Permanent V Temporary Fillers – what’s the difference?

Article Medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)

Dr. Gavin Chan

Templestowe Lower and Berwick Clinics

Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
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In the past decade or so, temporary dermal fillers have become so popular that it’s not just celebrities and influencers who get regular ‘tweaking’. Dermal fillers are a popular non-surgical, anti-ageing treatment that effectively enhance the lips, cheeks, brow and face. Men and women of all ages and stages of life are being drawn to the benefits of anti-wrinkle injections and dermal fillers. A simple walk-in, walk-out appointment with a Cosmetic Doctor or Cosmetic Nurse is all that’s needed to look fresh faced and more youthful.

Temporary dermal fillers are made from a synthetic substance that’s similar to what’s naturally found in your body. Traditionally it’s been thought that temporary dermal fillers only last 6 to 12 months in your face. In the last year or so, Dr Gavin Chan (MBBS, Cosmetic Physician, Liposuctionist) has debunked this with his MRI studies. These studies show that temporary dermal fillers can last up to 10 years. They’ve also proved that dermal fillers can migrate around your face.

With this in mind and with over 12 years’ experience of injecting temporary dermal fillers, Dr Gavin Chan decided to start using permanent fillers for suitable patients. He notes, “It took me 12 years of doing temporary fillers before I actually decided to do permanent fillers. You have to get to a certain stage of confidence where you know you can put in a permanent filler accurately 99.99% of the time. It’s a bit like when you’re in primary school and you have to graduate from pencil to pen. You only get a pen license when you’re really good at working with a pencil.”

It’s important to note, unlike temporary fillers there is no ‘eraser’ for permanent fillers. If there’s an issue with temporary fillers, it’s easy to fix with a reversal agent called hyaluronidase. This enzyme easily breaks down the temporary filler. Permanent fillers cannot be reversed – they last forever.

The pros and cons of permanent fillers

When it comes to permanent fillers, there’s no room for error. Dr Gavin Chan explains, “when I use permanent fillers, there’s a lot of pressure on me to get it right. It takes twice as long to inject permanent fillers compared to temporary fillers. I also take the patient to our sterile operating theatre.” Having permanent filler treatment in a sterile environment is extremely important. Permanent fillers are more susceptible to complications if germs are introduced. It’s important to note that unlike temporary fillers, permanent fillers are manufactured from substances that aren’t naturally found in your body.

The cost saving of having permanent fillers is very appealing for some patients, despite permanent fillers being twice as much as temporary fillers. Instead of having temporary fillers every 12-24 months or so, you’ll only need to pay for the treatment once. However, the inability to reverse permanent fillers must be considered. Dr Gavin Chan notes, “It saddens me that I’ve seen quite a number of cases come in of people who had permanent filler – often many years ago. They’ve had lumps and issues from when it was injected. One patient had to have surgery to remove the lump and has scars on her face now.”

Dr Gavin Chan explains permanent fillers are appropriate for some patients. “A good example is fixing a post rhinoplasty deficit in the nose. If the doctor has taken out more of your cartilage or bone than required, you may have a dip in your nose. This can be corrected with permanent filler and is a good alternative to getting a rib graft to add volume back to your nose.” Permanent fillers can be appropriate for patients with atrophic scarring on their face. Injecting permanent fillers is a good solution to correcting the small divots in your skin.

Dr Gavin Chan notes once you’ve had permanent filler treatment, you can’t mix it with temporary fillers because of the risk of developing an infection or complications including sequelae. It’s also important to note that in technically difficult areas of the face like the tear trough, permanent fillers aren’t appropriate.

Permanent fillers are recognized as foreign substances by the body which can often set up an immune response. When your body detects a permanent filler, it can try to remove it by creating granulomas. This side effect occurs when your body’s immune system contains foreign substances, they’re unable to eliminate. A granuloma presents as a hard, often red lump – often where the filler was injected.

Dr Gavin Chan notes, “treatments for this are difficult and often require a cortisone or steroid injection into the filler. If that doesn’t work sometimes surgery is required to remove it. The risk of this sort of problem occurring with temporary fillers is a lot less. The body doesn’t tend to see temporary fillers as a foreign substance as much.”

As with temporary fillers, permanent fillers have a risk of intra-arterial injection. This occurs when the filler is injected into an artery which supplies a part of your face or your eye. If a permanent filler is injected into an artery and the Cosmetic Doctor or Cosmetic Nurse notices there’s a lack of blood supply, there’s nothing they can do to return it.

The pros and cons of temporary fillers

Temporary fillers have the ‘inbuilt reassurance’ that you can reverse them using hyaluronidase. Because they’re made from a natural bio engineered substance of your body, there’s less risk of developing granulomas than with permanent fillers.

Unlike permanent fillers, using temporary fillers for small areas, like the nose can be problematic. Dr Gavin Chan explains, “if you have to inject it more than once you increase the risk of intra-arterial injection which can lead to blindness. Injecting this area once with permanent filler is a perfect solution.”

If temporary fillers have traversed the artery wall, it’s possible to dissolve them using hyaluronidase. This can dissolve the filler inside the artery and potentially recover that blood supply. Dr Gavin Chan cautions, “although uncommon if this does occur through the blood supply of the retina or the eye with a temporary filler you have some chance of reversing that blockage and returning vision to that eye. In very rare circumstances, blindness can occur.”

Temporary fillers are ideal if patient’s want to ‘keep up’ with trends. For example, if big lips go out of fashion, a patient with temporary fillers would just stop having them. If they had permanent fillers in their lips, they’d be stuck with big lips forever.

Where to get the best permanent filler treatment in Melbourne

When you’re researching which medical clinic to attend for permanent filler treatment, it’s important to ask the following questions:

  • Will the permanent filler treatment be performed by a Cosmetic Doctor or Cosmetic Nurse?
  • Will the permanent filler treatment take place in a sterile environment, like an operating theatre? If not, what contingencies does the medical clinic have in place if infection occurs?
  • What permanent filler experience and training has the Cosmetic Doctor or Cosmetic Nurse got?
  • Has the medical clinic got up to date before and after photos of patients with permanent fillers?

Since 2005, Dr Gavin Chan and his team of highly trained and experienced Cosmetic Doctors and Cosmetic Nurses have been refreshing their patient’s faces by using fillers. For patients who are interested in permanent filler treatment, an initial consultation is required. Not all patients will be suitable for permanent filler treatment. If you’ve got a lot of volume loss in your face, facial fat transfer may be a more appropriate treatment. Call our friendly customer service team to book a consultation today 1300 863 824.

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Dr. Gavin Chan
Dr. Gavin Chan

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