Hyaluronic Acid: Filling and Volumetry

What you need to know

Hyaluronic acid is nowadays considered as the reference product used in medical volumetric rejuvenation.
Faced with the growing demand for alternative (non-surgical) Aesthetic Medicine techniques to combat the effects of ageing, the number and quality of injectable materials has changed considerably in recent years and their use has become extremely frequent.
Hyaluronic acid, or hyaluronan, a combination of uronic acid and aminoglycan, was discovered in the vitreous humour of the ox's eye in 1934.
The exceptional properties of this molecule have determined its use in many medical specialties including ophthalmology (cataract surgery), ENT (vocal cord surgery), urology and to help wound healing.
Since 1996, this molecule has been developed in the field of aesthetic filling.
Without species or tissue specificity, endowed with exceptional viscoelastic and hydrophilic properties, this polysaccharide, which does not require a test prior to treatment, thus becomes, thanks to its qualities, the natural successor of injectable collagen in the treatment of wrinkles and depressions.
Hyaluronic acid is considered as a reference product thanks to :

  • Its seniority: we have seen it used since the 1990s.
  • Its in situ duration that varies from 8 to 24 months: the injections are long enough to be effective and their transient nature makes it possible to monitor ageing.
  • Its absence of tissue specificity: it is therefore biocompatible and tolerance tests before injection are not necessary (except in special areas).
  • Its ease of use: it does not require any preparation.
  • The scope of its usable range: the same product can be declined in different forms adaptable to different types of ageing.
  • Its immediate results
  • Minimal and exceptional side effects.

Duration of hospital stay
10 minutes to one hour.
local anesthesia.
Average length of stay
24 to 48 hours.
the injection session can last from 10 minutes to 1 hour.

Hyaluronic Acid: Filling and Volumetry
Hyaluronic Acid: Filling and Volumetry

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Before the treatment

A precise interview will be conducted to look for possible contraindications:
• Known hypersensitivity to hyaluronic acid
• Pregnant or breastfeeding woman.
The interview will also have to detect elements implying particular caution (example: herpes for lip and perioral injections) or specify the nature of any previous injections in order to avoid certain dangerous associations of products on the same site.
Aspirin or anti-inflammatory drugs should be avoided within 3 days before injection.
It is best not to drink alcohol or expose yourself to strong sunlight the day before and on the day of the session.
A careful clinical examination in a seated position is confronted with the patient's request and expectations in order to clarify what is achievable and what is illusory.
Injections can be carried out without anaesthesia, especially since many products are currently supplied in combination with a local anaesthetic in the syringe.
For some more sensitive patients or in certain difficult areas (lips and oral perimeter), one of the two existing methods can be used:
Emla* Cream: applied in a thick layer on the areas to be treated at least one hour before the injection, it reduces painful sensations on the surface.
True local anaesthesia: obtained by injecting an anaesthetic product at the beginning of the session, it is the only way to ensure total insensitivity.

What does it involve?

The basic principle is to inject the product into the thickness of the skin or more deeply, in order to correct certain wrinkles or depressions of the face and volume losses due to age.
A hyaluronic acid injection aims to correct, by a simple and fast means, certain signs of aging or discomfort present on the face, by filling or giving volume where necessary.
The most frequently made corrections can be divided into four categories:
Furrows: naso-labial furrows (from the wing of the nose to the corner of the mouth), bitterness folds (from the corner of the mouth, on either side of the chin), chin furrow…
Wrinkles and fine lines: forehead, "lion's wrinkles" (between the eyebrows), "crow's feet" (at the corner of the eyes), cheeks, chin, "sun wrinkles" around the mouth.
Lips: redraw the hem (contour), thicken them if they are too thin, or make them fuller
Depressions (hollow) or lack of volume: nose, cheekbones, dark circles, chin, mandibular contour, cheeks, temporal pits, back of hands, scarring sequelae (acne, chickenpox, trauma…)
Usually, these discomforts will not completely disappear but will be considerably reduced by the injections. Some alterations respond much better to treatment than others that are more difficult to manage. Similarly, the durability of the correction varies according to the type of hyaluronic acid and the patients, but the correction is only temporary and the treatment will have to be renewed to maintain the result.
It should be noted that many other alterations may be present but their treatment is only possible by using more complex medical and surgical techniques than simple injections. This is particularly true for sagging tissues (e. g. jowls) and excess skin (e. g. eyelids), which can only be removed surgically. Similarly, some skin anomalies (roughness, small scars, spots, micro-wrinkles, "wrinkled skin") will only be corrected by resurfacing (peeling, laser, dermabrasion).
Injections, carried out in both women and men, can be carried out from the age of 30-35. However, they are sometimes performed much earlier when the discomforts are constitutional or hereditary and not related to age (lips, cheekbones…).
These products differ in particular in their viscosity, which determines their more or less volumizing nature.
Among the most used, we will mention Juvederm, Surgider, Restylane, Perlane, Stylage, Teosyal, Voluma, Emervel…
In case of significant volumetric correction (cheekbones, chin…) or in allergic patients, it is advisable to discuss with your practitioner the benefits of reinjecting autologous fat.
The area to be treated is disinfected before injection.
Injections are made using needles or micro cannulas (not pungent).
Depending on the practitioner, the number of areas to be treated, the extent of the improvements to be made, and the possible need for anesthesia, the injection session can last from 10 minutes to 1 hour.
In practice, there are several injection techniques and each doctor will adopt a method that is specific to him/her and that he/she adapts to each case to obtain the best results.
The quantity of product required (number of syringes) is of course extremely variable depending on a wide range of parameters. It will be evaluated as precisely as possible in advance.
After the injection, the practitioner takes care to massage the treated areas well to optimize the uniformity of the correction.
In some cases, it is preferable to immediately consider a retouching session after a few days or weeks in order to perfect the result.

Hyaluronic Acid: Filling and Volumetry
Hyaluronic Acid: Filling and Volumetry

After the treatment

A few days are necessary to assess the final result. This is the time required for the product to integrate well, the oedema to disappear and the tissues to regain all their flexibility.
The immediate result after treatment is therefore not a reflection of the final result.
The injections will have made it possible to correct the defects, thus discreetly and naturally correcting the aged and tired appearance of the face. It should be noted that the filling injections, unlike the Botulinum Toxin injections, do not alter the mobility of the facial muscles and therefore do not reduce facial expressions.
Usually, the discomforts treated are very clearly reduced by the injections, but do not always disappear completely. Some locations are particularly difficult to treat and there are deep and old wrinkles that can never be completely erased.
It has been observed that the duration of action is extremely variable according to the products (absorbable or not) but also according to the areas to be treated (less durable on the lips), the injection technique, and the patients according to the type of skin, the lifestyle (stress, tobacco, alcohol, sun…) and the degree of perfection sought. In most cases, however, the correction is only temporary and the treatment will have to be repeated to maintain the result.

About Hyaluronic Acid: Filling and Volumetry

When several zones are processed in the same session, the results are:
• More visible (overall rejuvenation) • More harmonious (less differences between the different parts of the face) • The face will remain More balanced when the injected products are absorbed.
The most common indications for hyaluronic acid injections are:
Depressions and volume losses due to age.

  • Wrinkles, fine lines and furrows of the face and neck
    Lips that can be redesigned, thickened to make them fuller.
    There are other indications:
    • Some moderate morphological anomalies (receding chin, insufficient projection of the cheekbones or forehead, nasal irregularities…)
    • Skin abnormalities (scarring sequelae, depressed and irregular scars)
    • Deformations or small deficiencies in body volume.
    MEDICAIM organizes your entire stay for you: post-operative nursing care, biological follow-up, therapeutic, nutritional and psychological support.
    Any additional questions? Ask your MEDICAIM doctor about it: careteam@medicaim.com
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