What are Dermal Fillers?


As we age, we lose the volume in our face that makes our skin look plump and youthful, so dermal fillers can be used to ‘fill out’ lines and wrinkles and replace lost volume in the skin caused by aging. They can also be used as a non-surgical alternative to facial implants to add volume to the cheeks or chin, to correct minor deformities in the nose, to get rid of hollows underneath the eyes and to plump up thin lips.

There are many different types of dermal fillers available which last anywhere between three months and five years. Although dermal fillers, particularly temporary fillers, are now very safe, you should make sure you are seeing a properly qualified practitioner to avoid any complications. As the use of dermal filler products has grown, so has the choice of different filler substances. There are now many options on the market, so it is important to find the right product for you.

Most people who opt for dermal fillers are over 35 and are experiencing the effects of premature aging, however younger people in their 20s often have fillers to give them a sexier pout or correct minor deformities in the nose as an alternative to a nose job.

If you have any of the following concerns, you could be a candidate for dermal fillers:

  • Deep nose to mouth lines (nasolabial folds)
  • Smoker’s lines around the mouth
  • Loss of volume in the cheeks
  • Thin or un-shapely lips
  • Minor nose deformities such as nasal humps
  • A receding chin

Fillers are generally very safe nowadays however pregnant women or women who are breast feeding are not advised to have treatment. People with acne should get the condition address first as skin conditions like this can increase the risk of infection following injections with dermal fillers.

Some fillers, such as those made from bovine collagen, can cause an allergic reaction and involve a skin test prior to treatment. Make sure you check what material the filler you are having is made from in case you are allergic to any of the components. Certain conditions such as auto-immune disease and rheumatoid arthritis can also make you an unsuitable candidate for this type of filler.

The best way to discover if fillers are right for you is to speak to a qualified cosmetic practitioner who will be able to discuss the types of filler available and decide which may be best for you.

The results you get from your fillers will again be dependent on what type of product you have. Hyaluronic acid fillers can last anywhere between six and nine months, calcium hydroxyapatite lasts around 18 months to two years and permanent fillers can last five years or more. The results can be very dependent on the individual, but with most fillers you will need to maintain your results by going in for repeat treatments after the effects start to diminish.

There are many different brands of dermal fillers in the market and it is often difficult to know which fillers are the best.  All dermal fillers offer something different and it will be up to you and your specialist to determine which ones are suitable for your particular needs.  Learn about both temporary and permanent fillers below and visit some of the branded dermal filler pages for more specific information.

Temporary fillers

Most dermal fillers used are temporary or resorbable products which last between six and nine months. These types of fillers are considered to be very safe as the product is absorbed by your body over a period of time so any unwanted side effects are not long lasting. They can be used to address a variety of concerns from fine lines and wrinkles to volume loss. They are also the most popular choice of product for lips, to avoid being left with the Lesley Ash ‘trout pout’, that many people undergoing this type of procedure fear. Temporary fillers are made from various kinds of man-made and synthetic materials including collagen, hyaluronic acid and calcium hydroxylapatite.

Hyaluronic Acid Fillers

Are the most widely used fillers and have a very high safety profile. Hyaluronic acid is a naturally occurring substance, present in every living organism so it is very biocompatible and rarely causes any reactions. It is estimated that 30 million patients around the world have been treated with some form of hyaluronic acid. Hyaluronic acid products can come in different thicknesses or viscosities which make them a versatile choice for treating different areas of the face. A thinner product would be well suited to fine lines and wrinkles or for subtle enhancement of the lips whereas a thicker product is ideal for addressing volume loss and very deep wrinkles. They typically last between six and 12 months.

Collagen Fillers

Were the first type of temporary filler used for cosmetic enhancement. Traditionally products were derived from bovine (cow) collagen and required an allergy test before treatment.

Calcium Hydroxylapatite

Has been safely used in the body for years in medicine and dentistry as well as for cosmetic applications such as cheek, jaw, cranial and chin implants.

Collagen Stimulators

An injectable treatment that encourages your own collagen to be formed giving you a similar effect to dermal fillers. Made from poly-l-lactic acid (PLLA), the product cannot only add volume and address lines and wrinkles like traditional fillers, but it also improves skin texture and tone by stimulating new collagen growth. The effects include improvements in the overall thickness of the skin and an enhancement of facial volume, can last for up to two years and happen gradually over several months, making the results subtler – a factor that is drawing increasing interest from women who do not want to look like they have had something ‘done’.

Permanent Fillers

Permanent or non-resorbable fillers are not as widely used as temporary fillers because of their longer-lasting effect. However, you may wish to opt for a more permanent solution and in some cases your doctor may recommend it. As with temporary fillers there are a number of permanent fillers used. The main ones are polymethylmethacrylate and polyacrylamide (Aquamid). Polymethylmethacrylate is made from a mixture of tiny plastic (methylmethacrylate) beads and bovine collagen. The mixture is injected underneath the skin, and the plastic beads become encapsulated in scar tissue. The collagen holds the plastic beads in place, which can then last for months or years after the collagen has dispersed. Aquamid implants are 97 per cent water and are composed of a highly polymerised polyacrylamide gel, which integrates naturally with the body’s own tissue to create instant facial volume. If you opt for a permanent filler make sure you go to someone who is very experienced with using the product they are injecting as most complications occur as a result of the product being injected incorrectly. It is also advisable to try out treatment with a temporary product first to make sure you are happy with the result as if you are not there is no going back once you have had a permanent product injected.

Problems with most dermal fillers are extremely rare. Temporary fillers, such as hyaluronic acid or porcine collagen are very safe and rarely cause any problems.

One possible dermal filler side effect following treatment is infection at the injection site. You can avoid this by carefully following your practitioner’s post treatment advice.

Some people do suffer from allergic reactions to fillers but again this is rare. If you have any lasting redness, itching or swelling after your treatment, contact your practitioner.

Another side effect of some fillers is the appearance of lumps or bumps under the skin. This can often be attributed to the product being injected too superficially and therefore being visible through the skin. Hyaluronic acid products can be dissolved using a product called hyaluronase. Speak to your practitioner if you have any lumps following treatment. In some cases, lumps can be permanent.

Another possible complication is over enhancement of the area. If you have had a temporary filler, this will reduce over the next few months. If you have had a permanent filler, be aware that any over correction will last for a number of years. It is usually advisable to have treatment with temporary filler first to make sure you are happy with the results before you consider having a permanent filler.

If you have had any cold sores in the past these can break out again after treatment so you should alert you practitioner to this during your consultation so they can prescribe medication to minimize this risk.

Most negative side effects of fillers are manageable and can be dealt with by your practitioner. If you have any concerns following your treatment contact them to talk through your concerns.

After filler injections you can be quite red and swollen and in some cases you may be bruised. You may also get bleeding around the injection sites. The extent of the swelling and redness you experience can depend on a number of factors including practitioner skill, the area being injected, the type of product being used and the amount of product being used. These side effects can last for a couple of days but can be disguised with make-up. If you are applying make-up straight after treatment you are advised to use mineral make-up as your normal make-up may increase your risk of infection. A lot of clinics now carry lines of mineral make-up and many now apply some after treatment for you.

The post treatment advice you are given will vary depending on the product you are having and the area being treated. Make sure you follow the advice given to you by your practitioner carefully. Ice packs, or even a bag of frozen vegetables, can be useful to help reduce swelling and post treatment pain can be managed with painkillers.

How your treatment is performed will depend on the type of filler you are having and the area being injected. Thicker fillers, used for volume replacement, will be injected at a deeper level and may be more uncomfortable than fillers being injected into fine lines and wrinkles at a more superficial level. How fine the needle being used is will also depend on the product, however most fillers can be injected through very fine needles.

All filler treatments however involve a series of injections of the product into the area being injected. For some areas only a couple of injections will be needed whereas multiple injections may be needed in others. You may feel some stinging or burning during treatment.

The treatment will usually take around 30 minutes to an hour.

Before you decide whether or not to have treatment with dermal fillers you will need to have a consultation with an aesthetic practitioner. They will be able to talk to you about your concerns and decide if fillers are the right option for you and what type of filler will be best suited to your needs.

During your consultation the practitioner will take a medical history and discuss any risks or complications with you. Use this as an opportunity to ask any questions you have or bring up any concerns. Don’t be afraid to ask your practitioner what their experience and training is with the product they are using. Also ask to see before and after pictures to give you an idea of what kind of results they can achieve.

Although you can have your treatment done on the same day as your consultation it is a good idea to go away and think about it before you go ahead. This will give you a chance to research the product your practitioner has suggested. Your clinic should be able to give you leaflets on the product they are going to use. Read these thoroughly to make sure you know exactly what is being injected. A lot of people who encounter complications with fillers do not know what is being injected into them and this can make the problem difficult to deal with. The most important message is to do your homework.

With the development of so many new, bio-compatible products it is no longer that common for practitioners to use bovine collagen products, however if you do decide to go down this route you will need to have a skin test before having your treatment as a small percentage of people are allergic to this substance. The practitioner will usually inject a small amount of the product into your arm. You will then be checked at a follow up appointment to make sure you are not allergic to the product.