History of Dermal Filler

In the early 1900s paraffin was used as a treatment for the augmentation of soft tissue. This substance was first injected as treatment for medical conditions such as bladder incontinence, or the formation of prosthetic testicles. From this, treatments progressed and evolved to include augmentation of the face. The use of paraffin for soft tissue augmentation resulted in significant complications such as pulmonary embolism, necrosis, persistent fistulas, breast amputation and fatality. This then led to the discontinuation of the use of paraffin during the time around the first world war.

In 1893 the first fat graft was performed by a physician called Dr Neuber, where fat was removed from the arm and placed into the face to treat scarring. It was in 1912, when photographic record of fat transplantation though the use of a hypodermic needle was presented, which was identified as a live tissue transplant. Through the introduction of the cannula by Miller in 1926, fat grafting became successful in treating facial lipoatrophy.

Silicone was then discovered and utilised as a means of breast and facial augmentation; however facial silicone injections are banned in most countries around the world due to the irreversible complications. Complications associated with this treatment were often more severe than those seen with that of the use of paraffin.

Bovine Collagen was approved for cosmetic injection by the FDA in 1981. This was used for the correction of deep nasolabial folds, depressed acne scarring, lipoatrophy and soft tissue augmentation. Discoverable complications included anaphylaxis, palisading granulomas, and foreign body granulomas.

In 1934, Karl Meyer and John Palmer together discovered and formulated a facial filler substance called glycosaminoglycan disaccharide otherwise known as hyaluronic acid. Hyaluronic acid is a naturally occurring substance found in the body, of which 50 percent is found in the skin. Following natural production, hyaluronic acid is released into extracellular space providing a plumping, volumizing effect. The cross linking of hyaluronic acid improves the impact of volumisation hence its prolific use in cosmetic procedures for facial rejuvenation. Benefits of hyaluronic acid for use in facial rejuvenation includes safety, effectiveness, affordability, reversibility, or the non-permanent nature of the product.