Hyaluronic acid is a type of soft tissue filler. Soft tissue fillers are moldable substances that can be injected into the skin to improve fine lines and wrinkles, to augment lips and cheeks, to repair various facial imperfections, to improve scars, and to fill in deep skin furrows. Hyaluronic acid filler treatment provides a more radiant and rejuvenated face with minimal post-treatment “downtime” and maximum safety. What does hyaluronic acid do? As we age, collagen and hyaluronic acid are lost from the dermis, elastin fibers begin to degenerate, and facial fat tissue begins to diminish. These phenomena occur most notably around the eyes, mouth, cheeks, jawline, eyebrows, and face, as well as in the nasal folds, nasolabial folds, laugh lines, the “grooves” of the forehead, and the “hills and valleys” of the lower third of the face. Hyaluronic acid has the unique ability to modify these changes. Hyaluronic acid can be filled into the lips to give them a fuller, more youthful appearance, or into the hollows of the cheeks to change their haggard appearance. How does hyaluronic acid work? Hyaluronic acid is a natural component of human skin and forms the framework of the skin’s cellular living environment. Hyaluronic acid is injected under the skin’s surface to temporarily hold up the skin and smooth it out, thus correcting various deep facial furrows and wrinkles. What happens during and after the treatment? A skin test is required before the first treatment to see if you are allergic to the filler substance; of course there are many new commercially available fillers that do not require a skin test. The doctor will ask about your use of aspirin, warfarin, and alcohol consumption, as these may increase the patient’s tendency to develop bruising and swelling. Patients are asked to clean their face before treatment and may have a topical anesthetic applied. The filler is injected directly into the treatment area by a very fine needle. A biting or stinging sensation may be felt during the injection. Several consecutive treatments may be required in order to fill in and smooth out wrinkles and deep furrows or to fill in depressed scars to the level of the surrounding skin. There may be some temporary swelling, redness or slight bruising at the injection site after the injection. These usually subside quickly. Makeup may be applied after treatment. Are there risks associated with the treatment? There are risks associated with all medical procedures. However, hyaluronic acid is widely considered to be safe and effective. Side effects are minimal, except for allergic reactions to the injectables, and are limited to the injection site. How long will the treatment last? This depends on the type of filler being used, the area being treated and the ability of the patient’s skin to absorb the filler. The effect usually lasts for 6 months. Occasionally, a “touch-up” is needed immediately after treatment.