During the ageing process, the most major changes in terms of your skin’s appearance take place in the dermis. This layer is normally thick (especially in much younger skin) with connective tissue- mainly collagen, elastin and proteoglycans- which provides a large amount of the skin’s strength and resilience- and some of its ability to retain water.

As we grow older, the dermis becomes thinner and these support tissues lose their ability to retain tension. This makes your skin less elastic (known as elastosis) and prone to sagging and wrinkling. Both dermal fillers and volumisers have become increasingly popular in the UK and across the pond in America over the last few years.

A-List celebrities such as Courtney Cox are confirmed fans, both admitting they have turned to the treatments to plump up their skin and banish the wrinkles.

A variety of substances are available for injection to help augment the soft tissues of the skin.These products are broadly known as dermal “fillers”. They essentially act to improve the appearance of skin that is missing volume, literally by filling out any wrinkles, folds and creases from below, to smooth out the skin and re-establish an appearance of youthful richness to the skin. In addition, they act like a sponge to draw water from the surrounding tissue, retaining it in the target area.

Commonly used fillers include:

• Collagen
• Hyaluronic Acid
• Polymethyl methacrylates (PMMA)

The effect of these injections is immediate and their cosmetic effects last as long as it takes for the body to break down and take in the injected material. This varies from product to product as you would expect. Injected collagen lasts for 2-3 months, while highly cross-linked HA can last for almost 12 months. Eventually most fillers will need to be repeated at regular intervals to maintain the desired effect and look of fullness to the skin.

Some injections act as stimulators to trigger to the production make healthier collagen, elastin and GAGs.

These products are known as volumisers, and include:

• Hydroxylapatite – e.g. Radiesse
• Poly L-lactic acid (PLLA) – e.g. Sculptra
• Platelet Rich Plasma Therapy (PRPT )

Unlike the immediate results of fillers, the full effect of volumisers can take several weeks to evolve, as new matrix is gradually laid down. Its cosmetic effect may last for many years, as the rate of generation and turnover of collagen in the skin is fairly slow. By and large it does not need to be frequently reapplied although touch-ups are sometimes needed to fix spots are that are missed or uneven the first time round.

Each product has its own specific properties which makes it more suitable for certain uses in different parts of the face and at different times for different people. The choice of which agent, or combination of agents, to use is largely determined by your face and its particular needs. Different fillers may be suited to different areas, e.g. some products are thinner or thicker, making them more or less appropriate for use around the eyes.

Many injections combine both fillers and volumisers in a single product, in which matrix production eventually replaces the filler as the carrier gel slowly disappears. Some products also contain a local anaesthetic, to numb the skin at the injection site.

You only need minimal preparation for treatment with Dermal Fillers or Volumisers. Your doctor may ask you to avoid taking warfarin, aspirin or anti-inflammatory drugs, like NSAIDS (e.g. ibuprofen, ketoprofen) one to two weeks before the procedure to reduce your risk of bruising. Some doctors also recommend stopping vitamin E, ginseng, fish-oil tablets, or herbal supplements with anticoagulant effects for the same reason.

On the day of your treatment, make sure that your skin is free from facial products such as make up, moisturiser, lotions, oil, etc. Allergy skin tests may be required prior to the treatment for those using products containing bovine collagen. Volumisers don’t require pre-testing. Both fillers and volumisers are extremely useful in helping to revert the signs of facial ageing.

Which treatment you decide to choose should be based on your personal needs and after your consultation at the APSARAS Clinic in Coventry, West Midlands. We will guide you towards the best choice for you, and ensure your hopes for the end result are realistic.