Many facial imperfections can be easily modified with infiltration of materials of biological or synthetic origin, in the dermis and subcutaneous tissue, referred to as fillers. These products have the same aesthetic purposes but differ in their physical-chemical and biological characteristics. The first fillers used injectable collagen, but now there are several authorised bio-compatible substances that can be injected with no contraindications. Their widespread use has led to the appearance on the market of various types of filler to satisfy the increasingly pressing demands for longer lasting results; they often consist of substances that cannot be metabolised by the recipient organism, and are therefore potentially harmful. They are fillers which, among other things, are registered and carry the CE mark, making them easy to procure, but have not complied with all the rules of absolute safety for patients and, on the contrary, have caused extremely complicated and numerous side effects especially for immune reactions as a result of the injected substance and the tissue response of the recipient organism. This led to the need to endorse some guidelines shared by the majority of specialists, the precepts of which have been the subject of frequent congressional debates in recent years to achieve a series of recommendations regarding clinical behaviour.
These guidelines refer to: clinical indications, clinical and aesthetic indications; precautionary measures to be implemented; technical methods of application; achievable results and the indications to be observed during the phases following such treatment;
- non-sensitising at a short or long term level;
- completely absorbable;
- a consistency similar to or compatible with natural tissue;
With extensive and conclusive scientific evidence produced by multicentre trials lasting at least three years, conducted in public and private centres of undoubted scientific professionalism and publication of the results in accredited scientific journals and finally authorisation granted by the Ministry of Health.
Unfortunately, even today there is no perfect filler, although there is a huge variety of substances and materials that individually do not meet all the useful characteristics required.