Non–hyaluronic acid fillers

Abstract 

Fillers are numerous, and the products currently available have effects that may last from a few months to many years. These are used to treat facial wrinkles, and some of the new fillers exert a stimulatory effect, restoring volume in focal areas of the face by inducing collagen fibers. The dermasurgeon should thoroughly understand the indications and uses of these fillers to meet fully a patient's expectations. Some fillers are biodegradable (12-18 months), others slowly biodegradable (2-5 years), whereas others are permanent implants.

The disadvantage of the traditional biodegradable fillers is their short duration (6-12 months). Over the past decade, semipermanent fillers (polylactic acid and ceramics) have been used: they do have a longer effect, but they might induce granulomas especially on the lips. Also, permanent fillers are traditionally linked to a higher incidence of granulomas and extrusions, although with the new formulations, the adverse events are decreased.