Fillers with hyaluronic acid and autologous fat – volume where it is lacking

Skin aging begins earlier than many people think: from around the age of 25, firmness decreases, and from around 30 it becomes visible. There are two types of wrinkles. Dynamic wrinkles are caused by muscle movement – they are treated with a wrinkle treatment that relaxes the muscles. Static wrinkles and sunken areas are caused by volume loss – here, fillers help.

Hyaluronic acid

Hyaluronic acid is a substance naturally produced by the body that binds water and gives the skin fullness. For filler treatments, it is produced biotechnologically and cross-linked to different degrees:

• low-viscosity gels for fine lines in the upper layers of the skin
• firmer gels for deep wrinkles and building volume, for example in the cheeks or chin
• particularly soft gels for the lips

One advantage: hyaluronic acid can be dissolved again with an enzyme (hyaluronidase) if a result needs to be corrected. Allergic reactions are very rare. Depending on the product and region, the effect lasts about 4 to 12 months; low-viscosity gels are broken down faster than firm ones.

Typical areas of use

• Nasolabial folds and marionette lines
• Tear trough and dark circles under the eyes
• Lips and lip contour
• Volume restoration in the cheeks, temples and chin

Autologous fat (lipofilling)

Lipofilling uses the body’s own fat – for example from the abdomen or thighs. It is gently harvested with a fine cannula, purified and then introduced under the skin in small portions in a fan-shaped pattern. With autologous fat, sunken areas can be filled extensively: hollow cheeks, cheekbones, deep wrinkles, dark circles under the eyes, drooping corners of the mouth or uneven contours of the chin.

Autologous fat comes from your own body and is well tolerated. However, not all of the fat takes – a portion is broken down in the first few weeks, while the remaining portion usually remains permanently. A second session is therefore sometimes advisable. Because fat is harvested and introduced, lipofilling is a minor surgical procedure with a few days of recovery.

Which substance for whom?

	Hyaluronic acid	Autologous fat
Suitable for	targeted wrinkles, lips, smaller volume deficits	extensive volume restoration, larger sunken areas
Duration	about 4–12 months, depending on the product	a portion is broken down, the rest usually remains permanently
Correctable	yes, by dissolving with an enzyme	only to a limited extent
Effort	Injection, about 15 minutes	minor procedure with fat harvesting
Downtime	usually none	a few days to about two weeks

Procedure

1. Consultation I look at where volume is lacking and whether facial expressions or tissue loss are the cause.
2. Hyaluronic acid Numbing cream or local anesthesia, injection with a fine needle or blunt cannula, about 15 minutes.
3. Autologous fat Harvesting and introduction under local anesthesia or twilight sedation, on an outpatient basis.
4. Afterwards Cooling; with hyaluronic acid, usually fit for everyday activities immediately; with autologous fat, a few days of rest.

After the treatment

Slight swelling, redness or small bruises are normal and usually subside within a few days. You should not massage the treated areas in the first few days; avoid sports, sauna and intense sun for a short time. After autologous fat treatments, the swelling lasts longer – allow up to two weeks.

Risks and contraindications

Possible side effects include bruising, swelling, small nodules or irregularities and – very rarely – inflammation or an injection into a blood vessel, which must be treated immediately. Precisely for this reason, filler treatments belong in experienced hands with precise knowledge of anatomy. Among other things, no treatment is performed in case of acute inflammation in the treatment area, during pregnancy and breastfeeding, with certain autoimmune diseases or while taking some medications – we clarify this in the preliminary consultation.

Frequently asked questions