What Are Dermal Fillers?

It’s 100% up to you what you do with your body – if it makes you feel confident and comfortable, then you do you. However, when it comes to cosmetic procedures, it’s super important that you do your research and are totally clued up on the treatment you want in order to make the right decisions and find a person who you trust to (literally) take your face into their hands. Dermal filler is one of the most popular and readily available cosmetic procedures out there, but there’s still a lot to know. We asked Bridie Bukorovic, cosmetic injector and founder of Subtil Aesthetics to share the most important things to know before getting filler.

Scroll down for the answers to your most-asked questions about dermal filler.

Dermal fillers are soft gel-like substances that are injected under the skin. Typically they’re made up of non-animal based hyaluronic acid. Most people will have heard of hyaluronic acid – it’s a common ingredient in your skincare line-up. if you’re not aware, then put simply it’s a molecule that’s present naturally in our own bodies and by holding on to moisture keeps the eyes, skin and joints lubricated. The body produces this clear gooey substance and it has a life cycle, so our bodies have the ability to break it down, dispose of it, and replenish it!   

The lab-made version has a whole host of cosmetic purposes one of them being dermal filler, which you may have heard of as a brand name such as Juvéderm, Restylane or Belotero. But…there are other types of fillers known as bio-stimulatory which are non-hyaluronic-acid based (the most popular brands of these are Sculptra and Radiesse) these contain something called calcium hydroxylapatite and these types of fillers are best for mimicking bone structure and aren’t as fast acting as HA fillers. 

Dermal filler increases volume wherever it is injected under the skin. This is usually specific areas of the face such as lips, cheeks, under-eyes, nose etc. Meaning they can plump thin lips, soften wrinkles, balance facial features, address asymmetry, boost shallow contours and even improve the appearance of indented or pitted scars. 

That all dermal filler is created equally. A journal article in 2010 cited there to be around 140 dermal fillers available in the UK/EU market and only 6 were FDA approved for use in the US. This was 12 years ago, so imagine the figures now. There are lots of cheap sub-standard brands of filler with flashy marketing behind them but have no clinical trials behind them. A cheap product can mean a higher profit margin but do you really want, cheap un-regulated product in your body? It’s a strong no from me.

Within each brand of filler there are different products intended for use in different ways. Softer filler that is able to move more naturally with dynamic parts of the face such as the lips and denser fillers with slightly larger molecules can provide structure to areas like the cheeks. Really, your injector should be able to talk you through this and explain why they’re using each product. To attain really natural results sometimes it’s appropriate to use a combination of different types of filler.

There’s currently no research showing that dermal fillers are safe for pregnant or breastfeeding women, so you may want to hold off if you’re pregnant or recently had a baby.

Results with filler are noticeable immediately. You may have some bruising, swelling or bleeding at the injection site(s) as well as tenderness. Over the next few days to week the product will attract water molecules, hydrating the surrounding area and integrating with the tissue. 

As always I would suggest finding a provider whose aesthetic and philosophy aligns with your own. I would look for injectors with a medical background and reputable training history that can look after you should complications arise. The enzyme used to dissolve filler is a prescription only medication, your local A&E department won’t have it, so really you want someone you can trust and who is trained in complications offering thorough aftercare should any complications arise.

This is variable based on a number of factors. Depending on the type of filler used, the location and also lifestyle factors of the individual also contribute to the breakdown of filler. We normally say between six to nine months but treatments built up slowly overtime can last longer.

There are some very serious risks to filler. The biggest one is what we call a vascular occlusion or VO, that’s when the filler is injected directly into a blood vessel causing blockage, or too much filler is injected around a major vessel causing compression either of these will stop the blood flow and oxygen supply to the tissues beyond. If this isn’t treated and reversed in a timely manner then the tissue starved of oxygen will begin to die, this is called necrosis and there’s not much you can do beyond this. These are the horror pictures you see in headlines. It’s very serious and in some cases has caused blindness. That’s why it’s so important to choose a practitioner who’s confident in dealing with and trained in complication management.

It’s the nature of the game that no two faces are the same and although there are safety measures and checks we perform to look out for this and also prevent it, but it does happen and more often than you think. We only hear the horror stories about the poor few that weren’t looked after and where errors were made.

Another side effect is migration. Lots of people now talk around migration of filler like it’s the devil, and it pretty much is, nobody wants filler to spread to areas it shouldn’t be creating the dreaded “duck look” etc. however, no matter how skilled your injector, migration is always a risk, it can happen naturally over time. If you don’t want migration the only way to guarantee it is to not have filler, simple!

Side effects and risks are always easier pills to swallow when you trust your practitioner, have a mutual understanding and have made an informed decision based on all the facts. Choose your aesthetic practitioner like you would a life partner or best friend. Aesthetics a long-term partnering not a flash in the pan.