Facial plast Surg 2012; 28(01): 08-20
DOI: 10.1055/s-0032-1305786
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Injectable Fillers for Volume Replacement in the Aging Face

Timothy M. Greco1, 2, Marcelo B. Antunes1, Seth A. Yellin3
  • 1Division of Facial Plastics and Reconstructive Surgery, Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
  • 2Eastern Cosmetic Surgery Institute, Bala Cynwyd, Pennsylvania
  • 3Division of Facial Plastic Surgery, Emory Healthcare; Emory Facial Center; and Department of Otolaryngology–Head and Neck Surgery, Emory University, Atlanta, Georgia
Further Information

Publication History

Publication Date:
14 March 2012 (online)


In recent years, there has been a better understanding of the aging process. In addition to changes occurring in the skin envelope, significant changes occur in the subcutaneous fat and craniofacial skeleton. This has led to a paradigm shift in the therapeutic approach to facial rejuvenation. Along with soft tissue repositioning, volumizing the aging face has been found to optimize the result and achieve a more natural appearance. Early in the aging process, when there has not been a significant change to the face requiring surgical intervention, fillers alone can provide minimally invasive facial rejuvenation through volumizing. Multiple injectable soft tissue fillers and biostimulators are currently available to provide facial volume such as hyaluronic acid, calcium hydroxylapatite, poly-l-lactic acid, polymethyl methacrylate, and silicone. A discussion of the morphological changes seen in the aging face, the properties of these products, and key technical concepts will be highlighted to permit optimum results when performing facial volumizing of the upper, middle, and lower thirds of the face. These fillers can act as a dress rehearsal for these patients considering structural fat grafting.