title: Dermal filler agents: a practical review.
abstract: OBJECTIVE
  Facial aging results from multiple microscopic (histopathologic) and macroscopic (anatomic) changes. Whereas skin care and traditional surgery have much to offer patients desiring cosmetic improvement, they can fail to adequately address certain signs of facial aging. Soft-tissue augmentation with dermal fillers can successfully address these signs of aging by filling soft-tissue defects caused by age, scar formation, or disease. All dermal fillers aim to achieve the same goal: long-lasting soft-tissue augmentation without side effects. Each dermal filler preparation available for patient use has unique compositions and characteristics that impact its proper handling, therapeutic results, potential complications, and, ultimately, its ideal use. This review surveys the currently available preparations for soft-tissue augmentation.
  
  
  RESULTS
  A review of the medical literature and manufacturers' information are included for dermal fillers currently approved for use by the US Food and Drug Administration. The composition, use, and potential limitation of each available preparation are reviewed.
  
  
  CONCLUSIONS
  Dermal filling agents offer an excellent option for management of certain facial cosmetic changes. Since a wide range of products with significantly different characteristics is available, the treating physician should have sound knowledge of them all.
authors.affiliation: Oculofacial Surgery, Department of Ophthalmology, The Permanente Medical Group, Inc., Sacramento, California 95815, USA. sukhjit.s.johl@kp.org
authors.forename: Sukhjit S
authors.initials: SS
authors.lastname: Johl
authors.forename: Richard A
authors.initials: RA
authors.lastname: Burgett
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D001672:Biocompatible Materials / Q000008:administration & dosage*; D003094:Collagen / Q000008:administration & dosage / Q000009:adverse effects; D003357:Cosmetic Techniques; D020405:Dermis; D005145:Face; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D007267:Injections; D019344:Lactic Acid / Q000008:administration & dosage / Q000009:adverse effects; D011091:Polyesters; D011108:Polymers / Q000008:administration & dosage / Q000009:adverse effects; D012826:Silicone Elastomers / Q000008:administration & dosage / Q000009:adverse effects; D015595:Skin Aging / Q000187:drug effects*
chemical_list: D001672:Biocompatible Materials; D011091:Polyesters; D011108:Polymers; D012826:Silicone Elastomers; D019344:Lactic Acid; C033616:poly(lactide); D006820:Hyaluronic Acid; D003094:Collagen