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Objectives: This presentation focuses on the specificity of the aging of dark and mixed skin and its medical treatment with fillers.

Introduction: Dark skin is often thicker than white skin and aging in the face has specificities. In black and mestizo patients the medical indications of the fillers must respect the racial and ethnic anatomical characteristics as well as the beauty criteria.

Materials / method: A series of black Africans, Brazilian and Caribbean Mestizos are presented.
We describe the specificity of their skin aging and their most frequent requests.

Results: The facial signs of aging appear later than for the white skin.
The thicker skin, the deeper grooves or the wrinkles lead to choose thicker hyaluronic loads. Volume restoration usually requires more product.
Calcium hydroxyapatite is often a good choice for nasolabial folds.
Polylactic acid can be used to improve the jugal area.
The number of units of botulinum toxin is often greater in the frontal region. Lip augmentation is an infrequent demand. Afro-Caribbean anthropometric beauty standards must, of course, be respected.

Conclusion: Wrinkles appear later, but are deeper in dark skinned patients. Their demands are not similar to those of Caucasian skin patients. Thicker loads used with more volume should be chosen.

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Objectives: Adequate knowledge of the factors governing filler behaviour in tissue is important for every physician. This presentation aim to improve the understanding of the biological mechanisms that play a role in inflammatory complications after filler injections

Introduction: The term biocompatibility is used to describe the amount of interaction between tissue and foreign materials. Ideally this should be minimal. The current available resorbable fillers have an excellent biocompatibility record. Yet, from research on older (permanent) fillers, it has become clear that the chemical structure of fillers may change in time once inside tissue. This may cause an immune-mediated response. Also with modern resorbable fillers late nodular reactions have been reported. The questions what causes these reactions hase been subject of this research.

Materials / method: Our group published several studies on filler complications. Our ongoing research delivers new and interesting ideas about their pathogenesis.
Together with other European experts treatment schemes are being developped.

Results: The three relevant factors, being (1) filler material itself and its degradation products, (2) patient's immune profile and status, (3) treating doctor, all have their role in the development of problems after filler injections. Prevention is key in this respect, but adequate treatment schemes are also relevant

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