the fillers have a long duration (more than one year).
Pigmentation will be treated in different ways depending on its origin. It can be treated with home depigmenting creams and peeling. Carboxitherapy greatly improves the purplish color of dark circles, due to the transparency of the vascular weave in this area.
In case of asymmetries or volume correction, either the cheeks (which over the years has tendency to lower), the chin (lack of projection) or other areas such as the nose, they can all be corrected by injecting high density hyaluronic acid and crosslinking, which maintains the result for about a year and a half.
ELLANSÉ® (PCL) also permits us to make these corrections.