The treatment of facial wrinkles is one of the most popular medical aesthetic treatments in recent years. Of all the molecules available, hyaluronic acid is certainly the most widely used and offers the greatest safety guarantees. Bio revitalization using polyvitamin cocktails has always been associated with this treatment.

Bio-Nutri-Lift or Shape or Lip combines the two treatments into a single, synergistic treatment with a lower cost and significantly greater benefits. See what is used:

What is hyaluronic acid?

It is a natural mucopolysaccharide in the body formed by glucuronic acid and N-acetylglucosamine. The connective tissue of the skin consists of 63% water, 32% collagen and 1% hyaluronic acid.
Hyaluronic acid is represented in different ways in the body: for example, it is highly concentrated in the vitreous humor, umbilical cord, and joints, where it also allows good mobility of bone heads.
It is an amorphous, water-soluble substance and has among its most important functions, that of retaining water, giving the skin tissue that plasticity and turgidity so typical of young creatures: think, for example, of the skin of an infant!
It also regulates hydration and turgor in the dermis, determining its three-dimensional scaffolding.
Hyaluronic acid is used, in addition to cosmetic medicine, in orthopedics for intraarticular injections to restore viscoelasticity of joint fluid, (by virtue also of its antiphlogistic and analgesic action), in dermatology, in the treatment of some dermatitis, and in urology for the treatment of interstitial cystitis.

How can wrinkles be filled in?

It involves depositing via a cannula the gel in the decided districts, normally malar area and mandibular border with the cheeks, or where volume is lacking: for example, to restore shape to cheekbones, or volume to lips that are too thin or worn out by time.
The injection is made with a very thin cannula into the deep dermis and subcutis. Experience is crucial in this step, but most of all the wisdom of the operator.
Exaggerated lips or overly pronounced and false cheekbones are often requested by unwary patients, but other times found at the end of the treatment without the necessary consent and awareness of the patient.
I personally tend not to treat patients who want exaggerated results, and I must admit that I have often lost patients whom I see again deformed by poorly conducted injections.
Both operator and patient must have a certain artistic sense to achieve good results.

Is the treatment painful?

The patient should come to the office at least half an hour before the treatment: an anesthetic cream based on lidocaine or prilocaine is applied, which takes away the pain almost completely.
In some areas, this anesthesia is almost total, while in other areas such as the lips it may not be totally sufficient.
In addition, the effectiveness of anesthesia is dependent on the individual pain threshold. In almost all of my patients, however, I do not perform any anesthesia. The treatment is not painful because a blunt cannula and no needles are used.

The Bio-Nutri-Lift or Shape or Lip: what is it all about?

Aside from hyaluronic acids imported from outside Europe, mostly countries in the Far East, which in my opinion are not totally safe, what we are talking about in this article is the new range of Fillmed (the old Filorga) fillers called ART FILLER, very high quality proven by serious and published scientific studies. Of the Art Filler range there are several references:

Nowadays there are then fillers that can be cross-linked so that they can last longer. Also having the addition of biointeractive hyaluronic ac.ac, the injectability has improved exponentially and it is therefore possible to use needles of a thinness unthinkable only a few years ago.
The duration varies according to the substance and the amount injected, and therefore, approximately from 12-18 months of the fine line to about 18 months of the Volume.
The injection technique involves the use of a blunt cannula with which one injects both the revitalizing agent, normally NCTF HA and immediately after the filler. This avoids the formation of hematomas and distributes the product in a highly distributed manner.

In particular, on the cheeks, this new type of technique called Bio-Nutri-Lift by Fillmed is very useful. The effects are twofold:

• a regenerant that thus allows the formation of new collagen and elastin with a thus healing function.
• A filler typical of any filler.

This dual action allows for significantly longer lasting results quantifiable approximately around a year, but in many cases even longer, as I said up to 18 months according to scientific studies.
In addition, we still have on the market fillers consisting of cross-linked hyaluronic acid with the addition of hydroxy-propyl-methyl-cellulose, cross-linked dextane and lactic acid.
I remain of the opinion that it is better to spend a little more but be sure that a great quality acid is used.

Biorevitalization using polyvitamins: NCTF HA

There are some products, called bio-revitalizers, that serve less as fillers but are intended to revitalize tissues. They are used alone and in combination with other substances and injected locally into the face, neck, décolletage and hands, the areas most prone to aging.
The product I normally use is NCTF HA, a cocktail of number active ingredients that are very useful in preventing aging: vitamins, amino acids, minerals, but also revitalizing hyaluronic acid.
It is a hyaluronic acid identical to that found in tissues, which, once infiltrated intradermally, makes it possible to recreate an ideal physiological environment, to stimulate cell function, stimulate fibroblasts, and replicate the conditions one has when one is young.
These hyaluronic acids are very useful, for example, in treating the neck and décolleté, but also effective in treating the knees and arms.

Advantages and disadvantages

Benefits	Disadvantages
Very safe material, fully resorbable	Reabsorbable yet revitalizing
Immediate result	Rare swelling in the days following injection
Outpatient, with or without local anesthesia
No allergy test required
It can be touched up smoothly whenever you want

What can we treat with the Bio-Nutri-Lift technique?

This technique is very useful in volume filling, so in all cases where we need to fill a particular district or in direct filling of wrinkles.

Cheekbones
This is a very important area in facial aesthetics. In fact, the entire zygomatic malar area inexorably tends to slide downward and medially, accentuating the nasogenial groove wrinkle.
By naturally filling the zygomatic area invariably the nasogenial groove improves greatly. Of course, it is of paramount importance not to overdo it by making improbable zygomata.
The injection is very easy, not painful, and should be done very deeply using a large-particle, highly cross-linked hyaluronic acid so that it lasts as long as possible.

Peribuccal area by Bio-Nutri-Lip: barcode wrinkles
This is the area of greatest interest and has always been typical of hyaluronic acid treatment. A very superficial technique using a blunt cannula is used. The result, if the indication is precise, is always very good, but above all very natural. No labiaplasty!

Nose genienal grooves
These are also treated very often and with sometimes really striking results. the result can remain evident for a long time thanks to the revitalizing component, for months but the amount of filler that must absolutely be used must be adequate and usually abundant (even 2-3 vials)

New areas: mandibular border
The mandibular border with marionette wrinkles often tend to become irregular as the tissues tend to slip medially and inferiorly.
With bio nutri lift and bio nutri shape we can greatly attenuate this defect. Botulinum toxin can also give sometimes unhoped-for results in this area, and as I always stress, it is with integrated techniques that great results can be achieved.

There is still no technique that solves all problems!