Injectables
Hyaluronic acid fillers
Targeted injection of hyaluronic acid to smooth lines, for naturally accentuated lips and gentle volume restoration – individually tailored and carried out by a physician.
Treatable areas
- Lips
- Nasolabial folds
- Tear trough
- Jawline contouring
- Cheek augmentation
- Chin correction
- Marionette lines
- Nose correction
- Vertical lip lines
- Décolleté lines
- Backs of the hands
Hyaluronic acid is a building block that occurs naturally in our skin, where it binds moisture and gives the tissue firmness. With increasing age, its content declines – the skin loses elasticity, lines and loss of contour become visible. Modern hyaluronic acid fillers compensate for this selectively: the gel-like preparation is introduced into the skin with fine needles or blunt cannulas and is, over time, completely broken down again by the body.
Classic uses are nasolabial folds and marionette lines, the lips (contour and subtle volume) as well as volume restoration at the cheeks and jawline. In liquid lifting, several areas are injected in coordination with one another to achieve a harmonious overall appearance – without surgery.
All information is provided for general guidance and does not replace personal medical advice. Treatment results can vary from one individual to another.
Indications
Who it is suitable for
Whether a treatment makes medical sense in your case is something we determine together in a personal consultation. Typical concerns include:
- Nasolabial folds (lines between the nose and the corners of the mouth)
- Marionette lines (lines from the corners of the mouth towards the chin)
- Lips: loss of contour, asymmetries or a wish for subtle volume
- Loss of volume at the cheeks, sunken facial areas
- A poorly defined jawline or a receding chin
- Under-eye circles / tear trough: softening of shadows and volume loss in the lower lid area
- Non-surgical nose correction: balancing out of small irregularities or asymmetries of the nose
- Fine lines of the upper lip (so-called smoker's or crinkle lines)
- Fine lines on the décolleté
- Loss of volume on the backs of the hands
- First signs of skin ageing that are to be treated without surgery
- Liquid lifting: harmonious refreshment of several facial areas as an overall concept
Step by step
How the treatment works
This is how the treatment usually proceeds with us – from the first consultation through to aftercare.
Consultation and analysis
We discuss your wishes, analyse your facial anatomy, check for possible contraindications and explain which result is realistically achievable. You receive detailed information about the procedure, effect, risks and costs.
Preparation and anaesthesia
The skin is cleansed and disinfected. On request, we apply an anaesthetic cream (about 20 to 30 minutes to take effect); many preparations also contain a local anaesthetic, so that the treatment is usually well tolerated.
Injection
The hyaluronic acid is introduced precisely into the previously determined areas with fine needles or blunt cannulas – depending on the region, using different injection techniques and depths. We continuously check the result in the mirror, together with you.
Final assessment
Immediately afterwards we assess the result, even out small irregularities and cool the treated areas in order to prevent swelling. You receive specific advice for the first few days as well as the offer of a follow-up appointment.
Transparency
Prices
- Liquid Lifting (6 ml)
- 1.200 €
- Lippen (1 ml)
- 400 €
- Jawline (3 ml)
- 600 €
- Nasenkorrektur
- 450 €
- Kinnkorrektur
- 400 €
All prices are guide values for initial orientation. Medical services are billed according to the German scale of fees for physicians (GOÄ); the final amount depends on the individual effort involved and is discussed transparently with you before treatment. For treatments without a listed price, we are happy to give you a guide value during your consultation.
Patient information
Safety & patient information
Responsible treatment includes open information about possible risks and side effects – even when they occur only rarely.
Swelling, redness and a feeling of pressure
Very common and usually harmless: at the injection points, slight swelling, redness or a feeling of tension and pressure often occurs shortly after the treatment. This usually subsides on its own within a few hours to days and can be soothed by cooling.
Bruises (haematomas)
The prick can injure a small blood vessel, so that a bruise forms. Haematomas are common, harmless and usually disappear within a few days; they can generally be covered well with make-up. Blood-thinning medications or certain dietary supplements can increase this tendency.
Pressure pain and sensitivity to touch
In the first few days, the treated areas can be sensitive to touch or hurt slightly, particularly at the lips. These complaints usually subside quickly.
Asymmetries and irregularities
The result may initially appear slightly uneven, for example through a different tendency to swelling on the two sides. This often balances out in the following days; persistent small asymmetries can usually be selectively corrected at a follow-up appointment – an advantage of the readily controllable hyaluronic acid.
Palpable or visible nodules
Occasionally, small hardenings or nodules can form at the injection site, for example with a superficial placement or an accumulation of material. Many are temporary and can be treated with massage, patience or – if necessary – dissolving with hyaluronidase.
Tyndall effect (bluish discolouration)
If hyaluronic acid is introduced too superficially, for example under thin skin as in the area of the tear trough, the gel can shine through with a bluish tinge. This so-called Tyndall effect is not dangerous, but can usually be remedied by selectively dissolving the material.
Infections and inflammatory reactions
As with any injection, despite sterile working, germs can enter and trigger a local infection (increasing redness, warmth, pain or the formation of pus). Such reactions are rare, but must be treated by a physician; at signs of an infection, please contact us immediately.
Allergic reactions
True allergic reactions to modern hyaluronic acid preparations are rare, as the material is similar to the body's own substance. Reactions to accompanying substances, such as the anaesthetics contained, are possible. Very rarely, a pronounced allergic reaction can occur that requires prompt medical care.
Late reactions, delayed nodules and biofilm
Weeks to months after the treatment, delayed inflammatory reactions or nodules can – rarely – occur, sometimes triggered by infections or a so-called biofilm (an accumulation of microorganisms on the material). Such late reactions require a medical assessment and are treated, depending on the findings, with medication and/or dissolving of the filler.
Vascular complications (vascular occlusion, embolism)
The most serious, though very rare, complication is the accidental injection of material into a blood vessel or pressure on a vessel, whereby the blood supply is disturbed (vascular occlusion). The consequence can be paleness of the skin, severe pain and – if untreated – the death of tissue (necrosis). In very rare individual cases, the medical literature describes visual disturbances up to and including blindness when material enters vessels that supply the eye. Sound anatomical knowledge, suitable injection techniques and the immediately available emergency medication hyaluronidase, with which hyaluronic acid can be quickly dissolved, are the central measures to minimise this risk. In the case of sudden severe pain, skin discolouration or changes in vision, medical help is required immediately.
When we do not treat
In certain situations we do not carry out a treatment, or only at a later time – for your safety.
- Pregnancy and breastfeeding – in the absence of sufficient safety data, we refrain from treatment during this time.
- Acute infections, inflammation or open skin areas in the treatment area (e.g. an active cold sore); the treatment is postponed until these have fully subsided.
- Known allergy or intolerance to hyaluronic acid or accompanying substances contained, such as local anaesthetics.
- Active autoimmune or chronic inflammatory diseases that may speak against an injection – here an individual medical assessment is required.
- Known coagulation disorders or therapy with blood-thinning medication; a treatment is carried out only after medical consultation and careful weighing of benefit and risk.
- A tendency to excessive scar formation (keloids) in the planned treatment area.
- Previous pronounced or delayed reactions to fillers in the medical history.
- Permanent fillers or unknown foreign materials in the planned area – these require particularly careful clarification, as we deliberately do not use permanent fillers.
- Unrealistic expectations or a wish for treatment for which, from a medical point of view, there is no sensible indication.
This information does not replace a personal medical consultation. Before every treatment we inform you individually about the procedure, risks and alternatives.
In depth
Medical details & background
How it works & the evidence
Hyaluronic acid (also hyaluronan) is a sugar molecule produced by the body (a so-called glycosaminoglycan) that occurs in the skin, the connective tissue and the joint fluid. It can bind large amounts of water – one gram can store many times its own weight in moisture – and thereby provides volume, firmness and well-hydrated tissue. With increasing age, the body's own content declines, the tissue loses moisture and supporting strength, and lines as well as volume deficits become more visible.
In fillers, a distinction is made between non-cross-linked and cross-linked hyaluronic acid: non-cross-linked acts above all through moisture binding and is broken down quickly (the skinbooster principle); for line injection and volume restoration, more stable cross-linked gels are predominantly used, which withstand enzymatic breakdown for longer. The mechanism of action rests on two pillars – the immediate gel volume and the water binding in the tissue. Through injection depth, technique (fine needle or blunt cannula), cross-linking and concentration, the gel can be adapted to the skin layer, area and desired effect.
A modern, zone-oriented approach (known in the professional field as, among other things, the MD Codes concept) views the face in connected anatomical zones and uses defined injection points for a harmonious overall appearance rather than filling in individual lines in isolation – this requires a sound knowledge of facial anatomy, in particular the course of blood vessels and nerves. A key safety aspect is degradability: the material is gradually and completely broken down by the body's own enzymes (the hyaluronidases) and can be selectively corrected with medically administered hyaluronidase if needed, or quickly dissolved in the event of a complication. This fundamentally distinguishes hyaluronic acid from permanent fillers, which we deliberately do not use.
Hyaluronic acid fillers are among the most frequently used agents in aesthetic medicine worldwide and have been established for many years. Controlled studies and systematic reviews describe them, when used appropriately, as predominantly well tolerated and as effective for the correction of lines, contours and volume deficits. Serious complications are regarded in the specialist literature as rare, but are documented and are a central subject of the medical information given to patients.
The significance of the evidence has its limits: many studies have a limited observation period, examine individual preparations or areas and are not infrequently manufacturer-funded; results on effectiveness and durability cannot therefore be transferred to every product, every technique and every person. Reliable figures on very rare but serious events such as vascular occlusions stem predominantly from case reports and registers, not from large randomised studies. Hyaluronic acid fillers are thus an established, well-studied procedure with a favourable safety profile – guaranteed results or complete freedom from risk cannot, however, be derived from this. We are guided by the recommendations of medical specialist societies and by the prescribing information of the preparations used.
Preparing for your treatment
A few simple measures before your appointment help you contribute to the best possible result with as few complications as possible.
- Where possible, refrain from intensive sunbathing and tanning beds in the days before the treatment; freshly tanned or irritated skin should settle beforehand.
- Please do not stop blood-thinning medications or anticoagulant painkillers (e.g. from the group of non-steroidal anti-inflammatory drugs) on your own initiative – discuss their use in advance with us and your treating physician, in order to assess the tendency to bruising.
- Certain dietary supplements and herbal preparations (such as fish oil, vitamin E, ginkgo) as well as alcohol can increase the tendency to bruising; a time interval can be sensible.
- Inform us about your medical history, allergies, previous aesthetic treatments as well as any tendency to cold sores – with a known tendency to herpes, preventive medication can be sensible.
- Allow a buffer of about two weeks before important social occasions or trips, as swelling or bruises can be visible for a few days.
- Come, if possible, without make-up in the area to be treated, or expect a cleansing of the skin before the treatment.
Aftercare
The right care after treatment supports healing and the result. You will receive individual recommendations from us – as a rule:
- Cool the treated areas carefully in the first few hours and without strong pressure, in order to counteract swelling and bruising.
- Avoid massaging, touching firmly or sleeping on the treated areas in the first few days, so that the material can settle evenly.
- For about 24 to 48 hours, refrain from intensive exercise, sauna, steam bath, tanning beds and very hot baths, as heat and increased blood circulation can intensify swelling.
- Protect the skin consistently from UV radiation, use a high sun protection factor (SPF 50+) and avoid direct, intense sun exposure.
- On the day of treatment, refrain if possible from alcohol and blood-thinning substances, as these can promote bruising.
- Care for the skin gently in the first few days and refrain from irritating cosmetics, peels or microneedling in the treated area.
- Contact us immediately if unusual complaints occur – in particular severe or increasing pain, a conspicuous paleness or discolouration of the skin, increasing swelling with warmth, or changes in vision.
- Attend the offered follow-up appointment after about two weeks; once the material has fully settled, the result can be selectively refined if needed.
FAQ
Frequently asked questions
Answers to questions we are asked particularly often about “Hyaluronic acid fillers”.
Sources & guidelines
- AWMF guideline register – register of the scientifically based guidelines of the medical specialist societies (www.awmf.org).
- German Dermatological Society (DDG) – specialist society for dermatology with recommendations and patient information.
- Prescribing information of the medical devices used as well as assessments by the competent European authorities (including the EMA) on tolerability and use.
- Publications of medical specialist societies of aesthetic medicine on injection technique, complication management and the use of hyaluronidase.
Personal consultation
Arrange a personal consultation
In a confidential conversation on our practice floor at the Albertus Zentrum in Mönchengladbach, we take time for your questions and assess whether the treatment may be suitable for you.
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