[Facial fillers: evidence base, anatomical principles, materials, risks, techniques, and future perspectives]

Area of Science:

• Aesthetic Medicine
• Dermatology
• Biomaterials Science

Background:

• Dermal fillers are a rapidly growing aesthetic medicine intervention.
• Hyaluronic acid fillers dominate, but alternatives like calcium hydroxylapatite and poly-L-lactic acid are increasing.
• Advances in techniques and safety have improved outcomes, yet severe complications like vascular occlusions persist.

Purpose of the Study:

• To provide a comprehensive, evidence-based review of current literature on dermal fillers.
• To analyze filler materials, mechanisms of action, and anatomical risk zones.
• To discuss injection techniques, indications, complication management, and future developments.

Main Methods:

• Comprehensive literature review.
• Evidence-based analysis of current research.
• Synthesis of data on materials, techniques, and complications.

Main Results:

• Dermal filler use has significantly increased over two decades.
• Various filler materials exist, each with unique properties and applications.
• Vascular occlusions remain a critical challenge despite improved safety standards.

Conclusions:

• Dermal filler therapy has advanced significantly, offering improved clinical outcomes.
• Understanding materials, anatomy, and techniques is crucial for safe and effective use.
• Managing rare but severe complications, such as vascular occlusions, is paramount.