About Dermal Fillers

Dermal fillers are used in order to restore the balanced fullness of the youthful face, with the first step being the selection of the right product for the area and problem to be treated.

Dr Sotirios Foutsizoglou is considered to be an authority in non-permanent facial and body implants. He has treated more than 3,000 people in UK and Europe with outstanding results. Dr Sotitrios Foutsizoglou is also involved in teaching young doctors and dentists the various dermal filler injection techniques. Treatment with dermal fillers is a highly skilled procedure requiring knowledge of the anatomy of the skin and underlying tissues for optimal aesthetic enhancement in a safe and natural way.

Anatomy of the skin

The skin consists of two layers, the epidermis and dermis. The major cell types of epidermis and dermis are the keratinocyte and fibroblast respectively.

  • Keratinocytes synthesize keratin, a protein whose structural matrix provides skin with a robust and waterproofing barrier. Keratin is also the key structural component of hair and nails. Keratinocytes also produce cytokines in response to injury.
  • Fibroblasts synthesize collagen and elastin fibres. Collagen and elastin production is gradually diminishing as part of the ageing process.

The epidermis is divided in five layers:

  • Basal cell layer (Stratum Basale)
    • Keratinocytes originate from this layer.
    • Melanocytes (responsible for skin colouring) are also present in this layer making up 5-10% of the cell population.
  • Spinous or prickle cell layer (Stratum Spinosum)
    • Langerhans cell can be found in this layer providing an antiviral defense mechanism, destroying incoming viruses.
  • Granular cell layer (Stratum Granulosum)
    • Ketatinocytes in this layer contain intracellular granules of keratohyalin. This protein makes the outermost layer of the skin (i.e. horny layer) impermeable providing thus protection from the environment and a robust waterproofing barrier.
  • Stratum Lucidum
    • Only present in the skin of palms and soles.
    • Contains transitional cells.
  • Horny layer (Stratum Corneum)
    • Outermost layer of the skin.
    • In direct contact with the environment.
    • Consists of corneocytes. That is keratinocytes that have shed their nucleus during their migrating process from the granular cell layer.
    • The time from cell division to shedding from the horny layer is about 28 days under normal circumstances.

The dermis is a tough, resilient layer that protects the body against mechanical injury and contains specialised structures. It is divided in two layers:

  • Papillary dermis
    • Thin upper layer of the dermis
  • Reticular dermis
    • Composed of thick, densely packed collagen fibres, and is the primary location of dermal elastic fibres

Dermis also contains ground substance, a shapeless, gel-like, primarily composed of glycosaminoglycans (most notably Hyaluronic Acid), proteoglycans, and glycoproteins.

Hyaluronic Acid (HA) has important structural and hydrating functions, and is responsible for the fullness and firmness of skin. Though abundant at very young age, HA production decreases over time leading to characteristic signs of ageing:

  • Wrinkling
  • Loss of volume
  • Decreased elasticity
  • Fatigued and dull-looking skin

Dermal Fillers

Biodegradable dermal fillers can be injected below the skin’s surface through a fine needle. A local anaesthetic in the form of a cream is usually used prior to the treatment in order to make the injection process much more comfortable. No allergy testing is needed before treatment as SFMedica’s policy is to use only non-animal products which combine enduring quality and safety.

Dermal filler injections are used to

  • fill lines by replenishing the age-related loss of hyaluronic acid
  • stimulate the production of the body’s own collagen
  • rehydrate the skin tissue (e.g. face, neck, décolletage and hands)
  • restore lost volume and bring back a fuller, smoother and healthier appearance
  • rejuvenate skin
  • reshape lips, cheeks, and chin
  • improve overall skin quality which makes dermal fillers a fantastic treatment for all ages, even for those not yet experiencing the full-blown effects of ageing skin
  • improve the structure, firmness and elasticity of the skin
  • smooth scars (e.g. acne, trauma)

Venus M., Waterman J. and McNab I. Basic physiology of the skin. Surgery. Volume 28:10. Medicine Publishing, October 2010.


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