Dermal Fillers

What it is

Dermal fillers are gel-like materials injected under the skin to add volume or support to specific areas of the face. The most commonly used type is based on hyaluronic acid, a substance found naturally in the body. The effect is temporary, because the product breaks down gradually over time, and the doctor decides after an assessment whether the procedure is suitable.

Who may benefit, and why people ask about it

• Loss of volume in some areas of the face, such as the cheeks, with age.
• Wanting to define the lips or add moderate volume to them.
• Folds and lines, such as the lines running from the sides of the nose to the corners of the mouth.
• Mild imbalance in facial features, such as the chin or jawline.
• Hollows under the eyes in some cases, after a careful assessment.

Fillers can help some people, but they are not suitable for everyone, and they do not replace surgical options where there is marked sagging.

What the consultation covers

• A review of your health history, including autoimmune conditions, bleeding disorders, blood thinners and any known allergies, including allergy to local anaesthetics.
• Questions about any previous fillers, threads, implants or surgery in the same area, and what type they were if known.
• For the lips, questions about any history of cold sores.
• An assessment of facial balance, skin quality and volume distribution.
• A discussion of realistic expectations; the doctor may suggest a different option or advise against injections.
• An explanation of the risks — including rare and serious ones — and the aftercare, followed by informed consent.

Questions you may want to ask the doctor:

• What type of material will be used, and can it be dissolved if needed?
• Which signs mean I should contact the clinic immediately after the procedure?
• Who do I call if a problem appears outside clinic hours?
• Is there a follow-up appointment to review the result once the swelling has settled?

What a visit looks like

1. Registration, and review of the health-history and consent forms.
2. Clinical photos may be taken with your consent; they are kept in your medical file only and never published.
3. The skin is cleaned with an antiseptic, and the doctor may mark the injection points.
4. A topical numbing cream may be used in some cases, and some products contain a local anaesthetic.
5. The injections are given with a fine needle or a blunt-tipped cannula, depending on the area and the doctor's judgement.
6. The result is reviewed, aftercare instructions are given, and a follow-up appointment is booked if the doctor considers it necessary.

The number of sessions, their length and the interval between them vary from person to person and are set by the doctor based on the assessment.

Preparation

• Please tell the doctor about all medicines and supplements, especially blood thinners and supplements that may make bruising more likely.
• Do not stop any prescribed medicine without speaking to the doctor who prescribed it.
• Please tell the doctor if you are pregnant, breastfeeding or planning a pregnancy; fillers are usually postponed in these situations as a precaution.
• Please tell the doctor about any recent or planned dental treatment, and any recent or upcoming vaccination, as the doctor may suggest different timing for the injections.
• For lip fillers, if you have a history of cold sores, the doctor may discuss a preventive measure.
• If you have an important event coming up, mention the date during the consultation, to allow enough time for swelling and bruising to settle.
• It helps to arrive with clean skin and no make-up on the treatment area.

After the session and possible side effects

Common effects, usually temporary:

• Swelling, redness or tenderness at the injection site.
• Bruising.
• Small lumps or slight unevenness, which often improve as the swelling settles.

Less common effects:

• Infection or inflammation at the injection site.
• An allergic reaction.
• Nodules or swelling that appear some time after the injections.

Rare but serious effects:

• Blockage of a blood vessel by the injected material, which can damage the skin and, very rarely, affect vision.

Contact the clinic immediately, or seek urgent medical care, if you feel severe or increasing pain, notice a change in skin colour near the injection site (pale, bluish or dusky), or notice any change in your vision.

Aftercare instructions may include not pressing on or massaging the area unless the doctor advises it, and avoiding strenuous exercise, intense heat and make-up for a period the doctor specifies.

The doctor explains the full list of risks during the consultation.

Limitations

• Results vary from person to person and cannot be predicted precisely in advance.
• The effect is temporary; the product breaks down at a rate that varies with the person, the area and the type of material.
• Fillers do not replace surgery where there is marked sagging.
• In some cases the doctor can dissolve hyaluronic acid filler; that procedure has its own risks, and it does not apply to every type of filler.
• The doctor may advise against injections in situations including: infection or inflammation in the area, pregnancy or breastfeeding, some autoimmune conditions, an allergy to the product's components, previous injected material of unknown type in the same area, or expectations the procedure cannot meet.