HA Dermal Fillers are used to restore and maintain facial volume in patients where the subcutaneous structures have become dystrophic, meaning disappeared or reduced in size to a point where volume replacement is the indicated treatment. Other than HA Fillers there are so called semi-permanent products. Those are mainly used in patients with severe lipodystrophy meaning the sub cutaneous, structural fat pads have disappeared. In the past silicone was a popular option, back in the 80’s or even before. The trouble is that the silicone is still increasing in size due to its ongoing skin reaction and might explain why a lot of the ageing celebrities might look more and more weird. Most patients I see will not have come across this phenomenon.
The prime medical indications for dermal fillers are disproportionate volume loss, asymmetry, acne and general scarring, loss of elasticity and volume.
My preferred injection method by now is through a canula, the 3rd generation HA products are more difficult to apply and the old style bolus technique might cause problems. The canula is perfect in combination with the modern products and allows for a huge variety of treatment options.