Cosmetic Injections Offer Plastic Surgery Alternatives

Dermal fillers are one of the most popular cosmetic injections. They offer impressive changes in appearance without the longer recovery time required in Plastic Surgery procedures.  These procedures are available either at Plastic Surgery practices or a medical Spa. Calcium hydroxylapatie, Hyaluronic acid, Polyalkylimide, Pollactic acid and Polymethyl-methacrylate microspheres (PMMA) as well as fat taken from the abdomen or buttocks are used as dermal fillers.

Knowing which part of the face each filler is used is useful to know for deciding which procedure might be suitable.  Cosmetic injection guides provide information about the types of dermal fillers that are available and what conditions these fillers can improve for the facial appearance.  

Calcium hydroxylapatite is a mineral type substance found in human bones and is used to fill frown lines, make cheeks fuller and fill areas where the face has a sunken appearance from illness such as HIV.  The Calcium hydroxylapatite used for this procedure is produced in a lab so is animal friendly and it has been used for dental procedures and plastic surgery for many years.  A study in the Journal of Drugs in Dermatology in September 2013 found that the clinical trial that followed people for three years after they had had Calcium hydroxylapatite treatments found there were no ongoing or delayed reactions to the treatment.   

Hyaluronic acid is also a naturally occurring substance in the body.  The injections are used to improve the skin texture and smooth out indentations from injuries, facial lines and scars. This injection can also be used for highlighting lip lines. Hyaluronic acid injections are also used in Arthritis treatment to ease aching joints in osteoarthritis and to provide extra padding for the joints.  These treatments are known as  viscosupplementation.  For many Hyalronic acid injections relieve chronic pain and this treatment is used instead of having knee replacement surgery.


Polyalkylimide dermal filler is used to enhance thin lips, cheeks and jaw line and to treat sunken appearance as a result of HIV treatment or due to ageing. The substance does not require an allergy test and is radio transparent so any needed x-rays for dental work will still be able to be taken. If needed, the Polyalkylimide can be removed so it is semi-permanent.  Some clinics only use semi-permanent fillers so the results can be altered or removed if requested.

Polylactic acid stimulator dermal filler helps the body produce collagen. Polylactic acid is used to enhance lips and fill laugh lines. Procedures using this dermal filler take a few months to achieve the desired results as the collagen is produced and will need a couple of months of treatment as well as top up treatments to keep the results.  A study published in the Facial Plastic Clinics of America in November 2015 states the aging face surgery has become more complicated than just filling lines and doing face lifts of soft tissue and skin.  Structural changes that happen in the facial bones, different fat pads, as well as muscular and ligaments changes and the composition of the skin also need to be understood for the appearance of a younger looking face.

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Polymethyl-methacrylate microspheres (PMMA) are used to enhance thin lips and treat deeper wrinkles. It is also a longer acting cosmetic injection option and may take a few weeks to see the desired results. This type of dermal filler needs a more experienced professional to administer this product.  Most people can use PMMA treatments which comprise 20 percent PMMA microspheres of the dermal filler and suitability is dependent on which suspension is used which comprises 80 percent of the collagen gel. After about three months the body has produced collagen as the collagen gel used in the PMMA treatment breaks down.

Fat dermal fillers use liposuction fat from the abdomen or buttocks and it is a more uncomfortable procedure than using the above mentioned fillers.  This fat becomes a fat skin graft and will be a permanent feature once the graft is successful. A study published in Facial Plastic Surgery in December 2016 views this procedure as beneficial in remedying the signs of facial ageing. Because of the different types of fats located in the face it was recommended to take this into the planning when doing less invasive surgical procedures such as dermal fillers and skin grafts when trying to achieve a younger looking face. 

Neuromuscular blocking Botulinum toxin (Botox) is a temporary procedure that decreases the appearance of facial lines and wrinkles by preventing the muscles from contracting to cause wrinkles. Various brands have been approved by the FDA for specific treatments.  Studies were done on the safety of use were published in Plastic and Reconstructive Surgery in January 2020 for it use on glabellar lines, which run horizontal on the forehead. The study determined it was safe to use for this condition.  A no line or mild glabellar line was possible for duration of about an average of 24 weeks.

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A questionnaire on if cosmetic injection procedures might be for you is available from Web MD. In the video Dr. Carolyn Jacob says genetics, skin thickness and sun damage are often the deciding factors to begin cosmetic injections.  Volume in the lips and cheeks become more noticeable with age and facial lines become more pronounced.  

The use of dermal fillers is the second most popular procedure in the USA according to the American Journal of Dermatology study published in August 2015. JAMA Facial Plastic Surgery publication in May 2019 discussed in depth the theory of facial beauty to help clinicians in their strategies for treatment. Eleven sets of 43 digitally altered pictures and actual line drawings were used to rate levels of attractiveness. 

Given the long history of use of cosmetic injections a suitable course of treatment can be arranged to achieve whatever attractiveness that is wanted to be achieve. Knowing ahead of time what different types of dermal fillers are available and how permanent a change is wanted can help achieve the results needed for a younger looking appearance.

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