Wrinkle injections with hyaluronic acid, fillers, and autologous fat for natural and aesthetic results in wrinkle treatment with Botox and hyaluronic acid

As we age, the skin loses its natural elasticity. This leads to the formation of wrinkles. Also,

• age-related loss of skin moisture,
• natural facial expressions, and
• not least, gravity

all contribute to the formation of wrinkles.

In a wrinkle-filler treatment, the doctor uses a thin needle to inject a filler substance under the skin. It is designed to lift the wrinkles and thereby smooth them out, and is used primarily for wrinkles

• around the mouth,
• on the forehead,
• on the nose, and
• around the eyes

.

A wrinkle filler treatment, also known as a “liquid lift,” costs between 250 and 750 euros, depending on the material used and the area being treated. Wrinkle filler treatment is an alternative for people who wish to avoid surgical procedures, such as a facelift. This minimally invasive wrinkle reduction via injection is significantly gentler and better tolerated by the patient.

The treatment is usually performed on an outpatient basis. If necessary, wrinkle injections can also be administered under local anesthesia using an anesthetic cream or spray. These anti-aging treatments are usually performed by specialized clinics. Wrinkle filler injections may require multiple sessions to ensure the best possible results. This depends on the depth of the wrinkles being treated and the condition of the skin.

For non-surgical wrinkle treatment, both dissolvable and non-dissolvable substances are available. In medical terminology, these are referred to as dermal fillers or simply “fillers.”

Dissolvable fillers are so named because the body breaks them down on its own. They are categorized as follows:

• Hyaluronic acid
• Collagen
• Botulinum toxin (Botox)
• Poly-L-lactic acid
• Autologous fat
• PRP

Permanent injectable fillers include Aptos threads and silicone and are considered permanent implants.

The thin threads are made of the synthetic material polyurethane (PU) and are studded with tiny barbs. The cosmetic surgeon inserts them into the area of skin to be tightened using a needle. There, they become anchored in the tissue and fuse with the connective tissue. The connective tissue completely envelops them, thereby providing the desired plumping effect to the affected area of skin. The threads are primarily used to lift sagging corners of the mouth and reduce sagging cheeks.

Wrinkle filler treatment does not remove wrinkles. The wrinkles are simply no longer as clearly visible. After the treatment, the wrinkles are flatter and do not cast dark shadows. After a few months, the wrinkles become more prominent again, and the treatment should be repeated.

Injecting the skin with substances that the body can break down poses no health risks.

In rare cases, however, allergic reactions may occur. Fillers permanently injected into the skin can cause nodules on the skin’s surface or even migrate. Under certain circumstances, this may require facial surgery to repair the resulting damage.

If you are considering cosmetic wrinkle injections, you should only have them performed by a specialist. Incorrect dosing of the filler and improperly placed injections can lead to bruising. With Botox, a so-called “mask-like face” is also possible. The facial muscles become so severely paralyzed that the face looks unnatural, like a mask.

Sessions with a cosmetic surgeon last no more than 30 minutes and usually do not even require local anesthesia. Patients who are particularly sensitive to pain can, of course, request the administration of a local anesthetic. In most cases, an anesthetic ointment is applied to the treatment area.

Wrinkle filler injections are a minimally invasive procedure that carries significantly fewer risks than surgery. Nevertheless, you should strictly follow your doctor’s instructions for preparation.

In the 14 days leading up to the treatment, you should avoid pain relievers such as aspirin, as these can delay blood clotting. You should also avoid alcohol and sleeping pills as much as possible.

Wrinkle filler treatment should not be performed as long as the area to be treated is inflamed or has an acute skin condition. Wait until the affected area has fully healed.

Among the most popular methods of non-surgical wrinkle treatment are injections with

• hyaluronic acid,
• collagen, and
• Botox.

Hyaluronic acid

Hyaluronic acid is found in the connective tissue of the human body and provides it with the necessary elasticity. This chemical substance is capable of retaining a great deal of moisture.

The hyaluronic acid used for anti-aging treatments is synthetically produced in a laboratory. However, it can bind a similar amount of water as natural hyaluronic acid.

How much water the filler binds depends on its consistency. Hyaluronic acid with a higher density has a gel-like consistency. It is required

• for injecting deep wrinkles,
• to lift the corners of the mouth, and
• to plump up thin lips.

To build volume—for example, to create fuller cheeks or to contour

• the chin,
• arms,
• neck, and
• décolleté,

a filler with an even firmer consistency is required.

Fine lines around the eyes and lips, on the other hand, are smoothed with low-viscosity (slightly cross-linked) hyaluronic acid. Products from various manufacturers are typically used. They differ in terms of their consistency and the duration of their effects. Hyaluronic acid is generally used only to smooth static wrinkles. These are clearly visible even when the facial muscles are relaxed. A good example of this is the nasolabial fold, located between the nose and mouth. If it is too pronounced, it can make the face appear tense. The skin-smoothing effect of hyaluronic acid is immediately visible.

After the wrinkle injection, the treated skin area is cooled with a cold mask or cool packs. This helps reduce any swelling and redness that may occur.

The body will have completely broken down the filler no later than nine months after treatment. To achieve long-term wrinkle reduction, it is recommended to repeat the treatment at that time. Hyaluronic acid can also be used to fill and smooth scars. To do this, it is injected into the affected area once a year.

Collagen

Collagen is also found in human connective tissue. However, for wrinkle injections with these fillers, collagen derived from biotechnologically processed bovine hides is used.

The filler is primarily used to smooth facial wrinkles and reduce deeper furrows. It can also be used to fill in facial scars.

The injected collagen immediately bonds with the collagen already present in the skin. It thus integrates directly into the supportive lattice structure of the skin tissue. It is usually administered along with a mild anesthetic so that the cosmetic treatment is painless. The substance produces the desired effect immediately. Another collagen injection is required no later than 6 months later if the anti-aging effect is to be long-lasting.

To prevent an allergic reaction, the patient should be tested for collagen intolerance 2 to 3 weeks before the scheduled collagen treatment. Collagen used as a filler is broken down by the body within 3 to 9 months.

Botox

Botox is the short name for botulinum toxin, a neurotoxin produced by a bacterium. This filler is primarily used for treating expression lines—that is, dynamic wrinkles and fine lines. These include, for example,

• the eye area (crow’s feet),
• the glabellar lines, and
• the “think lines” on the forehead.

The cosmetic surgeon injects Botox into the muscle located near the affected wrinkles. The substance first blocks the nerves and then causes temporary paralysis of the muscle. The muscle can no longer contract, thereby smoothing the overlying skin.

The injections are administered with a precisely measured dose of the active ingredient and spaced a few millimeters apart. The treatment takes full effect after three to four days. It must be repeated after three or, at the latest, six months.

After the injection, some general reactions associated with the injection may occur in the treatment area. These include, for example,

• mild redness,
• swelling,
• tenderness, and
• itching.

These side effects are generally not particularly severe. They usually subside on their own after one to two days.

Other types of reactions are very rare. However, in a very small number of patients, a local reaction known as a hypersensitivity reaction may occur.

During the first six hours, you should avoid touching the treated areas of your face unnecessarily. After that, light makeup and gentle washing with soap are fine. Until the initial redness and swelling have subsided, you should avoid exposure to extreme heat (e.g., tanning beds and sunbathing) or extreme cold. Generally, a touch-up treatment is required after three to twelve months.

To achieve the best possible results, minor touch-ups may be necessary within two to four weeks after the initial treatment.

A touch-up treatment usually requires smaller amounts of the product. However, the choice of filler also plays a role in follow-up treatments. Some products are designed to be used in a series of initial treatments as part of the treatment plan. With other products, optimal results may be visible immediately after the first treatment.

The results depend on the depth and severity of the wrinkle being treated. As a general rule, the deeper the wrinkle, the more material is needed. In some cases, multiple treatments may be necessary to achieve optimal results.

For deep, pronounced wrinkles that have been present for many years, a complete lifting of the tissue is sometimes no longer possible. In any case, however, a “soft-focus effect” is still possible, making the entire face look more youthful and refreshed.

Fine lines and moderate wrinkles can often be corrected by up to 100% after just the first treatment. The results are visible immediately after treatment. In particular, wrinkles around the corners of the mouth—which often convey a negative facial expression—can be reduced or corrected through this treatment. This can result in a more positive facial expression right after the treatment.

First and foremost, the effect of a treatment depends on the product used. Fillers are generally classified as either permanent or non-permanent products. Permanent products are not broken down by the body and remain in the body indefinitely. Non-permanent products are broken down by the body within a few weeks. The patient can then decide for themselves if and when they would like a new treatment.

Hyaluronic acid stabilized using a patented process has special properties. It is characterized by a long-lasting effect of up to 12 months and excellent tolerability.

How long the effects of a treatment last with biodegradable products varies greatly from person to person and depends on many factors, such as

• age,
• skin type,
• lifestyle, and
• muscle activity.

The injection technique also plays a role.