Skin aging is a natural and biological process of the body. In the structure of the skin, there are various cells such as keratinocytes and fibroblasts, as well as various structures such as elastin, collagen, and sodium hyaluronate, which decrease in proliferation and production of these cells and structures with age. On the other hand, the amount of fat in the skin decreases, and the combination of these physiological events causes signs of aging in the skin. The skin loses its clarity and freshness and wrinkles appear.

Some causes can aggravate the aging process of the skin and its symptoms or cause it prematurely, such as improper nutrition, smoking, exposure to sunlight for a long time or without using sunscreen, solar, heavy sports, due to some jobs that deal with chemicals, stress, lack of sleep, repetitive facial habits such as frowning, and some diseases such as HIV and some metabolic diseases such as diabetes

Skin aging is a physiological and natural process of the body, which sometimes can be accelerated or aggravated by some causes. (Refer to question 1) But today, with the advancement of science and the use of some pharmaceutical products that have been made and produced for this purpose, the speed of skin aging can be slowed down, Of course, it should be used from a younger age. Such as the use of mesogels and mesococktails, chemical peels, the use of some oral supplements, dermabrasion and microdermabrasion, some lasers with the indication of biological stimulation and increasing the production of skin structures and some skin creams.

Dermal fillers are one of the medical devices that are mainly used to improve skin aging symptoms such as wrinkles and to restore facial skin volume. Depending on the length of time they remain in tissue, dermal fillers are classified as: 

• Permanent fillers: These types of fillers have a long durability and last for more than 2 years. Due to the high and sometimes serious side effects, these fillers are the least used and desired for beauty and to eliminate wrinkles and volume. Polyacrylamide gel and Dimethyl siloxane polymer are two examples of this type of fillers
• Semi-permanent fillers: These types of fillers last at least 18 months, and due to their type, color, and mechanism of action, they are mostly used in deep skin injections, so they are not used much except for special indications. Radiance and Ellanse are two examples of semi-permanent injectable gels made from calcium hydroxyapatite and polycaprolactone, respectively. These types of gels disappear shortly after injection, but their effects remain because they are biological stimulants and cause collagen formation.
• Temporary fillers: As it is known from the name of this type of fillers, they have a short durability of between 3 and 9 months, which varies depending on the type of filler and the depth of injection and the injection area.

• Autologous fat: Which is suctioned from patient and injected during a purification and preparation process. 
• Collagen fillers: Which have different types and are rarely used due to their effectiveness and short durability.
• Hyaluronic acid fillers: It is the most popular and most widely used and safest filler for beauty. The best type of filler is synthetic hyaluronic acid, which has different types depending on the formulation and manufacturing characteristics. According to statistics published by the American Association of Aesthetic Plastic Surgery, 85% of beauticians use this type of fillers.

Unlike other fillers, it has the least side effects, and in case of any complication or technical error, the injectable filler can be destroyed by a decomposing enzyme called hyalase (hyaluronidase) and the complication can be treated or corrected.

• To eliminate or reduce lines and wrinkles such as smile lines, frown lines, crow's feet wrinkles around the eyes, wrinkles around the mouth, forehead wrinkles.
• To restore lost volume in facial areas such as cheek, lip, and chin volume.
• For contouring and angularization such as the jaw line and chin area.
• In order to change, such as injecting lip filler in the Russian lip method or injecting into the radius and tip of the nose
• To repair scars and acne.
• In some diseases, the distribution of fat under the skin is disturbed and causes wrinkles and subsequent complications. such as HIV and lipoatrophy

The best answer is after the initial examination and consultation by an expert physician.

But mostly hyaluronic acid skin filler will be suggested to you as the first option. There are different types of hyaluronic acid dermal filler, which are distinguished based on the characteristics of formulation and construction.

Undoubtedly, the manufacturing technology and standard formulation and especially the percentage of purity and freedom from impurities will have a direct impact on the effectiveness, durability and especially the reduction of side effects.

Manufacturing companies usually produce different types of hyaluronic acid fillers according to their structural characteristics and formulation, and specify and describe the uses of each one.

Soft gels are mainly used in areas with thin skin and superficial injection, and the more the thickness of the skin and the injection depth, the harder the gel will be. The hardness of the gel depends on several factors, including the viscosity (the amount and molecular weight of the active substance), the percentage of cross-linking, elasticity, and viscosity.

In addition to eliminating defects and signs of skin aging, due to its filling properties such as lines, wrinkles, it causes volume, contouring, and angularization. It has also been shown in several studies that the use of hyaluronic acid dermal fillers (whether linear or cross-link) can increase the proliferation and differentiation of skin cells such as keratinocytes and fibroblasts and increase the production of sodium hyaluronate and collagen.

As mentioned in question (3), there are different types of fillers, the permanent type of which is not recommended for general beauty purposes due to many and sometimes serious side effects. It is worth mentioning that temporary skin fillers, especially hyaluronic acid, usually after several injections in the same area, due to the replacement of fibrin at the injection site, can have a long durability.

The answer to this question is general. Several factors are effective and involved in the treatment duration of dermal filler. including filler brand, sub-brand types of a specific brand, injection techniques, post-injection care, and the physiological conditions of the beautician himself.

Under the same conditions, in terms of the type of brand, sub-brand, doctor and injection technique, the physiological conditions of patient can be mentioned. Some people have very active and strong muscles (hyperactive) or they do some repetitive facial habits, such as laughing and frowning, etc., which can cause the filler to migrate from the injection site and cause the filler to break down faster. Also, some people naturally have more hyaluronidase enzyme in the body, which causes the filler to break down faster, and other things.

It is certainly not required. But sometimes the site where the beautician wants to inject has hyperactive muscles or is in an area that has many repetitive movements. (Such as frown lines, smile lines, etc.) In this case, the physician advises the client to use Botox (botulonium) a few days before the injection (usually 10 to 14 days) to prevent the migration of the injected filler and to increase its duration of treatment.

A part of the answer to this question has been answered in question 3, which is related to the type of filler, but in general, the safest filler is hyaluronic acid based on the indications for the use of dermal fillers, which in turn can have side effects. 90% of these complications are usually self-healing and transient, such as inflammation, pain, stiffness, redness, and bruising, which depend on the technique and expertise of the physician, as well as post-injection care. There are some severe side effects, which, of course, is less likely to happen and require medical intervention and treatment, such as allergy, lump, infection, nodule formation, both side effects are related to the filler in terms of manufacturing quality and standards, as well as the injection technique by the physician. There is also the possibility of some serious side effects that require emergency intervention. Such as anaphylactic shock caused by sensitivity to anesthetics or dermal filler components, as well as intravascular injection, which in the absence of monitoring and emergency intervention can lead to irreparable injuries and necrosis.

It varies depending on the injection area and the required amount of filler for injection, as well as the injection technique by the physician. In total, in most procedures, the actual injection takes ten to twenty-five minutes.

Also, after each injection session, patient must be present in the physician's office for 2 hours and 2 days in the city where the physician resides, so that the doctor can quickly intervene in case of any complications.

Usually, 14 days after the first session, the physician asks the beautician to come back to have corrections or re-injections if needed.

In most dermal fillers, the physician uses very small needles, and as a result, you will only feel very small pinches. Most of the injections are completely painless. Many injectable fillers also contain lidocaine, which is an anesthetic, or depending on the sensitivity of the injection area, the physician injects lidocaine. Some physician even applies topical anesthetic creams throughout the injection area before the injection, to reduce any possible discomfort. In some cases, an ice compress may also be used for more comfort and to reduce swelling immediately after the injection.

The initial result is visible after the injection, but at least a few days are needed for the inflammation caused by the injection to disappear and the filler to perform its action and the main result to be seen. In some cases, there is a need for a second session for correction (such as the asymmetry, not removing the skin defects completely and re-injection, and conversely, the need for correction with hyalase injection due to the high volume of the injection, etc.), which is 14 days after the first session.

It is better not to use cosmetics on the day of injection of any type of dermal filler and the day after because of the increased risk of infection and covering the injection site, ignoring the change in skin color, and delaying the timely intervention of the physician.

• People with infection in the injection area
• People with active infection
• People prone to keloid and hypertrophic scar formation (extra flesh)
• Pregnant or lactating women
• People have acne or blisters in that area.
• Uncontrolled autoimmune diseases and immune system weakness

1. People with uncontrolled diseases such as diabetes
2. People with allergies to items in the gel or anesthetic
3. People with a history of heart attack, blood clots and deep vein thrombosis
4. People with a history of stroke
5. People with cancer

1. On the day of injection, the face must be completely clean and without makeup
2. To reduce the possibility of bruising and bleeding two weeks before the injection procedure, you should not use blood thinners such as aspirin, warfarin, vitamin E, vitamin C, fish oil, etc., if you use them, consult your doctor.
3. If you are suffering from cold sores in the injection area, you should not inject and should be injected after the cold sores disappear.
4. If the possibility of cold sores is high in you, it is better to consult your doctor to do cold sore prophylaxis (preventive) treatment a few days before the injection.
5. Do not schedule any dental appointments 3 weeks before and after the injection
6. It is better not to use any vaccine one month before and after gel injection to prevent hypersensitivity reactions.
7. Inform your physician if you are using Isotretinoin.

1. In order to quickly diagnose and prevent some side effects, it should be monitored for 2 hours in the office or clinic where you performed the injection.
2. Getting the doctor's contact number to respond to.
3. After the injection, it is better to stay in the city where your doctor is staying for 2 days.
4. Do not wear makeup for 24 hours after injection.
5. Using ice water compresses or ice packs alternately to reduce inflammation and bruising
6. Avoid drinking alcoholic beverages for at least 48 hours.
   Avoid heavy sports
7. Refraining from taking hot showers and using saunas and jacuzzis
8. Avoiding any rubbing and massaging of the injection site to prevent displacement and migration of the filler
9. Avoid exposure to extreme hot and cold weather.
10. You should sleep with your head up for 24 to 48 hours.
11. Dermal filler injection can dry the skin to some extent and it is better to use a moisturizer after consulting the doctor.

In order to quickly diagnose and prevent some side effects, it should be monitored for 2 hours in the office or clinic where you performed the injection.
Getting the doctor's contact number to respond to.
After the injection, it is better to stay in the city where your doctor is staying for 2 days.
Do not wear makeup for 24 hours after injection.
Using ice water compresses or ice packs alternately to reduce inflammation and bruising
Avoid drinking alcoholic beverages for at least 48 hours.
Avoid heavy sports
Refraining from taking hot showers and using saunas and jacuzzis
Avoiding any rubbing and massaging of the injection site to prevent displacement and migration of the filler
Avoid exposure to extreme hot and cold weather.
You should sleep with your head up for 24 to 48 hours.
Dermal filler injection can dry the skin to some extent and it is better to use a moisturizer after consulting the doctor.