Numerous natural and synthetic substances can be injected into the skin to augment the soft tissues and give the skin a smoother and more youthful appearance. Hyaluronic acid fillers, such as Juvederm, can be used to reduce the appearance of deep folds around the mouth and nose, add contour and volume to the cheeks and cheekbones, to plumb furrows and hollows, and to enhance definition of the lips. Certain scars and skin depressions also respond well to soft tissue fillers.
Fillers fall into 2 major categories, direct volumizers and collagen stimulators. Products such as Juvederm and Restylane are hyaluronic acid fillers which can be directly injected safely into a variety of lines and folds for an immediate effect which can last up to a year in duration.
Sculptra is an example of a collagen stimulator. This injectable is a suspension of minute particles of poly-L-lactic acid, which, when injected into the skin, stimulate the body to encapsulate the particles and form new collagen over a period of weeks to months. Overall volumization, recontouring, and an improvement in the texture of the overlying skin can last 1-2 years with this treatment.