Injectable fillers for volumisation
Also known as dermal fillers
What is volumisation using dermal filler?
Injectable fillers are an effective treatment to replace or add volume to the face. Volumisation may enhance existing features (e.g. lip and cheek augmentation) or replace facial fullness lost during the aging process. Dermal fillers are often used for facial rejuvenation in combination with muscle relaxant injections and appropriate skin surface treatments such as cosmeceuticals, peels, laser and skin care.
Types of dermal filler
There are a number of different types and brands of dermal fillers that have varying properties. The two main types are temporary and permanent fillers.
- Temporary fillers
The most common type of temporary filler is made from hyaluronic acid which is a complex sugar structure which avidly binds water. It is found naturally in the skin and other body tissues. It is also present in all living things so that it can be manufactured naturally from healthy bacterial strains which is in some way similar to the use of bacteria to make certain foods. Hyaluronic acid filler is a colourless, injectable gel which is used to add volume to the skin and replace lost underlying facial fat where needed.
Hyaluronic acid fillers are considered the safest filler to use, as allergic reactions are rare and the filler can be removed using enzyme injections if required.
Hyaluronic acid fillers generally last between 6 and 24 months depending on the treatment site and specific product used. Dermatologists have the impression that with regular maintenance the duration of effect continues to increase.
- Permanent fillers
Various types of permanent fillers include liquid injectable silicone (LIS), polyacrylamide gels (PAAG), polymethylmethacrylate (PMMA) and polytetrafluoroethylene (PTFE). These are non-resorbable (i.e. the body doesn’t resorb the filler or break it down naturally) and remain in the tissues permanently. Most dermatologists prefer not to use these products because they cannot be easily removed if there are any complications such as allergic reactions or bad placement.
What problems can be addressed with fillers?
Many issues can be addressed with dermal fillers including:
- Smoothing of facial wrinkles
- Restoration of shape and volume to the face (e.g. cheeks, temples, jawline)
- Filling of furrows or deep lines in the face
- Correction of hollowness/shadows under the eyes (tear troughs)
- Lip augmentation and smoothing of lines around the lips
- Lifting of depressed scars (e.g. acne scarring)
- Nose, brow, chin and forehead shaping or enhancement
- Full-face soft lift of an older face with significant volume loss.
What is involved in a dermal filler procedure?
A person should first be assessed by their injecting dermatologist. Appropriate treatment options and expected outcomes should be discussed, specific to the person’s concerns and objectives.
Dermal fillers are usually delivered to the superficial and deep layers of the skin via very fine needles that are minimally painful.
Injection discomfort levels, varies between people and treatment sites. Many fillers contain local anaesthetic which relieves discomfort during the procedure. Other pain relief such as topical anaesthetic cream, nerve blocks and ice may be used where necessary.
The improvements are immediate.
Are dermal fillers safe?
Hyaluronic acid fillers are generally safe in the hands of experienced and professionally trained dermatologists who have the necessary knowledge of facial anatomy and how to manage potential complications should they arise.
What are the potential side effects and complications of using dermal fillers?
Temporary side effects vary and can include redness, swelling, tenderness, small bruises and/or lumps at injection sites. Some individuals may experience extensive bruising and swelling but this is less common.
Serious complications are rare and should always be discussed in detail with your practitioner prior to any procedure. These can include infection, abscess, biofilms (fluctuating lumps),blocking of blood vessels (causing damage to surrounding tissue and in rare instances, blindness), skin pigmentation changes, nodules, asymmetry, under or over correction, allergic reactions, Tyndall effect (blue discolouration if hyaluronic filler is injected too superficially in the skin) or movement of the filler.
Are there any reasons not to treat with dermal fillers?
Dermal fillers should not be used in the following circumstances:
- Pregnancy or breastfeeding
- Previous allergy or adverse reaction to the product or local anaesthetic agent
- Active infection at injection site
This information has been written by Dr Cara McDonald
Updated 23 September 2016