Treatment with hyaluronic acid / filler

Associated terms

Filler, filler treatment, injection, volume build-up, wrinkle treatment, lip injections, Jawline contouring, liquid nose job, tear troughs, dark circles, skin booster, hyaluronidase

General info

As we age, our skin changes: the body's own production of hyaluronic acid, collagen and elastin decreases - the first wrinkles appear, volume is lost and facial contours look less defined. These natural signs of skin ageing are completely normal, but can make you look tired, tired or older than you feel. Aesthetic medicine offers gentle and effective solutions to gently counteract these changes. Hyaluronic acid fillers have played a central role in this for many years. They can not only smooth wrinkles and compensate for volume loss, but also harmonise facial features, optimise lip shape or visibly refresh the complexion with so-called skin boosters.

Thanks to their versatility, hyaluronic acid preparations can be customised to the needs of each skin region - for a natural, fresh appearance that preserves your personal radiance. The treatment is minimally invasive, well tolerated and immediately visible - a modern way to discreetly emphasise your own beauty.

Brief overview of treatment with hyaluronic acid / filler:

Treatment duration:
10 - 30 minutes

Anaesthesia:
not required, depending on the region possible with anaesthetic cream, local anaesthetic

Follow-up treatment:
Cooling

Load restrictions:
Avoid sport, sauna, sunbathing for 48 hours, no make-up for 24 hours

What is hyaluronic acid?

Hyaluronic acid is a natural component of the skin that stores moisture and thus contributes to skin elasticity and moisturisation. From the age of 26, the body's own production of hyaluronic acid gradually decreases, which initially leads to sallow-looking skin, smaller wrinkles and later deeper wrinkles and loss of volume.

As a synthetically produced filler, hyaluronic acid binds water, provides elasticity and hydration and is biocompatible and biodegradable.

There are a variety of hyaluronic acid fillers on the market that differ in their composition, cross-linking, particle size and application. They are mainly used for injecting wrinkles, filling volume and rejuvenating the skin.

What can be treated with hyaluronic acid?

Hyaluronic acid (also known as hyaluronic acid for short) can be used to lift wrinkles or emphasise lip contours. Hyaluronic acid is a substance related to natural connective tissue. The preparations are produced synthetically and broken down by the body's enzymes over time.

Hyaluronic acid is suitable for this purpose:

Wrinkles (e.g. nasolabial, marionette, forehead and lip wrinkles)
Volume build-up (cheeks, chin, jawline, temples)
Lip shaping
Skin improvement (skin booster)
Hands, décolleté, earlobes
Medical: joint treatment for arthrosis, scars, ophthalmology

How does the treatment with hyaluronic acid fillers work?

Each treatment is preceded by a detailed consultation with information about your desired treatment, products, injection techniques, expected results and, above all, risks.

During the actual treatment, the skin is first cleaned and disinfected. Sometimes the treatment also requires injection points to be marked (depending on the region and treatment technique).

Either a fine, pointed needle or a blunt cannula (depending on the region and target) are available for the injection itself. The filler is then slowly placed in the desired tissue layer.

Duration: 10-30 minutes depending on the region

Is treatment with hyaluronic acid fillers painful?

Hyaluronic acid injections are not entirely pain-free, but are usually well tolerated. Depending on the region and technique, our patients report a slight stinging sensation or even pressure. As most hyaluronic acid fillers contain the anaesthetic lidocaine, an additional anaesthetic is usually not necessary. Especially in experienced hands with the right techniques, the treatment is hardly unpleasant for many patients. For patients who are particularly sensitive to pain, we offer the option of applying an anaesthetic cream beforehand.

What do I need to consider after treatment with hyaluronic acid?

To prevent swelling, we cool the area immediately after the treatment and also give you cooling pads to take home if necessary.

Keeping the skin elevated, drinking plenty of fluids, gentle care and UV protection can also help - especially if a small bruise has formed.

You should also avoid sport, alcohol and sunbathing for approx. 48 hours. Make-up can be reapplied after 24 hours.

When can the result be expected and how long will it last?

Although a result can be seen immediately after the injection, the hylauronic acid molecules bind water over the next 14 days. Here you can see the final result.

Depending on the product and region, the result lasts between 6 and 24 months.

What are the risks of hyaluronic acid treatment?

One Hyaluronic acid treatment is generally regarded as safe and well tolerated - especially when performed by experienced specialists. Nevertheless, as with any medical-aesthetic procedure Risks and side effects possible.

Frequent: redness, swelling, haematoma, feeling of pressure
Rarely: Infections, lumps, vascular occlusion (emergency!), allergies

Important: In case of severe pain, white discolouration or visual disturbances, contact a doctor immediately. The hyaluronic acid may need to be mixed with Hyaluronidase The tissue must be dissolved again to avoid serious complications such as tissue necrosis (tissue death) or, in the worst case, blindness.

Can hyaluronic acid "migrate"?

Hyaluronic acid can migrate in the tissue in rare cases. This depends on several factors. If it is injected correctly, it largely remains in place. But under certain circumstances, so-called migration or displacement of the filler can occur.

Possible causes for such migration can be the use of too much product or overcorrection, an incorrectly applied technique or insertion into the wrong tissue layer. Mechanical stress, e.g. through massage or pressure and the use of unsuitable or inferior hyaluronic acid products can also cause the filler to migrate. Sport, sauna and heat can also favour the migration of hyaluronic acid. It is therefore important that you follow our aftercare recommendations!

Typical regions with a higher risk of migration are

Lips - Particularly mobile, frequent overcorrections → "Filler migration" possible above the lip
Tear trough / eye region - Poorly anchored tissue, Tyndall effect possible
Nose - If the dosage is too superficial or too high, the result may shift unattractively

But a filler can also migrate in other areas.

How can migration/migration be avoided?

The risk of migration can be significantly reduced if you only seek treatment from experienced specialists and ensure that high-quality products are used that are suitable for the region in question. We will be happy to provide you with detailed advice on the various products and injection techniques during a personal consultation.

We use these hyaluronic acid products:

Belotero® from Merz Aesthetics
Profhilo® and Profhilo Structura® from IBSA
Maili® from Sinclair Pharma

Dr Michaela Montanari's practice for plastic and aesthetic surgery was named a Belotero® Centre of Excellence many years ago. In a Belotero® Competence Centre, you will find specially trained specialists who are highly experienced in the use of Belotero® hyaluronic acid fillers and have outstanding expertise in aesthetic wrinkle and volume treatment.

What should you look out for when choosing a doctor?

When choosing a specialist, make sure that you use the term Specialist in Plastic and Aesthetic Surgery. Other designations such as beauty doctor, cosmetic surgeon, etc. are unprotected and not a sign of qualification (more on "What should you consider when choosing a specialist?„.

Make sure that you receive a comprehensive preliminary examination and information about the course of treatment, possible risks and the healing process.

Why should you come to us?

Extensive experience, maximum hygiene and infection protection, continuous further training and the utmost care are the basis of our practice. This is also reflected in the large number of positive patient reviews and our seals & awards.

Take advantage of our almost 20 years of experience for your desired change. Dr Michaela Montanari has been a member of the board of the German Society for Aesthetic Plastic Surgery (DGÄPC) since 2021.

Do you have any questions?

We will be happy to answer all your questions about the procedure, options, risks and healing of your hyaluronic acid injection. Arrange your personal consultation. We will advise you individually about your options.