Soft Tissue Fillers

Also known as “dermal fillers,” they are a group of injectable substances that help create a fuller appearance on the areas where they are used.

Although the purpose is the same, the mechanism of action of the different fillers varies substantially because of their specific characteristics and the reaction that the tissues of the different parts of the body can present.

Typically, a filler used for lips is different from that used for cheek augmentation, hand rejuvenation, or phalloplasty; there are a product and a specific indication for each body area.

There are two primary groups of soft tissue fillers:

 

Gels

This group comprises a single family of fillers made from a gel that retains water: hyaluronic acid; the presence of the gel and the water in the tissues produces the increase in volume, and the implant is surrounded by a thin and delicate collagen capsule.

These products are excellent for low to medium-volume facial procedures, as they are available in varying degrees of concentration and viscosity.
Hyaluronic acid is very safe and is the most popular filler material globally, but when used in large amounts, as in nonsurgical phalloplasty, it becomes a soft implant that feels spongy and squeezy. The delicate collagen capsule is not strong enough to hold the product in place, and there may be unwanted migration or build-up.

Solid Micro-spheres

There are three products composed of solid microspheres: The first is polymethylmethacrylate (pmma, Linnea Avanti®, Linnea Safe®), which offers permanent results because the microspheres are not digested or absorbed by the human body and remain in the implant site for life.

The second group comprises two types of microspheres that are slowly metabolized and absorbed: calcium hydroxylapatite (CaHA, Radiesse®) and polycaprolactone (PCL, Ellansé®). These microspheres produce long-lasting results, but the tissues return to their basal conditions when they are absorbed.

Microsphere-based soft tissue fillers work differently from gels: the millions of microspheres injected into the tissues stimulate collagen formation that surrounds them individually, creating a stable and firm bulking. These materials can be used in greater volume and feel like natural tissues; however, unlike hyaluronic acid, they are not indicated in the face’s delicate areas, such as the lips and the under eyes.

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Clinical indications of soft tissue fillers available at Avanti Derma

Female

Male

Avanti Derma offers a full line of soft tissue fillers suitable for nonsurgical phalloplasty.

Linnea Avanti

Polymethyl-methacrylate (PMMA)

  • Made of microscopic spheres of PMMA, a plastic that is not absorbed by the body.
  • The micro-spheres get surrounded by the patient’s collagen, creating volume.
  •  Permanent results.
  • The implant is firm and stable; it doesn’t migrate.
  • Popular brand names: Linnea Avanti®, Linnea Safe®.

Ellansé

Polycaprolactone (PCL)

  • Made of microscopic spheres of PCL, a polymer that is slowly absorbed by the body.
  • The micro-spheres get surrounded by the patient’s collagen, creating volume.
  • Long-term results.
  • The implant is firm and stable; it doesn’t migrate.
  • It is available in three varieties that offer longevity of one, two, or three years.
  • Brand name: Ellansé®.

Radiesse

Calcium Hydroxyl-apatite (CaHA)

  • Made of microscopic spheres of calcium that are slowly absorbed by the body.
  • The micro-spheres get surrounded by the patient’s collagen, creating volume.
  • Temporary results.
  • The implant is firm and stable; it doesn’t migrate.
  • Its longevity is similar to Ellansé-S, the one-year version.
  • Brand name: Radiesse®.

Voluma

Hyaluronic Acid (HA)

  • Made of a hydrophilic gel (holds water) that remains as a soft substance in the tissues.
  • The gel deposits get encapsulated by a thin and weak collagen membrane.
  • Temporary results.
  • The implant may be “soft” or “spongy” to the touch if used for phalloplasty.
  • This line of products is widely accepted for facial procedures.
  • It can be reversed with injections of an enzyme called hyaluronidase.
  • Popular brand names: Voluma®, Volux®, Belotero®, and many more.