Categories of Dermal Fillers
Hyaluronic acid (HA) and biostimulators form the basis of modern injectable aesthetic medicine. Each product family has distinct physicochemical characteristics that determine its clinical indication, the appropriate injection depth, and the expected results.
Hyaluronic Acid (HA)
Injectable cross-linked HA gel, available in different densities and viscosities. The degree of cross-linking determines durability, cohesiveness, and volumetric support capacity.
| Density | Main Indication | Depth |
|---|---|---|
| Ultralight | Fine lines, deep hydration | Superficial dermis |
| Average | Moderate wrinkles, lips, neck | Mid-deep dermis |
| Dense | Structural volume, facial contour | Deep dermis / hypodermis |
Biostimulators
Biostimulators — such as calcium hydroxyapatite and poly-L-lactic acid — work by stimulating endogenous collagen synthesis. The result is progressive, but the duration is significantly longer than that of hyaluronic acid, typically between 12 and 24 months.
Selection by Anatomical Zone
Periocular Zone
High-sensitivity area. Preference for ultra-light HA using a cannula whenever possible. Never use dense products. Smooth PDO can be considered for gentle biostimulation of the area.
Malar and Zygomatic Region
PDO cog as a first option for moderate ptosis. Dense HA (1–2 ml per side) to restore structural volume. Technique with a 45° upward angle for a natural and symmetrical lift.
Nasolabial folds
Medium-density hyaluronic acid (HA) administered via threading or microaliquots. Maximum quantity of 0.5–1 ml per side to avoid asymmetry. Facial mesotherapy as a complement to improve the quality of adjacent skin.
Lips
Hyaluronic acid with lidocaine for patient comfort. Medium density to preserve natural texture. Maximum of 0.5ml per lip per session. Strictly respect individual proportions.
Jaw and Chin
Dense hyaluronic acid (HA) for mandibular angle redefinition. Consider PDO cog in combination for structural support. Constant attention should be paid to the location of facial vessels, especially the facial artery.
Injection Safety Protocol
- Skin disinfection — 70% alcohol or chlorhexidine with adequate contact time.
- Strict aseptic technique — Avoid all non-sterile contact with the area.
- Prior aspiration is mandatory — Essential to prevent intravascular injection.
- Small aliquots — Maximum of 0.1 to 0.3 ml per injection site.
- Immediate post-injection observation — Detection of signs of vascular compromise
- Instructions to the patient — Avoid massage, heat, and exercise for the first 24 hours.
Complications — Recognition and Management
| Complication | Clinical Signs | Immediate Action |
|---|---|---|
| Edema/Hematoma | Swelling, bruising | Ice; observation 7–10 days |
| Nodules | Palpable papules | Gentle massage or hyaluronidase |
| Vascular embolism | Intense pain, paleness, necrosis | EMERGENCY — Immediate hyaluronidase |
| Allergic reaction | Urticaria, angioedema | Antihistamine + corticosteroid |
All FILLERMA dermal fillers comply with CE/ISO certification, are stored at 2–8°C with complete batch traceability, and are supplied exclusively to licensed medical professionals.