SKIN FILLING
Should you think “if only I had thicker lips, less visible cheek veins, less sags in my nose, and less sags under my eyes”, the right method for you is “Skin Filling”. Some of us suffer from under skin tissue losses whether inborn or some or other reason during the course of life. In some cases, sags, wrinkles and creases occur due to ageing, sun, anxiety, gravity and other environmental factors. It is possible to eliminate sag, volume losses and wrinkles in the skin by injecting some filling materials under skin. Thus, younger and ore attractive outlook is ensured.

FILLING MATERIALS:
There are temporary and permanent filling materials. They are applied in one time. As for the temporary ones, it might be necessary to reapply the treatment but the advantage to it is that desired changes could be made in specific intervals. Materials with short and mid-term effects could be applied first to try materials with long-term effects after the desired outcomes are achieved.
A-Those with hyaluronic acid base:
Hyaluronic acid is naturally found in skins, cartilages, diarthroses, and eyes of living beings.
• Visagel: contains 100% pure hyaluronic acid produced synthetically.
• Restyllane, Perlane, Dermalive: produced by bacteria.
• Hylaform: produced from cockscomb.
B- Those with Collagene:
Collagene is a natural constituent found in a number of living tissues such as skin, muscles, tendons, and bones. While the older ones had an allergic risk, they were replaced with new ones with less risk.
• Those with cattle collagene: Zyplast, Zyderm
• Those with human base: Cosmoderm, Comsopast
C- Those with calcium hidroxyl apatite base: Radiesse (Radiance)
D- Those with Polylactic acid (PLLA) base:
It is synthetically produced. Sculptra: helps the skin produce collagene by stimulating its fibroblasts. It is not allergic. It is discarded from body after turned into carbon dioxide.
E- Fat: Fat taken from the abdomen or hips of the person is injected.
Which kind of effect do Filling Materials Create?
The filling injected under the skin fuses into natural tissue. It gains volume by retaining water molecules. It makes the tissue tighter and smoother. Those with temporary effect are drawn away from the tissue due to metabolic activities.
Which parts of the body are appropriate for filling?
• Lips, lip contours: An ideal place for such an application. Just in the middle of the face, it is one of the most striking points for make-up and is an important organ for social image as well as inducing positive feelings about self. Thanks to the filling, you can have thick lips whose contours are more clear-cut.
• Nose-lip veins: Such a facial expression which makes one look older then he/she is could be softened.
• Lip “barcode”: Skin creases vertical to lips are called as “barcode” as they leave an image like a barcode with lipstick. They can be prevented, eliminated or decreased with a filling to lip contours and those creases.
• Goose feet: Botox treatment should also be taken into consideration. If it is not preferred or else cannot eliminate all the wrinkles, filling might be applied.
• Under Eye Sockets: The sockets above the cheekbones make the face look older and more tired than it is with a shady appearance. The filling shall ensure a younger outlook for under eyes as it lifts drooped cheeks slightly.
• Local symmetries in the nose: Can be applied like shaping wax.
• Dorsum of hand: can be applied in dorsums of hands that have become thinner with more visible bones and tendons.
• Chin and cheek dimples, cavities
• Cavities at the corner of mouth
• Cavities of injuries

Application:
Mostly, it is injected specially without anaesthesia. If desired, anaesthetic pomade or injection could be used. Injection is applied to everywhere necessary. It is diffused to the tissue with massage and shaped. After one or two weeks, the patient is re-examined and small retouches are applied if necessary. The treatment is completed in 30-60 minutes.

Adverse Effects:
Adverse are not common. Allergic reactions, swelling, inflammation, ulceration, fever blister, bacterial infection, adenia could be reported. Many filling materials do not necessitate recovery period; it is possible to turn back to daily routine just after the injection. It takes one day to acquire a more natural appearance in radiesse whereas it might take 2-3 days to eliminate all the complaints after fat injection. Swelling and sensitivity could go on for 1-2 days after lip filling.

Duration of Effect:
The effect and duration of filling materials vary according to their special characteristics and the age, lifestyle, skin structure of the patient in addition to desired level of effect. Generally, temporary filling materials can have an effect from 3 months to 5 years. The shortest effect is that of collagene with 3-6 months. Visagel ensures a minimum 6-month effect. Restyllane has an effect for 6-12 months. The effect of Radiesse could be extended up to 3 years. Fat filling has an effect ranging from 3 months to 3 years. Sculptra is applied for 3-4 times in every 4-6 weeks and ensures a 2-year effect.
What are the critical points after the application?
Make-up, sauna, or steam bath is not advised for 12 hours after the application. Skin should be kept from sunlight and excessive cold for a few days. High factor sun cream is applied to the skin for a few weeks.
When to avoid fillings:
- Skin infections
- Collagene or autoimmune diseases
- “Exaggerative” expectations as to the result.