Hyaluronic Acid and Facial Volume

Hyaluronic acid occurs naturally in the body, particularly in the skin and connective tissue, where it helps maintain hydration and elasticity. In aesthetic medicine, a gel formulation is injected to restore volume, define contours or soften selected folds.

Gels differ in consistency and elasticity: some are softer and suited to delicate areas, others firmer, for supporting deeper structures. The product is gradually absorbed, so the effect is temporary. At Detalii Med in Baia Mare, treatment is carried out by Dr Marius Pruna and Dr Valeria Pruna, plastic surgeons.

It may suit patients seeking a subtle correction of the lips, cheeks, nasolabial folds, jawline or another area identified during consultation.

It is usually aimed at adults who notice age-related volume loss, a mild asymmetry or a less defined contour, and who prefer a non-surgical option.

Depending on the case, treatment is postponed or not recommended during pregnancy and breastfeeding, where there is infection or inflammation in the treatment area, in people with a known allergy to the product’s components, and in certain autoimmune or clotting disorders, which are assessed individually.

It can improve proportion and compensate for volume loss. It cannot stop ageing, replace a surgical lift or guarantee a shape copied from a photograph.

• It can: restore volume to the cheeks, temples or lips, soften nasolabial folds and marionette lines, define the jawline and chin, and subtly balance the profile.
• It cannot: correct excess loose skin, lines caused mainly by muscle contraction (other options are discussed for these) or significant changes in bone structure.

The consultation covers anatomy, skin quality, medical history and previous injectable treatments. The doctor selects the product, amount and injection plan.

The patient is asked about allergies, medication (including anticoagulants or supplements that may make bruising more likely), any history of cold sores and any procedures planned in the near future. Expectations are discussed, the doctor explains what is realistic for the individual’s anatomy, and photographs may be taken for comparison. Where the goal cannot be achieved safely with hyaluronic acid, the doctor recommends a different approach.

The gel is placed carefully with a fine needle or cannula in the appropriate anatomical plane. Treatment is conservative and progressive to preserve balance and natural tissue movement.

The skin is cleansed and disinfected, and injection points are marked where needed. The doctor injects small amounts, checks symmetry and contour along the way and gently moulds the area where appropriate. Depending on the number of areas, a session usually takes between 30 and 60 minutes. A cautious approach is preferred: if needed, a top-up is done at a later visit rather than in the same session.

Topical local anaesthesia is commonly used, and some products also contain anaesthetic. Comfort varies by area and individual sensitivity.

The anaesthetic cream is usually applied a few tens of minutes before injection. The sensation is generally one of pricking or pressure. General anaesthesia is not needed, and the patient goes home straight after treatment.

Temporary redness, swelling, tenderness or minor bruising may occur. Routine activities can be resumed quickly while following the aftercare advice.

For the first 24–48 hours, patients are usually advised to avoid strenuous exercise, saunas, strong sun or cold exposure and massaging the treated area. Make-up is applied as advised by the doctor. Any bruising usually fades within a few days to a week. The doctor may schedule a follow-up at around two weeks.

Alongside common local reactions, uncommon risks include infection, nodules, asymmetry and vascular complications. Treatment must be performed only by a doctor trained in facial anatomy.

• Common and temporary: swelling, redness, tenderness, bruising.
• Less common: palpable lumps or nodules, asymmetry, delayed inflammatory reactions, cold-sore reactivation.
• Rare but important: blockage of a blood vessel, which may show as severe pain, paleness or a bluish discolouration of the skin; in such situations the patient must contact the doctor immediately.

If needed, hyaluronic acid can be dissolved with a specific enzyme administered by the doctor.

The change is visible immediately, although the shape is properly assessed once swelling settles. Longevity varies with the product, area, metabolism and lifestyle.

The final appearance is usually assessed after about two weeks. As a guide, the effect lasts from a few months to more than a year; highly mobile areas such as the lips tend to absorb the product more quickly. Maintenance sessions are planned individually.

Hyaluronic acid allows volume and contour corrections without surgery, with a temporary effect. The result depends on a correct assessment of anatomy, the choice of product and a cautious approach that avoids overcorrection. At Detalii Med in Baia Mare, the treatment plan is agreed at consultation with the plastic surgeon.