Hyaluronic acid ("filler")

Discovered in 1934, hyaluronic acid has been used since 1997 to fill wrinkles and improve the appearance of the skin in general. HA is a natural component of the skin, ensuring its moisturising, elasticity and cohesion. During physiological ageing, its quantity decreases. It is a synthetic (not animal), biocompatible and biodegradable product. The HA chains are more or less linked together (cross-linking), making it possible to obtain different product qualities.

What are the indications for injections?

Depending on the indication, a more or less reticulated or concentrated HA will be used allowing a correction ranging from simple skin mosturizing to the treatment of more or less marked wrinkles, up to the restructuration of volumes:

- Deep injections allow the restoration of lost volume, the reshaping of facial features and contours (oval, valley of tears, dark circles, temples...): HA acts by supporting the cutaneous tissues,
- Injections in the middle or superficial dermis allow to fill in wrinkles that are more or less marked such as nasolabial folds, bitterness folds, cheek wrinkles, or to restore or increase the relief (lips, cheekbones...),
- Injections into the superficial dermis allow the skin to be mosturized in a more global way and to prevent ageing

What are the injection techniques?

The injection is either retro-tracing and is done using a fan technique in different directions, or point by point. There are now two injection methods available: the needle and the micro-cannula.
- The main advantage of micro-cannulas is that they can treat an entire area from a single point of entry. The procedure is virtually painless, limits the risk of bruising and significantly reduces the period of social exclusion.
- Needle injection allows a more superficial work for the treatment of fine lines, but increases the risk of bruising.

What are the absolute or relative contraindications?

- Severe allergic background.

- Sarcoidosis or granulomatous disease.

- Autoimmune diseases.
- Immunosuppression.

- Previous injection with a non-resorbable filler (risk of granuloma).
- Interferon therapy (risk of sarcoidosis granulomatous reactions).

- Pregnancy and breastfeeding: temporary contraindications.

WHAT ARE THE SIDE EFFECTS?

- An immediate erythema-like reaction (redness) may occur. It is minimal and disappears after a few hours or even a few days.
- Bruising may appear and persist for up to a week depending on the patient.
- An oedema (swelling) may appear, more frequent on the lips, and may last up to three days after the injection.
- Indurations or nodules may appear at the injection site.
- Very rare cases have been described of necrosis in the glabellar region (between the eyebrows), the nose, abscess formation, granulomas and hypersensitivity.

WHAT PRECAUTIONS SHOULD be taken?

The days preceding the injection:

- Avoid taking aspirin, non-steroidal anti-inflammatory drugs and vitamin C, for 3 days before the injection.
- In case of a frequent outbreak of nasolabial herpes, report it to the doctor
 
The day of the injection:
-If, on the day of the injection, an inflammatory process occurs (rash, blister, pustule, urticaria...), the treatment will be postponed until it is healed.
-For greater comfort, a local anaesthetic using a cream can be propose.
-It should be noted that several sessions may be necessary until the desired effect is obtained.
-A minimum period of 15 days should be respected between two sessions
 
After the injection:
- Avoid alcohol and anti-inflammatory drugs in the following hours.
- Remain "calm" during the 3 hours following the injections, i.e. avoid all reasons to move the face.
- Sauna, sun exposure, "violent” exercice, dental care, skin cleaning should be avoided for three days.
- Make-up can be applied the next day.
 
It is advisable to have a check-up within 15 to 20 days after the first injection, in order to assess the need for further treatment. Depending on the area, the type of skin, the stage of ageing, the lifestyle (stress, alcohol, smoking, sun...) and the product injected, the lengh of an injection can vary from 6 to 18 months.

WHAT IS THE COST? 

see the fees here