Filler injections first came on the scene towards the end of the 2000s, containing a substance known as hyaluronic acid, a naturally occurring molecule which can be found in the skin tissue. By injecting a high molecular weight hyaluronic acid gel into the dermis, practitioners were able to compensate for volume loss in certain areas of the face. Cross-linking hyaluronic acid both increased viscosity and prolonged the effectiveness of the hyaluronic acid injected into the skin. The injections would be performed using the 'bolus' method. Its objective was to add volume to specific areas of the face. What were the benefits? The effects were immediate, meaning an instant volume lift to the face. ...and the drawbacks? Very pronounced, high cheekbones and a flat lower face, none of which looks natural and what we would nowadays call 'squirrel face'. Scientific advancements eventually meant that the molecular weight of hyaluronic acid and the degree of cross-linking could be altered. Access to a wide range of options allowed dermatologists to select different hyaluronic acids for each area of the face and tailor their approach to each particular facial feature, without compromising how long the effects would last. The arrival of medium molecular weight hyaluronic acid, less viscous than its predecessor, meant that the injection was no longer performed in only one, but several places. The result was a more even and authentic look.
