Question 1

Injectable treatments for facial lines and volume restoration

Accepted Answer

With long-standing experience, I offer wrinkle and volume treatments using various premium products, including hyaluronic acid (Restylane®, Juvederm®), calcium hydroxylapatite (Radiesse®), and poly-L-lactic acid (Sculptra®).
These substances are suitable for smoothing facial wrinkles by carefully injecting the filler into the skin or deeper tissue layers to support and restore the overlying skin.
Areas commonly treated with fillers include:

Temples
Glabellar (frown) lines
Cheeks and midface
Nasolabial folds
Marionette lines
Lips
Chin
Jawline

Question 2

Which fillers are available for wrinkle treatment?

Accepted Answer

A variety of substances can be used for wrinkle correction and volume restoration:

Hyaluronic acid (HA)

Hyaluronic acid occurs naturally in the human body, for example in the eyes and joints, and is known for its ability to bind water, which explains its excellent volumizing properties.
Modern hyaluronic acid fillers are synthetically produced and not derived from animal sources. They are highly biocompatible, and adverse tissue reactions are infrequent. Hyaluronic acid is gradually and completely broken down by the body over several months.
An important safety advantage of hyaluronic acid fillers is the availability of an antidote (hyaluronidase), which can dissolve injected hyaluronic acid, if necessary. Overall, hyaluronic acid treatments are considered low-risk when performed accurately and with expertise.

Poly-L-Lactic Acid (Sculptra®)

Poly-L-lactic acid works by stimulating the body’s own collagen production. These products are particularly well suited for restoring volume in the cheeks and midface.

Autologous Fat (Fat Grafting)

Autologous fat can be harvested from the abdominal area and injected into various regions of the face. Fat is removed through a small incision (approximately 3 mm) near the navel, processed, and then reinjected.
The advantage of autologous fat is that it consists of the patient’s own tissue, which generally feels soft and natural and can provide long-lasting results. A portion of the injected fat is reabsorbed by the body, while the remaining fat integrates permanently. Because the degree of resorption cannot be predicted precisely, two to three treatment sessions are often required to achieve the desired outcome.

Question 3

Which lines are best treated with which technique?

Accepted Answer

Line and wrinkles result from several factors:

Loss of subcutaneous fat volume
Reduced skin elasticity and skin stretching
Downward displacement of tissues due to gravity
Repetitive muscle activity creating expression lines

Cheeks and cheekbones

Volume loss in the cheeks and zygomatic area can lead to a tired appearance. In these regions, viscous fillers are typically used to restore youthful fullness. Deeper injections along the jawline or in the temples can also provide improved support and skin tension.

Nasolabial Folds

Nasolabial folds result from descent of the cheek soft tissues, while the skin along the fold remains anchored by deep connective tissue structures. Medium-viscosity fillers are usually used to soften these folds and reduce harsh light-shadow contrasts.
Overcorrection should be avoided, as excessive filling may quickly result in an unnatural, over-volumized appearance. Since the aging face often becomes broader in the lower third, lifting and contouring approaches are frequently preferred over adding volume.

Lips and fine lines

With age, lips lose volume and definition, and the red lip becomes less visible. Lower-viscosity fillers are used to preserve the natural softness and mobility of the lips. Fine wrinkles around the mouth or in the lateral eye area may also be treated with thinner fillers when appropriate. I place great emphasis on not over – injecting the lips. Incremental restoration of the normal youthful lip volume may be done incrementally in small steps, so this goes unnoticed by the environment.

Question 4

Which filler is best for me?

Accepted Answer

The choice of filler should always be made after a detailed consultation. Different facial areas—such as the lips, cheeks, or nasolabial folds—often require different products to achieve optimal and natural results.

Question 5

How do I find a properly qualified practitioner?

Accepted Answer

It is essential that injectable treatments are performed by a physician with appropriate specialist training (e.g., ENT, dermatology, maxillofacial surgery, plastic surgery, ophthalmology) and in a licensed medical facility.
The treating physician should have extensive experience and be able to offer alternative treatment options when fillers are not appropriate. All emergency measures must be available, including hyaluronidase and injectable emergency medications. Written informed consent using approved forms should always be provided.
A key quality indicator is knowing exactly who treats you and who will be available for follow-up care if needed. Iti s advised you carefully read the CV and professional training record of your treating doctor, before you commit to the treatment.

Question 6

What Is the treatment process like?

Accepted Answer

During the consultation, I will ask about medical conditions, allergies, and medications you are taking. This information is essential for selecting the appropriate products and tailoring an individualized treatment strategy.
We will then analyze your facial features together and discuss which treatments are reasonable and beneficial.
The procedure itself typically takes about 15 minutes, depending on the extent of treatment. The skin is thoroughly cleansed and disinfected. If desired, a numbing cream can be applied for approximately 15 minutes to reduce injection discomfort.
Injections are performed using very fine needles. After treatment, gentle pressure is applied to minimize the risk of bruising. Makeup can usually be applied after about one hour, and most patients are immediately socially presentable.

Question 7

How long do fillers last?

Accepted Answer

Hyaluronic acid fillers (Juvederm®, Restylane®) typically last 7–12 months, depending on individual factors and treatment area.
Calcium hydroxylapatite (Radiesse®) is also fully absorbed by the body and generally lasts slightly longer than hyaluronic acid.
Poly-L-lactic acid (Sculptra®) stimulates collagen production; results appear gradually and may last up to two years.
Autologous fat is partially reabsorbed within the first three months; the remaining fat integrates permanently. Repeat treatments are usually required.

Question 8

What are the limitations of filler treatments?

Accepted Answer

Wrinkle treatment with fillers is widespread, but accurate analysis and experienced medical guidance are essential. A key limitation is the condition of the overlying skin. If skin laxity is pronounced, the amount of filler required becomes excessive and may lead to an overfilled appearance.
Recognizing when fillers are no longer appropriate is crucial. For example, deep nasolabial folds often result from sagging cheek skin. While fillers may be effective up to around age 40, more advanced skin laxity often requires alternative approaches, such as facelift surgery, to achieve natural results.

Question 9

What is the cost of Filler treatments?

Accepted Answer

Treatment costs start at approximately €275 for lip augmentation with 0.55 ml of hyaluronic acid. Final costs depend on the amount of product required and the specific filler used.

Question 10

Expertise

Accepted Answer

Over 25 years of experience in cosmetic facial treatments using hyaluronic acid
Co-author of the current S1 clinical guidelines on Aesthetic Botulinum Toxin Therapy and Prevention of Complications in Filler Treatments, which is regarded as the most important German-language reference publication for aesthetic injectable treatments

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Treatments / Hyaluronic Acid, Autologous fat & Dermal fillers

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Hyaluronic Acid, Autologous fat & Dermal fillers

Hyaluronic acid (HA)

Poly-L-Lactic Acid (Sculptra®)

Autologous Fat (Fat Grafting)

Cheeks and cheekbones

Nasolabial Folds

Lips and fine lines

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