Dermal Filler Melbourne – Conservative, Doctor-Led Medical Assessment

At Victorian Cosmetic Institute, we take a conservative, medical approach to facial volume changes. Our focus is not on chasing trends or replacing volume indiscriminately, but on understanding why facial changes occur and whether intervention is appropriate at all.

We consider volume replacement, including the use of dermal fillers, to be corrective rather than preventative, and only when there is a clear structural indication following medical assessment. Dermal fillers are not a substitute for lifting or repositioning the face, and they cannot replicate the effects of surgical procedures.

Facial volume loss is complex. It reflects progressive changes in skin quality, fat distribution, muscle activity, and underlying bone structure over time. Addressing any one element in isolation can increase the risk of imbalance or over-correction. For this reason, every patient begins with a comprehensive medical consultation, not a treatment-led discussion.

Objective assessment and perceptual drift

Vectra 3D facial imaging may be used as a clinical assessment tool where appropriate.

Three-dimensional imaging allows facial shape, asymmetry, and volume distribution to be assessed more objectively, and helps reduce reliance on memory or perception alone.

This approach may help reduce perceptual drift — where gradual changes become normalised over time — supporting more conservative, proportion-based decision-making.

Vectra imaging is used as a reference and safety tool, not a guarantee of outcome.

Our approach: skin first, volume second

Not all facial ageing is due to volume loss.

In many patients, changes in skin quality can create the appearance of volume loss even when underlying structure remains adequate.

For this reason, our philosophy is skin first, volume second. Skin integrity and quality are assessed before considering dermal fillers. Where dermal filler treatment is considered, it is approached conservatively and in proportion to underlying anatomy.

How long do dermal fillers last?

Long-term MRI studies have demonstrated that hyaluronic acid dermal fillers may persist in facial tissues for significantly longer than previously assumed.

Detectable filler material has been observed several years after injection in some individuals. Longevity varies depending on anatomy, injection depth, and tissue integration.

These findings reinforce the importance of long-term planning and conservative treatment.

Vascular occlusion and high-risk treatment areas

Dermal filler treatment carries a risk of vascular occlusion, which occurs when filler material disrupts blood flow. In rare cases, this may result in tissue injury or serious complications.

Risk of vision loss

In very rare circumstances, vascular occlusion may lead to permanent vision loss if blood supply to the eye is compromised. This risk underpins the need for careful patient selection and avoidance of higher-risk treatment areas.

The nose and other high-risk areas

The nose is widely recognised as a high-risk area for dermal filler treatment due to its vascular anatomy. In addition, fillers often do not maintain structural stability in this region over time. For many patients, the potential risks outweigh any potential benefit, and treatment is not routinely recommended.

Risk reduction

Risk reduction relies on:

• Detailed anatomical knowledge
• Conservative dosing
• Careful area selection
• Use of adjunctive tools such as ultrasound, where appropriate

No technique eliminates risk, and avoidance of treatment may be the safest option.

Hyaluronidase and filler reversal

Hyaluronidase is an enzyme used to break down hyaluronic acid dermal fillers in selected situations.

There is no robust scientific evidence demonstrating permanent damage to collagen or skin when hyaluronidase is used appropriately. However, some patients report changes following filler dissolution, such as perceived laxity or volume loss.

These experiences may reflect multiple factors, including sudden volume change, natural ageing, or altered perception. Causation cannot be reliably established.

For this reason, filler dissolution is approached cautiously, and conservative initial treatment is preferred to avoid the need for reversal.

Collagen stimulators: potential benefits and limitations

Collagen-stimulating treatments aim to induce a biological response rather than directly replace volume. The extent and distribution of collagen production vary between individuals and cannot be precisely controlled.

In some cases, excessive collagen stimulation may lead to fibrosis or altered tissue behaviour. Prior collagen stimulation may also complicate future surgical procedures.

These treatments are not inherently lower risk and are considered carefully on an individual basis.

Costs and treatment planning

Any discussion of costs occurs during medical consultation, based on clinical need rather than predetermined volumes or schedules.

Lower-cost approaches, larger volumes, or frequent repeat treatments are not necessarily appropriate and may increase the risk of over-treatment. Given evidence of long-term filler persistence, treatment planning should be conservative and long-term in nature.

Frequently Asked Questions

Why choose Victorian Cosmetic Institute?

• Doctor-led, consultation-first approach
• Conservative philosophy focused on balance and proportion
• Use of objective assessment tools
• Emphasis on education, limitations, and long-term planning

Patients seeking dermal filler consultations in Melbourne are encouraged to arrange a medical consultation to determine suitability, risks, and alternatives.