I began using hyaluronic acid during my first year of specialization in plastic surgery, during almost pioneering times. It was the year 2000 and the first “victims” who underwent, reluctantly, my first attempts at implant were my mother and some of her stoic friends, allowing themselves to be entrapped by the mirage of smoother skin.
Hard materials that didn’t last long and needles of considerable caliber were the best the market had to offer but were nevertheless able to titillate the curiosity of those of us in the field.
Learning was left to the advice of imprudent suppliers and the timid recommendations of colleagues who were starting to venture into fillers, as I was.
Collagen was still the rage. This was the true worthy forefather and archetype of fillers with outstanding visco-elastic characteristics. although potentially allergenic (thus requiring a prick test on every single patient intending to undergo treatment).
In the meantime the popularity our favorite was growing, rising to first place in sales, but gradually and without leaping.
Today the market has decreed hyaluronic acid as the only and uncontested winner, leaving behind competitors such as silicone, methacrylate, polyacrylamide and any other foreign molecule to our organism.
Why did it win? Because it is simply a sugar. Because it is recognized as a self molecule (from our body). Because it lets us sleep soundly as far as safety is concerned and because with the new microcannulas we can reach goals that up to a few years ago were unthinkable for esthetic medicine.
With the pages that follow I intend to explain EVERYTHING that I have learned in these last fifteen years of practice through errors, technical stumbling, small intuitions, and some epiphanies, without any reservations.
The best surgeons I have had the pleasure and honor to meet during my specialization training in 5 countries were cordial and humble people who did not hesitate to openly explain, without reservations, their techniques and little tricks that make the difference in day-to-day work.
I will try to do the same.
Dr. Filippo Brighetti
Chapter 1. What Is H.A.
Chapter 2. Hyaluronic Acid (H.A.) As A Filler
Chapter 3. Materials
Chapter 4. Implant Techniques
Chapter 5. Notions Of Facial Anatomy
Chapter 6. Aging Of The Face
Chapter 7. Anesthesia
Chapter 8. Analysis And Treatment Of The Individual Areas Of The Face
Chapter 9. Consultation, Preparation, Timing And Post-Treatment
Chapter 10. The Main Complications And How To Deal With