Facial and lip filler biomaterials: A general cosmetic application review

Facial proportion changes and volume loss are commonly experienced corporeal changes, whether due to the natural process of senescence or as a side effect of systemic illness. Because these physical transformations are inevitably experienced by most people, treatments that assist in the maintenance or restoration of a youthful, yet natural appearance have long been a subject of great interest in the medical field. Thanks to the relative ease and low cost with which they ameliorate certain aspects of the aging process, facial and lip filling treatments have developed into a point of focus in the world of aesthetic medicine. As it currently stands, facial and lip volume enhancement or restoration can be achieved with a multitude of injectable products, including temporary and permanent fillers. With an ever-increasing number of materials at their disposal, providers in the cosmetic industry have many important choices to make when advocating biomaterials to their patients based on desired aesthetic outcomes. This review aims to meticulously discuss different aspects of the most commonly employed biomaterials in the cosmetic facial and lip filler industry today, as well as the particular treatments for which each material is best suited. The specific biomaterials addressed in this review include: collagen (human bioengineered and bovine), hyaluronic acid (HA), poly(L)-lactic acid (PLLA), calcium hydroxyapatite (CaHA), polymethyl methacrylate (PMMA), and autologous fat grafting (AFG). For each biomaterial discussed, the review provides information on how they became commonly used in aesthetic medicine, specific injection techniques, desirable cosmetic medicinal properties, and optimal situational applications for each biomaterial in the setting of elective patient cosmetic augmentation.