Hyaluronic acid actually constitutes the building block of collagen in our body, which gives our skin its actual tightness. With aging, collagen support decreases or collagen quality decreases. As a result, the cheek lines, which we call the nasolabial fold, and the corners of the mouth, which we call the marionette line, become prominent, however, our under-eye grooves become clear, there are occasional sagging in our jaw line, and depressions in the cheekbone area, sometimes even deep grooves that give a double level. occurs. Reversing these processes is possible with fillings containing hyaluronic acid. With the filling application, which aims to replace the structure that should be present, it is aimed not to inflate or plump your face, but on the contrary, to make you look younger and livelier by softening the transitions to appear as it should be.
It is possible to separate the filler products produced for this purpose according to their hardness, crosslink content and extra skin support content. While the aim of botulinum toxin application is to reduce wrinkles by muscle activation blockage, it is aimed to remove wrinkles with hyaluronic acid injection, which acts as a support in the place where wrinkles occur, when it comes to filling applications.
Hyaluronic acid binds to water where it is given as a mechanism, and by gaining volume, it keeps the area more moist and alive. It also plays an important role in cell regeneration. One of the biggest advantages of hyaluronic acid filling application is that it can be dissolved quickly and in a short time with the enzyme called hyaluronidase in undesirable situations.
Hyaluronic acid fillers can be applied in many areas. The most common areas of use are:
Is filler applied to the glabellar lines?
The lines between the eyebrows are ideally removed with the application of botulinum toxin. However, filling application is required to eliminate very deep lines that cannot be softened with botulinum toxin. It is necessary to apply medium-hard filling products very superficially. Since the glabellar region, which we call anatomically between the eyebrows, is very rich in vascular and nerve networks, if the application is not performed by professionals in this field, intravenous injection and the complications that will develop may be inevitable. In case of application with botulinum toxin, the effect can last up to 2 years. Although there is a slight swelling in the first three days after the application, the crushing effect of the filler on the skin becomes more evident in 2 weeks.
Filling application for forehead lines
Botulinum toxin application is the ideal method for forehead lines as well as between the eyebrows. Medium-hardness hyaluronic acid filler can be applied in order to soften the very deep lines that do not go away despite the botulinum toxin application. The thing to be considered in this application is that the application should be done superficially and within the framework of vascular anatomy, it should be done with specialist physicians in this field. Application to the wrong area can again reveal the risk of intravenous injection. In order to reduce this, in my clinical practice, in the application of forehead filling, I prefer to apply the cannula, especially with blunt materials such as needles.
Under-eye (Tear Trough) light filling application
Under-eye light filling is a filling product that is specially produced compared to other filling products, in a very thin structure and enriched with various amino acids and vitamins that will shine under the eyes. While applying this filler, I prefer to apply it with a cannula, especially to avoid bruising and to avoid intravenous injection. Generally, by entering from a single point, the line in your under-eye groove is filled in two layers in the submuscular deep plane and superficial plane above the muscle, thereby increasing the stabilization of your tissues with the sandwich effect and with the support of the deep tissue, especially on the outer part of the lower eyelid, the collapse here is eliminated. Although the effect is seen at the first moment, it is necessary to wait a few weeks for the regenerative effect especially under the eyes to become evident. After this application, edema can be seen under the eyes, especially in the first 3 days, and this swelling decreases rapidly after the 3rd day. The effectiveness of under-eye light filling takes an average of 1 year, sometimes longer, and with this filling, the expression that gives us a tired and sad appearance can be eliminated.
Filling application for lines around the eyes (Crow's feet)
Filling application may be required to open these fine lines, especially in patients who have started botulinum toxin at a very advanced age, which sometimes cannot be opened with botulinum toxin. For this purpose, it is possible to soften and even completely disappear these wrinkles with the application of hyaluronic acid, which is made very superficially in a thin structure.
Nasolabial fold filling application
The nasolabial fold is the grooves that define the corner of the mouth and the junction of the nose edge and should normally be. The nasolabial fold can be of different depth, length and width from person to person. In the general evaluation
Even when we look at a 2-year-old child, we can see that this groove becomes evident when they laugh or stand still. In other words, the purpose of filling this area is not to completely destroy this groove, but to ensure that it has a smoother transition when we laugh or make gestures, as in our younger days. On the contrary, excessive filling applications can lead to a sausage-like filling appearance that becomes evident on the cheeks, especially when we laugh, and this is a very unnatural appearance. With the help of filler needles, the application can be made on many point-by-point lines, as well as with the help of cannulas, along the length of a single point. The current anatomy of the patient is important in making this decision. While I prefer cannula application in patients with very deep retraction, I prefer needle application in patients with more superficial wrinkles.
Cheekbone (Malar region) filling applications
This application is one of the most frequently used non-surgical procedures, especially in terms of creating a facelift effect with fillers. Deep applications with hard fillings on a few support points on the bone can create a non-surgical face lift effect by moving the fat pads that sagged down over time and that make the nasolabial fold more prominent. We can notice this effect immediately during the application, and it becomes more evident in a few weeks, especially with the water-retaining effect of hyaluronic acid. In this way, our sunken cheekbone line can be clarified, as well as structures that have been displaced down over time due to the effect of gravity can be reinstated. It is important to avoid applying pressure to the line applied in the first week after the application and to avoid applying hot water to the face for the first three days in order to obtain better results.
Filling Marionette lines
Marinette lines describe the grooves between the corner of the mouth and the chin and become particularly evident with the effect of aging and gravity. With this clarification, the corners of the mouth turn downwards and give us the appearance of an unhappy face. With the application of medium-hard hyaluronic acid filling, this line is softened and the corners of the mouth that have turned downwards are moved upwards in the opposite direction to give the patients a smiling face appearance. The effect can be seen immediately after the application, and the effect becomes more pronounced in the first two weeks.
Filling applications to the jaw line (Jawline) and the jaw tip
With the effect of gravity, our jaw line hangs down and leads to an appearance we do not want. It is possible to obtain a triangular face appearance in golden proportions by clarifying the chin contour. If the chin is structurally behind during this application or regardless of this application, the chin tip can be moved forward with the application of hyaluronic acid and we can achieve a better triangular face appearance. When we take the chin tip forward with the filling application, one of the additional advantages it provides us is that if there is sagging in our jowl area, it will also alleviate it. It is absolutely necessary to perform the application by specialist physicians in order to make the jaw line and jaw tip fillings as deep as possible and to prevent possible vascular injuries in this region rich in vascular nerve network.
Lip filler application
Lip filling application varies according to the shape of the desired lip, the volume of the existing lip and the amount to be applied, and during the first examination, the application is made with the help of cannulas and needles in order to meet these demands in line with the expectations. Before the application, your lips are anesthetized with special creams, and if desired, your lip can be completely anesthetized with a procedure called nerve block. In an ideal lip appearance, the upper and lower lips should be the same volume or the lower lip should be a little more voluminous. In order to balance this situation, which we see in general lip structures, we prefer to make the majority of the filling we apply on the upper lip, while in the lower lip application we aim to avoid the middle line and give volume to the outer parts of the lower lip, which we call lateral. In the upper lip, it is acted according to the desired shape and avoiding too much filling in the midline, generally by shaping the areas outside of this. When we divide our face in the middle and think of it as right and left, the right and left halves of our lips are not equal to each other, as is the case with our face. In order to balance this, we can sometimes apply lip augmentation asymmetrically, that is, by giving more to one side and less to the other. Despite this application, it may be necessary to retouch the clearly asymmetrical lips, especially in the 2nd week when the lip filling is fully seated. After the application of lip augmentation, there may be swelling in the lips due to edema, especially in the first 3 days, and then this swelling decreases rapidly. Since we saw this edema during the lip augmentation application, basically 10% of the volume we achieved in the application was gone after the 3rd day.
r. This is not due to the melting of the filling, but due to the disappearance of the edema that occurs during the application. Although I generally recommend the filling application in the form of 2 tubes, it can be a good option to gradually put a few months in between and make the second tube after the first tube application. The reason why I recommend two tubes to patients is that one tube is insufficient to provide a significant fullness, especially in my patients with very thin lip structure. However, if your lips already have sufficient volume, a single tube application alone can give dramatic changes. The effectiveness of the filling after the application lasts for 8-10 months on average, and the permanence of the filling can be further increased with small reinforcements between this period. After the filling dissolves on its own, an average of 10% remains as residue, which allows us to achieve a better and more permanent volume in repeated applications.
Nose filler application
With hyaluronic acid fillers, we can instantly get rid of the appearance of the arch in the nose, and at the same time, we can lift your nose tip to a certain extent. The application is made in the midline under local anesthetic cream and the effect is seen immediately. On average, this effect may decrease a little in the second week, especially at the tip of the nose, and a permanent effect of approximately 10-12 months can be obtained with the re-application on the tip of the nose. One of the important things that patients who will have nose filling should know is that if the patients are considering surgery, they should put an average of 1 year between the nose filling and the operation until the filling dissolves. Because the rhinoplasty procedure to be performed while there is nasal filling changes the result to be obtained with the melting of the filling and may lead to an undesirable result. The hyaluronic acid fillers we use for nasal filling should have the feature of hard filling and should not be applied outside the midline. In patients with a previous rhinoplasty history, nasal filling should be avoided if there is no need for it. Regional applications after rhinoplasty can be performed by a specialist in rhinoplasty.
Filling application for hand rejuvenation
The back of the hand, which we call the dorsum of the hand, is one of the areas that lose volume and skin elasticity rapidly with aging. This aging appearance on the hand can be reversed with the hyaluronic acid fillers enriched with vitamins and amino acids that have skin rejuvenating and regenerating properties.
