As we age, past our twenties or thirties, most of us lose volume in all the facial tissues. Our bones shrink, muscles become thinner, facial fat cells seemingly migrate down south. The outer layer of the skin, the epidermis, becomes thinner, and because of harboring ultraviolet-light-induced alterations and environmental pollutant induced changes, the epidermis produces thicker and rougher dead layer. Below the epidermis, the dermis is made up of strands of protein that swirl around each other, having a polysaccharide molecule that is called hyaluronan (some call it hyaluran) dispersed around them. Each hyaluronan molecule absorbs water to itself by the order of one thousand times of its molecular weight. That is why our skin is soft and supple. In fair skinned people, much more than the dark skin-colored individuals, ultraviolet light induces collagen loss and alteration. That is added to the naturally occurring age related thinning of the dermis due to collagen loss.

The above paragraph has all been sad and depressing, but there is hope. Today, the gene that codes for hyaluronan is inserted in bacteria, and so the polysaccharide is mass produced in laboratories. In a later stage, the bacteria are separated from the hyaluronan molecules. Then, the hyaluronan molecules are polymerized together further, so that the enzymes that already exists in our skin would not break down the product over twenty four hours. An unexpected finding about hyaluronan-based fillers has been that it induces soft tissue, and collagen production in our skin that lasts for years. It is as if the injected hyaluronan-based filler lays down the scaffolding for our fibroblasts to move onto its particles, and lay down collagen and hyaluronan.