Dermal fillers are one of the most significant developments in modern aesthetics. Before fillers, changing your appearance meant surgery. Now, you can enhance and rejuvenate your appearance in minutes, on your lunch break.
There is a huge amount of information about dermal fillers available online. And often it is incorrect. Researching dermal fillers often becomes overwhelming, and can be off-putting. A shame, because dermal fillers have so many amazing benefits.
So, here is a guide to the most important things to know about dermal fillers. This information is factual and impartial. It is here to help you make an informed decision about dermal fillers.
Introduction to Dermal Fillers
What are dermal fillers, and how do they work?
Dermal fillers are an umbrella term for injectable gel implants. Made of various compounds (usually hyaluronic acid), they work by volumising the skin and fatty tissue.
Our facials bone and fat determines how we look, and this changes with age and weight gain and loss. We can therefore use dermal fillers to alter our appearance by changing the underlying facial structure. This can be done to treat signs of ageing caused by a loss of structure, or to change our natural features.
Dermal filler considerations
Longevity is an important consideration when deciding whether or not to undergo dermal filler treatment. it is critical to appreciate that filler longevity cannot be guaranteed, and you must make your decision based on the probability of longevity. Many people who claim that filler doesn’t last on them fail to appreciate the following considerations:
- A lack of visible effect does not mean that the filler has worn off.
- Initial swelling may give the appearance of a more pronounced result, that once settled leaves you feeling underwhelmed.
- People are often quick to forget how they appeared before treatment.
- Fillers can migrate to other areas of the face (generally when higher volumes are used more frequently).
- People age over the top of their fillers.
Dermal fillers can be immediately reversed by injecting a dissolving enzyme. Reversing dermal filler is generally done in cases where a complication has occurred, or if the results are not satisfactory, or when they are no longer desired. Reversing dermal filler is safe, but can cause bruising and swelling. There is also a rare risk of severe allergic reactions, and new anecdotal evidence suggesting that it may cause chronic pain and skin damage. Accordingly, reversing dermal filler should only be performed when absolutely necessary.
What are the different types of dermal fillers?
There are several different types of Dermal fillers and they are categorised into temporary and reversible, temporary and irreversible, and permanent.
Temporary and reversible fillers are made of hyaluronic acid (HA). This is a natural-occurring sugar-based molecule found in our skin. It is a great option to improve your appearance, and hydrate your skin. The key advantage of these fillers is that they are reversible.
There are many types of HA dermal fillers available. They differ in specific rheological and other properties. Each type of HA filler has its own unique combination of properties that should be taken into account when selecting that particular HA gel for use. The key properties of HA dermal fillers are:
- Cross-linking: how entangled the gel particles are.
- Hygroscopicity: how much water volume the gel can hold.
- Monophasic or biphasic: whether all filler particles are the same or there are two different forms in the one gel.
- Filler concentration: how many milligrams of hyaluronic acid is contained in the gel.
- Viscoelasticity (G’ or G-prime): how resistant the gel is to a change in its shape, and its tendency to spring back to its original shape after any force or pressure applied to it has been removed.
- Cohesivity: the degree at which the gel will tend to stick together and not break apart, and is related to cross-linking.
Longevity and thickness are not true measures of dermal filler, and should not be used when considering which type of HA gel is appropriate for a treatment. using a gel based on these properties can lead to the injection of the wrong gel for the treatment goal, increasing the risk of lumps that need to be dissolved.
Temporary and irreversible fillers are also known as collagen stimulators. Made of various compounds like calcium hydroxyapatite, they are not reversible. The key advantage of these fillers is that they stimulate the production of collagen. Collagen is a protein that gives your facial tissues strength. These products therefore actually reverse ageing at the molecular level.
Permanent fillers are rarely used. While the idea of a one-and-done treatment sounds appealing, there are many issues. Not only are complications much more severe, but as your face ages, the filler doesn’t change. This means a good result now, will not look good forever. If your permanent filler begins to look out of place over time, you will need surgery to remove it.
What are the best brands of dermal filler?
All brands approved for use are of high quality. As such, there is no one best brand of dermal filler. The quality of dermal fillers approved for use is more dependent on the skill of the clinician.
Where on the body do you usually get dermal fillers?
Dermal fillers are mostly used to rejuvenate facial features like your lips, cheeks, nose and jawline. However, they can be injected anywhere on your body (including the genitalia).
The reason we use them in many different areas is because they have a range of benefits.
- Improve sun damaged skin on areas like your chest, shoulders and hands.
- Reshape facial features are restore volume lost with age.
Dermal fillers can even increase the size of the penis, and add projection to your nipples.
How much dermal filler is required for the procedure?
We measure dermal fillers in millilitres. The number of mL required for your dermal filler procedure will vary substantially depending on the following:
- The treatment area
- The severity of your concerns
- What results you’re looking for
- Your skin quality
- Smaller areas like your lips and nose need far less filler than larger areas like your cheeks and jawline.
To find out how much filler you need, start with a consultation with an experienced doctor. Remember that you may need more or less than that estimated during your consult.
Dermal Fillers vs. Botox
What are the differences between dermal filler and Botox?
While both are used in facial rejuvenation, Botox and dermal fillers are not the same. Dermal fillers are injectable gel implants designed to restore or enhance volume. Botox is a protein that relaxes muscles. Both can treat wrinkles, but their mechanism of action is different. We typically use them in conjunction to achieve more natural looking results.
Does getting fillers hurt more than Botox?
The discomfort experienced from dermal fillers and Botox is quite different. Botox is typically felt as a sting that only lasts less than a second. Fillers generally give a dull ache-like discomfort during injection.
Most people believe that Botox is more painful than dermal fillers. However, most clinics will offer a range of numbing options to ensure your treatment is comfortable.
Effectiveness and Longevity of Dermal Fillers
How long do dermal fillers last?
The manufacturers of dermal fillers report that they wear off slowly over 6-24 months. The dermal filler’s thickness determines how long it lasts (thicker fillers generally last longer). However, new research is revealing that sometimes dermal fillers last far longer than expected. This is especially true when an area is treated more than once.
How can you make dermal fillers last longer?
The only proven way to make dermal filler last longer is to have a second treatment before the results from your previous session wear off. Another option is to use a thicker filler, however this increases the risk of lumpiness.
What happens when dermal fillers wear off?
As dermal fillers wear off, the treated area will slowly return to normal. However, if you’ve had fillers for a long time, they will have disguised the ageing process. When they wear off, the underlying ageing will be revealed. To avoid this problem, collagen stimulating fillers are a better option. Because these products restore collagen, when they wear off your facial tissues will be in better condition. This means you’ll look younger compared to if you never had the treatment.
Does smoking affect the longevity of dermal fillers?
No, smoking does not impact how long dermal filler last.
Suitability
Who are dermal fillers not suitable for?
Dermal fillers are suitable for almost anyone wanting to enhance or rejuvenate their appearance. However, there are some groups that are unsuitable:
- Under 18 years old
- Currently pregnant or breastfeeding
- People who are expecting an unrealistic result
What is the right age to start using dermal fillers?
The right time to start dermal fillers is when you are concerned about your appearance enough to justify the cost and risks involved.
Do dermal fillers work for people over 40?
Yes, dermal fillers are one of the best treatments for people over 40. People in this age-group are often experiencing the signs of ageing related to volume loss. Dermal fillers are therefore a great option to restore this volume, giving a naturally refreshed appearance.
Where can dermal fillers be used?
Dermal fillers are a very versatile treatment that can rejuvenate and enhance almost any area of your face, neck and body. Areas dermal fillers can treat include:
- Forehead dermal fillers
- Temple dermal fillers
- Brow dermal fillers
- Upper eyelid dermal fillers (also known as A-frame dermal fillers)
- Under eye dermal fillers (also known as tear trough filler)
- Cheek dermal filler
- Nose dermal filler
- Nose tip dermal filler
- Lip dermal filler
- Nasolabial fold dermal filler
- Marionette line dermal filler
- Chin dermal filler
- Jawline dermal filler
- Earlobe dermal filler
- Penis dermal filler
- Hand dermal filler
Can dermal fillers treat acne scars?
Yes, dermal fillers are a great way to smooth boxcar and rolling acne scars. They plump the skin, reducing the hollow appearance, giving a smoother appearance. This works best when combined with subcision for acne scars.
Results
What are the benefits of dermal fillers?
Dermal fillers have many benefits, which is why they are such a popular treatment. These include:
- Instant results
- Quick treatments taking 10-20 minutes
- No downtime required
- Reversible results (for hyaluronic acid fillers)
- Versatile, with applications for most concerns and areas of the body
- Highly precise, with results tailorable to very fine details
Do fillers help with facial lifting?
Despite what many claim, dermal fillers cannot lift the facial tissues. They can add structure and soften skin folds giving the illusion of a lift. This is a great option for people with mild sagging. Moderate to severe sagging cannot be effectively treated with fillers alone.
Can fillers look natural?
Yes, almost all results from dermal fillers look natural and undetectable. Unfortunately, bad filler results are obvious, which is why they often have a bad reputation. This is why it is crucial to ensure your dermal fillers are done by an experienced doctor with a proven track-record. Reviewing dermal filler before and after results is a great way to see what’s possible.
Can dermal fillers make you look younger?
Yes, dermal fillers are one of the most effective ways to look younger. With age, your face loses volume, causing a saggy, hollow appearance. Dermal fillers restore facial volumes, instantly and effectively reversing these signs of ageing.
Can dermal fillers tighten skin?
Collagen stimulating fillers can improve skin tightness. By stimulating collagen, the skin becomes stronger, thicker and tighter. Hyaluronic acid-based fillers cannot tighten skin.
Procedure and Aftercare
Is getting dermal fillers painful?
The discomfort experienced during dermal filler is highly dependent on the person injecting them. Pain with experienced providers is often surprisingly little. We keep pain to a minimum by using small needles, gentle techniques, and appropriate anaesthetic. Very painful procedures may indicate that your provider is inexperienced or careless.
Dermal filler volumes
Dermal fillers typically come in a 1ml syringe, although some types come with slightly more or less. The total quantity of dermal filler is not as important as the type and application of the dermal filler. It is always preferable to use smaller quantities and build up your result over time. Overfilling an area not only causes a bad result, but may ned to be reversed. Certain areas of the face can only fit a limited amount of dermal filler before the procedure risk increases and damage to the tissue can occur. Over-filling can also increase the risk of dermal filler migration due to the elastic properties of the facial tissues. Lip filler migration is the most common problem due to overfilling.
A guide to dermal filler volumes per session
- Lips: up to 1ml
- Nose: less than 1ml
- Upper eyelid: up to 1ml
- Under eyes: up to 1ml
- Forehead: 1-3ml
- Cheeks: 2-4ml
- Chin: 1-3ml
- Jawline: 2-8ml
- Side profile: 3-9ml
- Total face: 4-12ml
Just because you need more volume to achieve your goals does not mean it can or should all be injected in one session. Treatments are best staged over multiple sessions to reduce the risk and increase the precision.
What should you expect after a dermal filler procedure?
After dermal fillers it is normal to experience localised redness, swelling and tenderness. Bruising may occur, but these all typically resolve over 2-3 days. The treated areas may feel firm to touch for the first few weeks.
It is normal to feel slight worry about the results in the first few days. Expect to spend time looking in the mirror wondering if things will settle. It’s important to be patient and let your body heal. Almost all concerns go away as the treated areas settle.
How long does swelling last after fillers?
Most swelling will resolve 2-3 days after having dermal fillers. Some areas like the lips take longer to heal, and you can speed up the healing process by gently applying a cold pack. Prolonged swelling may signal a side effect.
What are the dermal filler aftercare steps?
Dermal filler aftercare is a straightforward process. The principles of dermal filler aftercare are to practice good hygiene, avoid things that delay healing, and to not disturb the filler.
- Avoid smoking, alcohol and intense exercise for 24 hours
- Avoid makeup for 24 hours
- Refrain from applying pressure to the treated areas for 5 days
- Gently use a cold pack to reduce swelling
Is it bad to smile after getting fillers?
You can smile confidently after getting dermal fillers without worrying, as it will not affect your result.
What’s the best way to sleep after getting fillers?
After fillers you should try to sleep on your back. You won’t need to use extra pillows or sleep upright. Sleeping on your back avoids pressure to the treated areas, and allows any fluid to drain from the swollen areas.
How should you wash your face after fillers?
It’s important to keep your skin clean after having dermal fillers. When washing your face use your normal products with warm water. Just ensure to be gentle to avoid moving your fresh dermal fillers for the first 5 days.
Can you wear makeup after fillers?
You can wear makeup 24 hours after having dermal fillers. Applying makeup too early increases infection risk. It can result in skin tattooing if the ink gets into an injection site.
When can you brush your teeth after fillers?
You can brush your teeth immediately after having dermal fillers.
Can fillers move if you touch them?
Yes, applying pressure to your fillers in the first few days after your treatment can move them. This is why it is important to be gentle when touching the treated area.
When can you fly after dermal fillers?
How long to wait before flying after dermal filler depends on where you’re going. You should avoid short interstate flights for 24 hours, and long flights for 7 days after having dermal fillers. Flying too soon after fillers can worsen swelling and delay healing. There are also some side effects that can occur in the first few days after fillers than may need urgent review and treatment.
Can dermal fillers migrate?
Yes, dermal fillers can migrate. Dermal filler migration is not harmful, and easily treatable, however it is preferable to avoid migration, as it can look bad.
What causes dermal filler migration?
Dermal filler migrates (moves away from its injection site) for three reasons:
- Poor injection technique, causing instant migration
- Applying pressure in the aftercare period can move dermal filler
- Injecting too much filler may result in migration
Lifestyle and Dermal Fillers
What foods should you avoid after fillers?
You don’t need to avoid any foods after having dermal fillers. Just avoid anything temperature hot if you’ve had lip fillers, as your lips will be numb and you may burn them.
Does drinking water help fillers work better?
Staying hydrated can help your fillers volumise more effectively. However, it is best to just drink your regular amount of water and build your result based on this.
Can you drink coffee after getting fillers?
Yes you can drink coffee after getting fillers. It will not have any positive or negative effect on your result. Just be careful to avoid very hot coffee after lip fillers, because they will be numb and you may cause a burn.
Side Effects and Other Concerns
How long before your wedding should you get dermal fillers?
You should get filler no later than 1 month before your wedding. The earlier the better, as it allows time for your to try out your new look, make any adjustments, or manage any adverse events.
Are there risks and side effects associated with dermal fillers?
Dermal fillers have a number of risks.
- Bruising, swelling, redness and tenderness.
- Infection
- Lumps and bumps
- Nodules
- Skin injury
While some of these risks are scary, they are extremely rare, especially when your treatment is done by an experienced medical doctor. It is so important to only have treatment at a reputable clinic. Cheap and inexperienced providers have a significantly higher chance of causing life-changing side effects.
Are permanent dermal fillers safe?
Permanent dermal fillers are safe to use in some circumstances, however there are some important things to consider before getting them. If you do not like the result, or have a side effect, you may need surgery to address the problem. Further, as your face changes with age, the permanent dermal filler may start to look out of place. Temporary filler avoids this issue, as it allows each treatment to be done differently, based on your pattern of ageing.
Dermal filler risks
HA dermal fillers are very safe, owing in part due to their reversibility. Risks of dermal filler injections include:
- Bruising
- Swelling
- Redness and local tenderness
- Mild and temporary headaches
- Infections
- Nodules
- Foreign body reactions including granuloma
- Allergic reactions
- Over or under correction
- Asymmetry
- Lumps
- Loss of vision (extremely rare)
- Stroke (extremely rare)
- Skin ischaemia and necrosis
Different areas of the face have different risk profiles regarding the likelihood of a complication. The best way to minimise a risk of by having treatment at an experienced, doctor-led cosmetic clinic. It is not possible to fully eliminate procedural risks, and so you must accept them before proceeding with any treatment.
Can you get dermal fillers when pregnant?
As a precaution, most clinics advise against having dermal fillers when pregnant or breastfeeding. This is because treating pregnant and breastfeeding people with fillers has not been studied for safety.
Does smoking affect the longevity of dermal fillers?
It is a myth that smoking affects the longevity of dermal fillers. It can however, increase the risk of lip filler migration. Smoking also accelerates the ageing process, which can make it look like your fillers are wearing off, even though they aren’t.
Does exercise affect the longevity of dermal fillers?
There is no evidence that exercise affects how long your dermal fillers will last.
What happens if you get too much filler?
If you get too much filler your appearance will become distorted. This is called ‘Facial Overfilled Syndrome’ (FOS), and is characaterised by a swollen, puffy face. People with FOS often appear to have a big face, large swollen lips, and small, inset eyes. FOS is extremely common because their are so many clinics that prioritise profits and don’t care about your result. Fortunately, it is extremely easy to avoid if you go to the right place.
Can dermal fillers cause ageing?
Dermal fillers do not cause ageing. They are an effective way to treat visible signs of ageing like facial hollowness.
Are permanent dermal fillers safe?
When performed correctly, permanent dermal fillers are a low risk treatment. However, if you are unfortunate enough to experience a complication, it will generally be much more severe and difficult (if not impossible) to treat without surgery.
Further, as your face changes with age, permanent fillers may start to look out of place, because they don’t change over time.
Cost of Dermal Fillers
How much do dermal fillers cost in Australia?
The cost of dermal filler in Australia varies significantly depending on the following:
- Quality of dermal filler used
- Amount of dermal filler
- Experience of the provider
- Area being treated
High quality fillers done by an experienced provider generally start from around $800.
Why are some places so expensive for dermal fillers?
It is not that some places are expensive, rather many places are very cheap for dermal fillers. The reason there are so many cheap places is because new businesses have made becoming a cosmetic nurse extremely easy. As there are so many cosmetic nurses available, they compete on price an quality. This means they have to cut costs, and resort to using inferior quality fillers, don’t invest in training, and often resort to rushed, dangerous and cookie-cutter techniques.
We hope this dermal filler guide has been helpful for you. If you have any questions about fillers, please get in touch so we can help.
If you’re interested in finding out if dermal fillers are right for you, we invite you to schedule a no-obligation consultation with one of our experienced medical doctors.
