In general, deep wrinkles, folds and volume loss in the face, lips and hands may be treated with filler materials and fat injections. There are different volume filling materials commercially available today. Of those, most commonly used is different hyaluronic acid products such as restylane, teosyal and hyaloform.

After injection under the skin or in the lips, these filler materials last about 6-15 months. Fat, on the other hand, is obtained from the patient and injected during the same session, and about half of the injected fat remains viable for the long term. Of the other filling materials, collagen is not much of use today because of potential allergic reactions and much faster absorbtion at the injected areas. The best candidates for filler materials are those patients with thin, dry and light colored skins. Filler materials and fat injections are also used in augmenting both the upper and lower lips and upper cheek regions as well.

Technically, filler materials and fat are injected just below the skin using a very thin needle under local anesthesia.
As mentioned above, restylane, teosyal etc. are commercially available products. Fat is obtained from an unwanted area such as the lower tummy using a very thin needle and injected during the same session, likewise under local anesthesia.

Duration of the procedure is 5-10 minutes for the fillers and about 30-45 minutes for the fat injection. Both procedures are performed using local anesthesia in the doctor’s office.
Normal daily activities can be started with almost no down time. Temporary swelling which occurs usually disappears in about 1-2 days after fillers and 2-4 days after fat injections.

Main risks of the procedure are temporary swelling, bruising, asymmetry and minor surface irregularities and very rarely infection. Since collagen carries risks of allergy and autoimmune reaction, and is absorbed much faster it is not much of use today. If used at all, collagen requires first an injection of a small test dose to investigate the possibility of allergic reaction. On the other hand, patient’s own fat does not carry allergic reaction risk. Hyaluronic acid products, likewise do not carry risks of allergic reaction other than very rare and temporary hyperemia, eg. pinkish swelling.