The author presents an interesting and popular aesthetic topic with discussion on the background of the growth and demand for dermal fillers, including some of the popular types currently favoured. There is discussion on poly-L-Lactic acid and calcium hydroxylapatite (CaHA) as examples of stimulatory fillers but other available formulations within this genre such as polycaprolactone are not discussed, whilst permanent fillers, such as polyacrylamide hydrogel are briefly explored. Boney changes of the face are described, supported by current references within this area, along with the senescent changes to superficial facial fat; yet, the significance of the deeper facial fat compartments is not addressed. In keeping with the context of the paper, the author principally addresses oestrogen deficiency as one of the principle causes of skin ageing, outlining the effects. A useful example of a patient assessment scale (Global Ranking Scale) is illustrated with rationale for use in conjunction with an interesting case study of a 46-year-old female with supporting photographs and a detailed account of the techniques and hyaluronic acid dermal fillers used. 

Assessment and management of the mature female face with dermal fillers.
Rahe E.
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Anna Baker

BJN Aesthetic Nurse of the Year 2016.

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