Dermal fillers (injectable fillers) are used to refine and improve the appearance of the skin and treat volume loss. They can smooth lines and wrinkles or be used to add volume and ‘plump up’ the skin by filling contours. Dermal fillers are especially popular to add volume to the middle face and create a fuller appearance.
Filler treatments have been used for more than a hundred years, first using fat transfer and a refined version of this involving liposuction is still available today. Collagen injections emerged in the 1970s but now products containing hyaluronic acid are the most widely used type of fillers.
Hyaluronic acid is a substance that occurs naturally in the human body and it works by acting as a cushion and lubricant in the joints and other tissues. Hyaluronic acid binds water in the skin, thereby increasing hydration and volume – hence its use as a dermal filler.
Natural hyaluronic acid is broken down by the body in one or two days so is constantly replaced. As we age this replacement mechanism diminishes so the moisturising and plumping effects of hyaluronic acid decrease.
The hyaluronic acid used in aesthetic medicine is produced in a laboratory, in most cases using bacterial fermentation rather than being animal-derived.
Dermal fillers can be used to improve:
- Facial lines, wrinkles and areas lacking volume
- Deep ‘smile lines’ which run from the side of the nose to the corners of the mouth
- ‘Smokers lines’ which are vertical lines on the top lip
- ‘Marionette lines’ at the corner of the mouth
- The definition of the lip border
- Lip volume and unevenness
- The shape of the nose (non-surgical rhinoplasty or nose job)
- Acne scars
- Depressions or pockmarks in the skin due to injury or disease, for example chickenpox marks
- Unevenness in the skin after surgery or skin grafting
Will the treatment hurt?
Most leading brands of filler contain a local anaesthetic and most doctors will apply ice or topical anaesthetic cream prior to treatment to numb the skin. After the treatment any discomfort usually settles very quickly.
How long do the results last?
Dermal fillers are gradually broken down by the body and reabsorbed. The results last from six to 18 months, depending on the type of filler used and the area treated.
Contraindications
It is important to tell your doctor about any previous history of pathologies such as auto-immune diseases, allergies, known hypersensitivity to hyaluronic acid, any tendency to develop hypertrophic scars, immunotherapeutic treatment, inflammatory or infectious diseases (acne or cold sores) at injection sites. Also, if you are pregnant or breast-feeding, and any previous aesthetic treatment, particularly the use of permanent products.
Do not take aspirin for at least three days before the injection session. During the injection, risk of bruising (haematoma) and swelling will be higher for patients under anti-coagulant treatment or taking aspirin.
You must also tell your doctor if you have had or are scheduled to have the Coronavirus vaccination as there are recommendations about the length of time that should be left before and after vaccination as a precaution.
Are there any side effects?
Following injection, you may experience redness, slight swelling, or bruising, itching or tenderness at the injected area. Your doctor will inform you about this. These side effects will not last and can easily be covered up with your usual makeup (although make-up is not recommended for the first 12 hours). The aesthetic results are immediate and very natural looking if performed correctly. You can return to work and resume your social life immediately.
Questions you should ask your doctor prior to any dermal filler treatment:
- What are your qualifications? (BCAM would always recommend an experienced doctor for your treatment)
- How long have you been doing fillers?
- How many patients have you treated?
- Which fillers do you use and why?
- Are there any alternatives that I should consider?
- How often have your patients suffered complications or problems?
- Is the is filler safe?
- What problems can occur?
- Do you audit your results and patient satisfaction?
- What do I do if there is a problem with my treatment?
- Do you routinely follow up the result?
- Do you have any patients who you have previously treated whom I could speak to?
- How much does it cost? (this is the least important question)