Our ever-changing and evolving appearance with ageing is a complex and multifactorial process. There are genetic, biological and environmental factors that play a role, all of which result in both volumetric and gravitational changes. In particular the volumetric changes and losses that occur start from within the deep tissues of our facial bones and skeleton and progresses through both the deep and superficial layers of fatty tissue, muscles and supporting ligaments and then ultimately the skin overlying these structures. The gravitational effects of sagging and drooping of withered muscles and atrophied fat pads along with the skin envelope which is no longer supported as well as it was in our youth results in the hollowing and sunken appearances around our face along with deeper folds and furrows of skin and drooping tissue.

Dermal fillers as a group, have been developed to correct these volumetric changes and help support the overlying skin. There are a variety of dermal fillers available now which are either designed to restore this lost volume, stimulate growth of supporting skin elements or both. Of these, the dermal fillers that most closely resemble the sugar moieties of our skin known as glycosaminoglycans are the most abundant and water retentive. Replenishing the lost volume with these sugar compounds has proven to be an effective method of correcting those age related changes.