What are dermal fillers?

Dermal fillers are a range of products that are injected into the face to add volume or to ‘plump up’ certain areas. They can be permanent or temporary and derived from synthetic or animal sources. The fillers that I use are all forms of ‘hyaluronic acid’ which is a natural constituent of everybody’s skin. I use this because it is a natural product, allergy testing pre-treatment is unnecessary, it has an excellent safety record and it gradually dissolves over 6 months. This last point is important as problems with permanent fillers are very difficult to correct.

How do dermal fillers improve wrinkles?

Dermal fillers are injected under a wrinkle to smooth them flat. They work simply by adding volume. Once in the skin the fillers absorb water for several days after treatment so the volume injected is effectively multiplied. Therefore the wrinkles may continue to improve for several days after treatment.

Do dermal fillers work on all wrinkles?

Dermal fillers will improve most wrinkles. However, if a wrinkle is particularly deep or the skin is excessively loose the volume of filler required to ‘fill’ the wrinkles is so great as to be impractical. In this situation other treatments such as chemical peels or surgery (facelift) may be more appropriate.

Can Botulinum Toxin be combined with fillers?

Yes. Some wrinkles are very deep and although they improve with Botulinum Toxin they may need fillers too for them to completely disappear. The combination can work well because the reduced muscle activity from the toxin can slow down the reabsorption of the filler so that it lasts longer.

How will I look after treatment?

In the hours after treatment there may be slight redness, swelling and some tenderness and itching at the site of the treated areas. This is normal and should disappear over 1 to 2 days. When the lips are injected the initial swelling may last longer. Some patients can experience swelling for up to one week and the lips can look uneven during that time.

How long does it take to have an effect?

There are three phases of volume enhancement with filler treatment. There is an immediate effect from the filler itself. This is followed by the filler absorbing water over the next 14 days. The last phase is collagen production which takes place over months.

How long will it last?

The effects of the treatment last about 6 months but may last longer in some individuals.

Are there any possible side effects?

Mild side effects are common but tend to resolve within 7 days. The most common side effects include, but are not limited to, temporary injection-site reactions such as:

  • Redness & bruising
  • Swelling, lumps/bumps (especially the lips in the first 72 hours)
  • Pain/tenderness, firmness, itching and numbness
  • Very rarely: Discoloration, Granulomas, skin necrosis (ulceration), infection, abscess formation, allergic reactions.

As with any procedure involving piercing the skin, infection is possible and if increasing redness and pain is experienced at the injected sites, please contact us immediately.

What should I do and not do after treatment?

Refrain from touching the treated area for at least 6 hours. Then, the areas can be washed gently with soap and water. Do not rub or massage the treated area for 24 hours. If the area is tender or swollen, apply an ice pack (or ice in a towel) to the area. Do not engage in strenuous exercise for 24 hours.  Avoid excessive heat such as hot water showers or baths / saunas / hot tubs for 24 hours. Avoid alcoholic beverages for 24 hours. Following these instructions will help minimise the risks of temporary redness, swelling and/or itching. Avoid direct sun exposure, sunbeds, saunas and hot tubs for 2 weeks after the treatment as these will reduce the persistence of the product. If painkillers are needed, please take paracetamol rather than ibuprofen or aspirin as bruising is more likely with these medications. Avoid make-up after treatment for up to 12 hours.

Where are fillers injected?

The commonest sites are furrows on the forehead, the folds between the nose and mouth (nasolabial folds), creases on the upper lip, the lips, the folds between the corners of the mouth and chin (marionette lines) and any depressed areas such as acne scars.

The common sites of injection in the face are shown below: