Loss of volume and enhancement of dermal (surface skin), subcutaneous (beneath the first layer of the skin) and muscular deficiencies can be treated with soft tissue augmentation—a synthetic or biological product or surgical restructuring.

While often used to improve photoaging and chronological aging, these techniques are also helpful in treating loss of volume from trauma, surgical defects and lipoatrophic conditions (those where there is some loss of adipose or fat tissue as in some metabolic diseases and HIV.

During the procedure

Before the procedure, an individual arranges an appointment with a plastic surgeon. The individual discusses cosmetic concerns with the doctor, and the doctor discusses treatment options. Based on the patient's skin and the area where the procedure will be performed, the doctor and patient choose the type and brand of filler that will be injected into the skin. If soft tissue injections are decided upon as a treatment, then the patient makes an appointment for the actual procedure.

Soft tissue injections are usually performed at a doctor's office. However, if the soft tissue procedure is combined with a more surgically invasive procedure, such as a facelift, the patient may have the injections performed at a hospital.

Collagen injections

Some patients are allergic to the collagen used in soft tissue injections. In order to screen for this allergy, the doctor injects the patient with a very small amount of collagen three to four weeks prior to the scheduled procedure. Patients who experience an allergic reaction are not able to have all of the desired areas of their body treated with the soft tissue injections.

The collagen used in soft tissue injections is available in several different brands. A painkiller called lidocaine is usually mixed into the collagen. However, some doctors also apply a painkiller to the surface of the skin as well. The doctor injects the collagen into several places along the undesired wrinkles or lines. The patient may feel some stinging or burning around the area. The doctor may put a pre-determined amount of collagen into each area; however, in some cases, the patient holds a hand mirror and tells the doctor when to stop injecting collagen. Some individuals have swelling, itching or reddening at the injection site for up to a week after the procedure.

Fat injections

This type of soft tissue injection takes fat from one part of the body and transfers small amounts of it underneath the facial skin. Typically, this fat is taken from the thighs, buttocks or stomach; this is called the donor site. The fat is removed using a very large needle attached to a liposuction machine. The fat from the donor site is then cleaned of impurities and injected into the face using a much smaller needle. The area receiving the fat that came from the donor site is called the recipient site. Both of these sites are numbed before the procedure begins.

If a patient chooses sedative drugs to feel drowsy during the procedure, then they are required to arrange for a friend or family member to return them home after the procedure. The doctor typically injects more fat than what may seem necessary into the face because the body slowly absorbs its own fat after the procedure. Some swelling, redness and bruising is common at either or both the donor and injection sites.

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