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

The use of dermal fillers has emerged over the past two decades as one of the fastest-growing interventions in aesthetic medicine. While hyaluronic acid-based fillers account for the largest market share, alternative materials such as calcium hydroxylapatite, poly-L-lactic acid, and polymethylmethacrylate-based products are gaining increasing importance. Advances in injection strategies, anatomical precision, rheological product differentiation, and safety standards have led to a marked improvement in clinical outcomes. However, the profile of rare but potentially severe complications-particularly vascular occlusions-remains a central challenge. The aim of this review is to provide a comprehensive, evidence-based analysis of the current literature regarding materials, mechanisms of action, anatomical risk zones, injection techniques, indications, complication management, and future developments in filler therapy.