Fillers
Wrinkles can be smoothed out by fillers. They can be used to fill wrinkles or to add volume to depressed areas at the face and the body.
They are permanent and occasionally can be rejected, exposed or infected. Others like hyaluronic acid, is absorbable and provide a temporary fill. It is well tolerated, it hydrates the skin by bringing water to the surface and gives a "bright" appearance. The augmentation needs nothing but anaesthetic cream before injection and lasts 6-18 months depending on the body chemistry. It has minor complications such as pain and redness and if there is an overcorrection or granuloma formation can be smoothened by hyaluronidase or better by 5FU and triamicinolone injections. Rarely inflammation may be occured and will be released by cortisone creams and antibiotics.
The semi-permanent fillers, like poly L-Lactic acid or polycaprolactone (PCL) microspheres suspended in water-based carboxymethylcellulose (CMC) gel–carrier are ideal to activate collagen, while stabilised injectable hyaluronic acid is indicated for the treatment of tissue remodelling and skin laxity.
Finally, permanent and safer filling can be done by fat transfer from one part of the body to another known as fat grafting or lipofilling. The fat used is liposuctioned from the abdomen or the thighs and usually is performed in an outpatient basis. Lipofilling can be used to recontour the face and provide fullness to brows, cheeks, chin, lips and lower eyes, the breast or the buttocks. It lasts longer in areas with no movement and can also improve atrophic aging of the hands. The procedure may need to be repeated until the desired correction has been achieved. Swelling, bruising or discomfort following the procedure can be easily controlled.
Lipofiling in Parry Romberg Syndrome, 6th Dermatological Days of Attica , 21-23 Jan 2011, Athens
Chapter “Hyaluronic acid in modern Cosmetic and Reconstructive Surgery"
Liapakis IE, Tzouganakis AC, Paschalis EI, Englander M, Christopoulos A, Gloustianou G, Kontoes P. Parry-Romberg syndrome treatment with fat transfer and a new bleaching formula.
J Cosmet Dermatol. 2019 Feb 15. doi: 10.1111/jocd.12819.
