What are dermal fillers?
Dermal fillers are used to revolumise the face. Lost volume may manifest as a fold, wrinkle, flattening or shriveling of an area. Facial volume loss is one of the key factors in the ageing process, and dermal fillers can help to replenish this lost volume and rejuvenate the face. Importantly, dermal fillers can be used for non-surgical facial enhancement, including;
- lip enhancement,
- cheek enhancement
- disguising eyebags/filling tear troughs
- nose reshaping
- chin enhancement
- brow shaping/lifting
- non-surgical facelift
- non-surgical jowl reduction
At the Victorian Cosmetic Institute, we only use temporary fillers lasting from 4 to 24 months, and some are composed of substances that are naturally found in the skin.
Case study: dermal fillers around the eyes
This patient presents to the Victorian Cosmetic Institute with concerns about looking tired. After having children, she found that she was getting more comments from others about her ‘looking tired’. She was treated by Dr. Natasha Moscato who identified her as having some volume loss around the eyes. She replaced this volume in the upper eyelids and tear troughs using 1mL of dermal filler with excellent and natural looking results.
Case Study - cheeks, jawline and lip enhancement
This patient presented to The Victorian Cosmetic Institute for dermal filler treatment. She had treatment of the full face with filler type JU/JU+. The main goal was to rejuvenate the face naturally without surgery. Dermal fillers were used to;
- Enhance the cheeks by replacing lost volume and lifting the cheeks
- Reduce the appearance of eye hollows/ eyebags by placing fillers in the tear troughs to smooth the transition of the lower eyelid to the cheek
- Hide the jowls by placing fillers along the jawline, and mouth corners
- Straighten the nose by putting dermal filler in areas of deficit in the nose
- Enhance the lips - to replace lost volume there and define her lips without over enlargement
What types of dermal filler are available?
The Victorian Cosmetic Institute offers a wide variety of dermal fillers, lasting from 4 to 24 months. Each filler is suited to different applications and we will advise you on which dermal filler is best for you at the time of consultation.
Due to TGA regulations, the exact name of some of the dermal fillers used cannot be mentioned. Instead they will be termed;
Filler type JU (0.8mL), Filler type JU+ (0.8mL), Filler type JRefine (0.6mL)
Filler type V (2mL)
Filler type R (0.5 and 1mL) Filler type P (1mL)
Filler type RSQ
Filler type RVL (2mL), Filler type RSQ (2mL)
Filler type E (1mL), Filler type M (2mL)
Radiesse (0.3mL and 1.3mL)
We do not advocate the use of permanent fillers as we believe that there is an increased risk of serious complications with these fillers including infection, granuloma formation (permanent lump formation that can occur even years after administration) requiring surgical removal, and filler misplacement.
Dermal fillers, type JU, JU+, JRefine, V, E, M, R, P, RVL, and RSQ (highlighted above in green) are made from a clear gel composed of a substance that is naturally found in skin. Being a natural product means that the risk of problems such as allergies are greatly minimised. The main differences between these fillers are their thickness, viscosity, and longevity. The finer and smoother ones tend to not last as long, whilst the thicker viscous fillers last longer. Finer fillers are generally used in areas where the skin is fine and smoothness is critical, such as around the eyes or upper lip. These fillers are very fine and can be placed superficially in the skin without causing lumps. The thicker fillers are used for more bulk revolumisation of areas such as the cheeks, or jawline. They are typically injected deeper than the finer fillers.
Most of these fillers also contain Lidocaine, a local anaesthetic, which is blended into the filler. This can significantly reduces the amount of pain during a filler procedure; there is less injection pain, and it mildly numbs the skin where it is injected. It is possible to fill a sensitive area like the lips with minimal discomfort – even without a a nerve block to numb the areas prior to treatment.
Radiesse is filler that is based on calcium microspheres that usually lasts for around 12-18 months. It is particularly suited to facial volumising in areas such as the chin, nose and mouth corners as it is slightly firmer than the other filler types. It cannot, however, be used close to the eye orbit (e.g tear troughs) or in lips.
What are the most common areas that dermal fillers are used and how long do they last?
||Filler used / longevity in this area*/no. of syringes required in this area**
|Lips||Filler type JU / 6 to 12 months / 1 – 2 syringesFiller type R / 6 to 9 months / 1 – 2 syringes|
|Nasolabial folds||Filler type JU, JU+ / 6 months / 1 – 3 syringesFiller type R, P / 6 months / 1 – 3 syringesFiller type V, RSQ, M / 12 to 18 months / 1 syringeRadiesse / 12 to 18 months / 1 (1.3mL) syringe|
|Nose||Filler type R, JU / 6 months / 1 syringeRadiesse / 12 to 18 months / 1 (0.3mL) syringes|
|Cheeks||Filler type JU, JU+, R, P / 6 to 12 months / 2 – 4 syringesFiller type V, RSQ, M / 12 to 18 months / 1 – 2 syringesRadiesse / 12 to 18 months / 1 – 2 (1.3mL) syringes|
|Vertical upper lip lines and other fine lines on face||Filler type JRefine / RVL / 6 months / 1 syringe|
|Marionette lines/jowls/oral commissures||Filler type JU, JU+, R, P / 4-6 months / 1 – 2 syringesFiller type V, RSQ , M / 12 months / 1 syringeRadiesse / 12 months / 1 (1.3mL) syringe|
|Chin||Filler type JU, JU+, R, P / 6 -12 months / 1 – 4 syringesFiller type V, RSQ, M / 12 – 18 months / 1 – 2 syringesRadiesse / 12 – 18 months / 1 – 2 (1.3mL) syringes|
|Brows||Filler type JU, R / 12 – 18 months / 1 syringe|
|Tear troughs||Filler type JRefine, JU, R, RVL / 12 to 24 months / 1 syringe|
|Frown lines||Filler type JU, R / 6 to 12 months / 1 syringe|
*Please note that filler longevity is variable from person to person and may last for a longer or shorter time than stated here.
**The number of syringes required for each area is to be used as a guide only.
*** Due to the irreversible nature of Radiesse, and the possibility of lumps in the tear troughs, it is not recommended in this area. We recommend reversible fillers only in this area.
Other commonly treated areas with dermal fillers include nose reshaping for those who do not want to undergo surgery, and also just under the eyebrows to give an eyebrow lift or to fill out any hollows there.
Tear troughs, or the hollows that occur under the lower eyelid, can also be filled with fillers type JRefine/JU/R / RVL. They help to smooth the transition between the lower eyelids and the cheek, and therefore reducing the appearance of under eye hollows and/or fatty bulges.
One of the most popular reasons for dermal filler use is lip enhancement. Dermal fillers can be used to outline the border of the lips to enhance the definition of lips or in the body of the lips to enhance lip size and pout. Filler type JU/JU+ is an excellent filler that is particularly suited to the lips due to its soft and malleable nature. It tends to last slightly longer than other equivalent fillers in the lips also. It tends to create less of a ‘trout pout’ or ‘duck’ look than other fillers in the lips.
Cheeks and naso-labial lines, or the lines that go from the corners of the mouth to the corners of the nose are usually filled with type R/P, JU/JU+/V/RSQ/M or Radiesse. Type R/P/ JU/JU+ tend to last a shorter time in this area (around 6 months) and are reversible, whereas Radiesse tends to last longer. Although more expensive, Radiesse tends to create more volumising of the fold, and lasts longer. RSQ and type V can also be used, and these fillers provide superior volumisation and the option of reversibility.
Finer lines are usually harder to fill with dermal fillers, and require finer fillers. Filler type JRefine/ JU / E are suitable for fine lines, especially those around the mouth. Skin resurfacing with lasers is a good option for the reduction of fine lines as it is a more permanent option, but requires some recovery time.
Case study - nasolabial folds
This before and after case study is one of our doctors. She had her naso-labial folds (the lines from the corners of the mouth to the nose) filled with filler type JU+ 0.8mL. The after picture was taken approximately 2 weeks after the treatment.
Case study - dermal fillers around the mouth
This lady was concerned with the wrinkles around her mouth. A total of 2 mL filler type R was injected into the wrinkles around the mouth, including some into the corners of the mouth to help turn the corners up.
What does treatment with dermal fillers involve?
During a consultation with one of our medical staff, we will discuss and advise you on the best filler and treatment areas for you, after a careful aesthetic assessment. We will outline for you the amount of fillers required, the price, the side effects and the after-care required.
The face is firstly cleansed with anti-septic solution. Local anaesthetic may also be used in the skin to numb specific areas where the filler is to be injected. We often use ice to help numb the skin prior to any injections. Fillers can be injected with either a needle or a cannula, and the following video describes the key differences here.
Often there is mild discomfort associated with the treatment, but it is well tolerated by most patients.
Treatment times vary depending on the amount of fillers required and the areas treated, but generally take from 30 to 60 minutes. After treatment, it is possible to apply make-up if applicable, and to go about your normal activities. We usually ask you to refrain from heavy exercise however.
Treatment with dermal fillers sometimes does take more than one session to get the best results. The first treatment lays the foundation for the subsequent treatments, and future treatments allow for any adjustments to be made.
What should I expect after having dermal fillers?
There is usually some transient redness after the injections. Swelling is also present after the procedure, especially with any lip enhancement procedure. Swelling of other areas post-treatment tends to temporarily enhance the effect of the dermal filler, and it often takes 3 or more days to see the actual real improvement without swelling.
Bruising can also occur, and if it does, it can take normally take a week or two to completely disappear. Make-up/lip stick can be worn (if applicable) soon after treatment should there be a need.
Asymmetry is also possible, but correctable on a subsequent visit.
Small lumps can occur, and these will either dissipate in a few weeks, or may require dissolving with hyaluronidase.
Note that if you have a history of cold sores and the treatment area is around the mouth, then you should notify your treating doctor as filler treatment can cause cold sore flare ups. You may be instructed to take anti-viral medications prior to treatment if this is the case.
There are few risks associated with the use of dermal fillers and few long-term side effects with the (temporary) fillers used at The Victorian Cosmetic Institute. Most fillers comprise of substances that are naturally present in the body. Dermal fillers have been used safely for cosmetic reasons for over 20 years.
Our opinion of permanent fillers is that their safety profile is not as high as temporary fillers. Permanent fillers have previously been fraught with complications such as severe infections and lump formation that requires surgical excision. No permanent fillers are used at The Victorian Cosmetic Institute.
Can dermal fillers be combined with anti-wrinkle injections?
Yes. Despite having different actions, they are commonly used together. In fact, anti-wrinkle injections often prolong the effect of dermal fillers. Anti-wrinkle injections relax the underlying muscle that causes expression lines, and dermal fillers provide volume to fill in static lines.
Why choose The Victorian Cosmetic Institute as your provider of dermal fillers?
Our dermal filler injectors have many years of specialist experience in the use of dermal fillers. We allow you ample time to communicate your aesthetic goals to us, and use our expertise to help you achieve your desired outcome. Furthermore, we offer a large range of dermal fillers and we will be able to best advise you on what dermal filler suits you best. The first step is simply contacting us for your initial dermal filler consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your treatment.
Our goals with your filler treatment are to;
- Provide you with a careful and honest aesthetic assessment
- Achieve the best aesthetic result possible
- Cause as little bruising and swelling as possible
- Ensure that your procedure is as comfortable as possible for you.
Making that first phone call about any cosmetic procedure can be a confronting task – many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.
Otherwise, you can phone us directly on 1300 863 824.