Hyaluronic acid

What is Hyaluronic acid?

Hyaluronic acid - Dermal Filler with compatible characteristics.
Hyaluronsäure - Restylane

What is Hyaluronic acid actually?

Hyaluronan - that is the correct chemical name for Hyaluronic acid, a naturally occuring double-sugar with enormous water binding capacity and tissue induction. As a dermal filler (skin filler), this gel contains 1% - 3% hyaluronan which allow volume build-up of the tissue. Hyaluronic acid gel can be used in liquid-viscous consistency to reduce fine skin lines, such as upper lip wrinkles. Durable and more stable hyaluronic acid gels are used for chin enlargement or cheek refilling.

What is Hyaluronic acid?

Most Hyaluronic acid products have gel consistency and all are transparent. The long-lasting fillers are clear crumbs in liquid, which are connected to one another. These hyaluronic acids look like Wackelpeter (god's food), which was divided into fragments. They are dry, tough-brittle. Some Hyaluronic acids are rather liquid but highly viscous.

What is Hyaluronic acid used for?

Hyaluronic acid is a universal skin filler (dermal filler) for large area wrinkle treatment, facial modeling, injection for individual wrinkles or furrows and "rehydrating skin rejuvenation". For hyaluronic injection, Hyaluronic acid gel is injected into the deep layers of the skin with a sharp injection cannula. Alternatively, a deep injection of the subcutaneous hypodermic fat tissue is performed with an atraumatic blunt needle (cannula). In addition to the aesthetic use, Hyaluronic acid is also used in orthopedics, surgery (wound treatment) and Urology.

Hyaluronic acid gel is basically a medium-term degradable and long-acting filler for relative tissue defects and facial modeling. Individual wrinkles can be individually underlined, raised and stabilized. Many small wrinkles or creases in an aged skin are injected several times over the skin or spot (skin booster) with Hyaluronic acid; skin rejuvenation can be achieved by stabilization.

The Gel is not universal

The Filler is not a magic medium. The expectation that wrinkles can be easily eliminated by injecting Hyaluronic acid can not be realized. Specialized doctors can tell you what is possible with hyaluronic acid and what expectation is wrong.

How long does hyaluronic acid stay?

Natural liquid Hyaluronic acid is usually degraded by the body within 24 hours. Stabilized and cross-linked hyaluronic acid can be decomposed by the body. Depends on the medicine, on average after several weeks or several months can be degraded. The effect of injection, however, usually long-lasting. Because even after a complete degradation of the injection material, a collagen fiber-rich connective tissue often remains.

The durability of the injected Hyaluronic acid also depends on the depth of injection. In general, the more superficial the gel is injected, the longer it is durable. However, this should not lead to a superficial injection since side effects such as long-lasting nodules or bulges which can lead to an unsightly treatment result. But negative injection consequence is usually correctable.

Hyaluronic acid – Injection Treatment

Which fillers are suitable for which facial wrinkles?

Fine wrinkles, e.g. eye wrinkles, those small wrinkles that at least as long as the skin is not yet very aged, should be treated with finely structured Hyaluronic acid. Medium wrinkles, for example on the crow's feet or in the mouth area, can be injected with Hyaluronic acid. Deep wrinkles, for example, nasolabial wrinkles or mouth wrinkles, at which the face is connected to the skull by band-like structures, these area are better use highly-stabilized, coarsely structured Hyaluronic acid gel in order to support the facial area.

Is a wrinkle treatment with Hyaluronic acid painful?

If the painful regions are well anesthetized, a Hyaluronic acid injection should be pain-free. Partially anesthetic is available in the form of an injection solution or a well-effective ointment.

How long does a Hyaluronic acid injection last?

The result of Hyaluronic acid depends on the product and selected material. Normally Hyaluronic acid degrades after 3 to 12 months. Due to the Hyaluronic acid gel, however, the new formation of a connective tissue rich in collagen fiber is to be triggered, so that even lasting effects are possible. Basically, a long-term positive result of a hyaluronic acid injection is achieved by an early injection with an experienced physician.

From a patient's perspective, the durability of hyaluronic acid injections is often not perceived objectively, since the treated patient is often quickly accustomed to the impressive result, and forget the previous condition before hyaluronic acid treatment.

When does the effect of a Hyaluronic acid injection begin? When can the result be visible?

The lifting effect of a hyaluronic acid injection treatment is immediately visible. As a result of developing swellings, reddening and possibly small hematomas, the final result is usually reached from the 14th day after the injection. Because of the necessary optimization time, we recommend to perform a hyaluronic acid wrinkle injection 14 days before a wedding, but 21 days before your wedding ceremony.

What side effects does Hyaluronic acid have?

Hyaluronic acid is a component of the intracellular matrix of humans and mammals. Here is an overview of side effects caused by Hyaluronic acid injections.

Side effects by the skin filler (Dermal Filler)

The Hyaluronic acid filler largely consists of water. This water is bound to relatively little Hyaluronic acid since the water binding capacity is very high. The ratio between water and the binding molecules can vary, so that a slight osmotic effect is obtained. This is a reason for possibly occurring swelling after injection. If relatively large amount of the gel are injected, the body can form a capsule around the Hyaluronic acid in the sense of an immune reaction. In this case, granulomeration may occur, which should be treated further if necessary.

Side effects through Treatment

Through the mechanics of the injection, small blood vessels are injured with sharp cannulae.

A longer bleeding of these injured blood vessels could cause bruises (hematomas).

The displacement of adjacent structures by Hyaluronic acid can lead to the transfer of small blood and lymph vessels.

Accordingly, another reason for a possible swelling after injection is a temporary drainage disability.

If a blood-supplying vessel (artery) is obstructed, a local circulatory disturbance may have to be treated.

Side effects by the practitioner

An injection into large or too small amounts of hyaluronic acid will cause a negative result. A superficial injection may be adversely affected by a bead or a bluish translucency.

Who can inject Hyaluronic acid?

Doctors and Nursing Practitioner can conduct hyaluronic acid injection. Dentists are not allowed to treat wrinkles. A self-injecting is not forbidden, but we must kindly warn you that of it may lead disappointing results. If you want to treat yourself with Hyaluronic acid, make sure that a subcorrection always looks better than an overcorrection.

How do I find a specialist doctor?

The treatment with Hyaluronic acid is not part of the medical studies of a doctor, you don’t need to have a doctor title to offer this treatment, so the referring to “spezieller Arzt” is misleading.

Faceshop clinics have focused on wrinkle treatments, wrinkle injections and tissue modeling with hyaluronic implants. The first Faceshop clinic with specialized focu opened in October 2010 in Cologne.

How expensive is a Hyaluronic acid injection? What is the cost of an injection?

Stabilized Hyaluronic acid is very precious and relatively expensive. The prices for Hyaluronic acid treatments are shown on our website. Our specialized doctors will recommend appropriate volume for you in accordance with your actual status. In general, calculate with approx. 390 Euro including treatment costs and VAT for the first Milliliter and 270 Euro for each additional milliliter of the Hyaluronic acid filler.

How many milliliters of hyaluronic acid do I need?

Depending on the depth of the wrinkles and volume deficiencies, slight wrinkles need about 0.5ml Hyaluronic acid. Moderate wrinkles often require 1ml, and large or aged faces require at least 2ml, but often 5ml or more hyaluronic acid may needed. In this case, it is better to start the wrinkle injection early with small volume, instead of spend more to repair large defects and fracture lines when it’s much aging.

Which injection technique is right?

Here, the practitioners differ very much. Misunderstandings can be present particularly in injection. In principle, the filler can be injected superficially, ie high, or deeply in the subcutaneous fat tissue or even as a cushion on the bone. Both sharp needles as well as short, thin, long or thick injection cannulas are used. For many areas, a dull and traumatic (non-injurious) injection technique is optimally suited for Hyaluronic acid. Hyaluronic acid can be sprayed as a net, as a depot, linearly or transversely underneath wrinkles or relative tissue defects. Therefore, physician’s experience should be considered.

Manufacturing of Hyaluronic acid Gel

Modern manufacturing methods use the bacterial (streptococcus) to produce biological Hyaluronic acid. Streptococci produce liquid Hyaluronic acid, which must be stabilized before use in aesthetic medicine. Each manufacturer has it’s patents and secret producing procedures.

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