Facial Aging and Fillers

After 25 years of age the first signs of aging on the surface of the skin begin to manifest. From the beginning, fine lines appear and, in the course of time, wrinkles, loss of volume and loss of density are perceived. WrinklesLoss of volume y Loss of density.

There are three main manifestations of skin aging in general. Each of them affects the facial aspect in a different way.


The first noticeable sign of aging after 25 years is the presence of fine lines and wrinkles. These small, shallow wrinkles tend to be seen at the outer corners of the eyes. They are also known as laugh lines or crow’s feet. The fine lines can also be located on the cheeks. On the forehead, wrinkles are perceived as horizontal lines, and may be triggered by facial expression and tend to be deeper in the course of time. The vertical lines, smaller in size, between the eyebrows are caused by the puckering of the same.

The deepest wrinkles that form between the nose and the mouth are called nasolabial folds. They are related to the sagging of the skin and are often associated with a loss of volume.

Loss of volume

Sometimes difficult to identify, the volume loss is also sometimes known as sagging skin, loss of contour, turkey neck, goose bumps or “contracted appearance”. Unlike the loss of density or wrinkles, changes the general appearance of the face in a transformative way but difficult to identify accurately, can give the face a negative, sad or fatigued. This can, in turn, lead to incorrect perceptions of a person’s mood or image.

Loss of density

More common in women of postmenopausal age, the loss of density manifests itself in the surface in the form of thinner and weaker skin; It affects the whole face instead of settling in certain areas.

It is often associated with deeper wrinkles and appears along with a decrease in luminosity and a tendency for more subdued skin.

One of the signs of volume loss is the sagging of the face, which results in areas of loose skin.

When the cutaneous structure is deteriorated, a loss of density manifests itself. This situation often appears next to darker-looking skin, which is perceived to be thinner.

Aging affects every layer of the skin

The signs of aging manifest themselves on the surface of the layers of the skin:

Epidermal layers:

A slower cell renewal and a decrease in lipid production on the surface of the skin represent a greater likelihood of roughness and dryness. As this particular layer of the skin ages, it becomes more sensitive to UV light. When the epidermis is altered, fine wrinkles, spots or irregularities of pigmentation and slight flaccidity appear.

Dermal layers

After 25 years of age, there is an annual reduction of 1% of collagen, one of the “building bricks” of the skin, together with a decline in elastin, leading to disorganization of the skin tissue. The structure of the skin deteriorates and is more likely the appearance of wrinkles, and a reduction in blood circulation that leads to a decrease in the pinkish glow of the young skin.

The loss of collagen and elastin causes deeper wrinkles and greater flabbiness, as well as dull skin and lack of shine and elasticity.

Subdermal layers

There is a decrease in the fatty layer, which exerts an impact on the loss of volume and can in turn lead to the formation of deep wrinkles  hollow cheeks, sagging of the facial tissues of the middle third of the face and neck, loss of volume of the cheekbones and obvious appearance of facial aging.


Internal causes of aging

Our biological age determines the structural changes in the skin and the efficiency of cellular functions. These functions decline as the years go by.

Genetics plays a key role in the way the skin ages. The race and the type of skin with which we are born make a difference in the rapid appearance of the signs of aging on the skin surface. For example, a clear sensitive skin is prone to wrinkles at an early age, while Asian skin may be prone to uneven skin tone and wrinkles appear at a later age. The age-induced dryness can also be caused by the specific genetic character of a person.

In young skin, the strong relationships between the layers translates into an efficient supply of moisture and nutrients to the most visible layers.

Over time these relationships and systems decline, becoming less efficient. The result is a visibly aged skin.

External causes of aging

The external factors that affect the speed of skin aging are all due to a single process, oxidative stress. It is the release of molecules called free radicals, or reactive oxygen species, in the body. The theory of aging based on free radicals asserts that we are aging due to the accumulation of damage caused by free radicals over time. A free radical is a very volatile atom or molecule, consisting of a single unpaired electron in an outer layer. Most have a great capacity to damage all cellular structures including lipids and proteins.

Oxidative stress is accelerated and triggered by various factors related to lifestyle.


Exposure to sunlight is the main external factor responsible for skin aging due to oxidative stress. Damage to the skin caused by prolonged exposure and daily exposure to UV rays se denomina fotoenvejecimiento, is called photo-aging, which is also responsible for uneven pigmentation .


Leaving the skin exposed to contamination, as usual in cities, can cause the release of damaging free radicals to the skin. In addition, pollution worsens the effects of sun exposure by accelerating oxidative stress.


The chemicals and nicotine contained in cigarettes are responsible for the rapid rise in the amount of free radicals present in the skin.


Antioxidants are molecules endowed with the ability to neutralize free radicals that damage the skin and accelerate its aging.

The ingestion of large quantities of fruits and vegetables (carrots, blueberry apricots, green leafy vegetables, sweet peppers, tomatoes, beans and other legumes and fish, especially salmon, and nuts) rich in antioxidants can become a fundamental tool in the natural approach to the prevention of the aging process.

Precarious care

A poorly groomed skin will age more quickly. A key piece of prevention is the use of effective sun protection in case of exposure to sunlight.


Smoking significantly accelerates aging, reducing elasticity and resulting in a dull skin tone. The abandonment of smoking will contribute to improving the appearance of the skin by excluding the chemicals and nicotine present in cigarettes.


Depending on the case, a type of combination of treatments is recommended, approaching the problem from all angles.

In other sections we have exposed the peels or treatments of the surface of the skin (epidermis), the Dermapen (micropuncture system), with or without the use of plasma rich in platelet factor, the use of botox for expression wrinkles, Accent treatment of flaccidity, and now we will treat fillers.


These are products manufactured specifically to fill the irregularities produced in the fabrics, both superficial and deep.


Hyaluronic acid is a substance that is found in many tissues and organs of our body as in the connective tissue that supports the spine, in the cartilage, in the synovial fluid of the joints or in our epidermis.

With the test of time, the presence of this substance decreases markedly, which produces, among other reasons, the aging of the skin and, with it, the appearance of wrinkles, flaccidity or loss of firmness. It is estimated that at age 50 we have only 50% of what we had at 20 years.

One of the main properties of hyaluronic acid is its great capacity to attract and retain water. Its use in cosmetic treatments for topical application, allows the epidermis of the treated area to be deeply rehydrated so that its appearance is smoother and, as its thickness and volume increase, the furrows of the skin also decrease.

In aesthetic medicine, the areas where it is most used are:

  • Contour and corners of the lips.
  • Contour and corners of the lips.
  • Lip or perioral wrinkles (around the mouth).
  • Nasogenian grooves (lines of expression that go from both sides of the nose to the mouth).
  • External periocular wrinkles (crow’s feet).
  • Frown.
  • Eye bags.
  • Filling of asymmetries and irregularities.


  • It retains a lot of water, so it spreads a lot when placed.
  • It acts as a deposit, reabsorbing and. Its approximate duration is 12 months, although it may vary slightly.
  • Affordable price.
  • It is an absorbable, biocompatible, pyrogen-free, transparent product, and there is the possibility of dissolving it if any problem occurs, through the enzyme hyaluronidase.


It is a new treatment based on hyaluronic acid placed in 5 strategic points to obtain an immediate tensor effect.

Facial bioremodeling in 5 minutes, The TREATMENT cconsists of a technique called “BAP” Bio Aesthetic Points, that consists in 5 personalized and strategic points per face side reducing to a minimum the risks and maximizing product diffusion in the malar and submalar areas. It is a preparation of natural hyaluronic acid that is distributed in 5 anatomically receptive areas of the face where there is absence of large blood vessels and nerve branches.

How does the treatment work? There are 2 sessions of one month interval followed by a maintenance at two months according to the level of aging so that it can be a prolonged treatment for a longer time.


It is a substance for an absorbable implant and is composed of synthetic hydroxyapatite calcium microparticles (CaHA) suspended in a carrier gel.

The  facial filling treatment with Radiesse® or calcium hydroxyapatite is an aesthetic treatment of very innovative in the world of facial aesthetic medicine; It is a soft injectable implant, safe, simple and immediately effective.

The texture, which is like a cream, stays soft, feels natural and remains in place for many months or years. Since Radiesse®  or calcium hydroxyapatite is a biocompatible product, it is not necessary to wait for results of allergy tests, and since it is biodegradable, it adapts perfectly to the aesthetic needs.

It is used mainly in the following cases:

  • Nose correction without surgery.
  • Correction of marionette lines in the mandibular ridge.
  • Achieve a young and healthy appearance of the cheeks.
  • Correction of folds in the corners of the mouth.
  • Increase in volume of the cheekbones.
  • Correction of folds in nasolabial folds.

Calcium hydroxyapatite is a durable but not permanent product. Its duration ranges between 18 and 24 months, making it a first choice product.

It is an ideal product to rejuvenate the hands, providing excellent immediate results in a single session.


Main advantages


  • Collagen injected fills in the space of lost collagen and binds to degraded collagen.
  • With time, it will be degraded and absorbed by the organism itself.
  • Sunmax I-Plus is a tissue filler based on type I highly purified Atelocolágeno porcine dermis (being the collagen more similar to that of humans) natural and cross-linked use as a filling in facial contour defects, unwanted wrinkles, etc. produced by the aging of the dermis and other external factors.
  • Thanks to its innovative SPF purification system, a pathogen-free product is obtained, so it is not necessary to carry out a preliminary implantation test, avoiding, in turn, all kinds of allergies, incompatibilities and unwanted side effects. It is a safe product and without risks.
  • The treatment lasts very little time, generally between 15 and 30 minutes and immediate results are obtained.
  • Thanks to its composition, the syringe with which the product is applied is thinner, so the pain is less.
  • By not requiring surgery or anesthesia, we can return home immediately after treatment and continue with our daily routine.
  • Compared with other dermal fillers, inflammation of the injected area is minimal.
  • The recovery period is minimal or null and by its cross-linking results are visible up to 12 months. No need to make subsequent retouching.
  • We use it preferably in very superficial fillings, such as crow’s feet.
  • The Sunmax I-Plus Collagen Implant is used as a filler for facial contour defects and unwanted wrinkles, caused by aging and loss of collagen in our skin. With its application it minimizes the defects and signs of aging that worry us so much, providing a younger appearance and renewing the vitality of our body in a period of up to 12 months.
  • FILLING: Unwanted wrinkles in front, crow’s feet, dark circles, nose, nasolabial wrinkles, smile line, corners.
  • CORRECTION: Scars, acne, depressions, holes in the face, …
  • INCREASE AND PROFILED: More attractive lips.
  • DEFINITION: Cheeks, chin, …
  • We use it preferably in filling fine wrinkles such as crow’s feet, in the treatment of dark circles and in perioral wrinkles and lip contour.



They infiltrate through a microcannula to avoid injury to vessels and nerve endings, so there is virtually no subsequent discomfort.

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