From Filling to Function – the Evolution of Dermal Fillers

Dermal fillers first gained interest in the late 19th century, but their safety and efficacy were inadequate. But the development of fillers continued and is going on. Temporary fillers like cross-linked hyaluronic acid are widely used nowadays. Biostimulatory semi-permanent fillers like poly-L-lactic acid and calcium hydroxylapatite offer an increase in longevity with excellent safety. Newer developments are the hybrid fillers that often combines a temporary and a semi-permanent filler type to obtain better rheological qualities for a natural look. With the development of products on the market, our understanding of fillers has moved from substitution of lost volume to stimulation of autologous cells, such as fibroblasts, endothelial cells, and adipocytes. An improved understanding of tissue regeneration will support the design of a new filler type for specific interaction with the host tissue.