Last updated: November 2021

What are dermal fillers?

Dermal fillers are a non-surgical treatment primarily used to contour, shape, volumise and proportion the face, making them a very powerful tool for facial rejuvenation or enhancement.

The most commonly used dermal fillers are made from cross-linked hyaluronic acid. They are temporary and reversible, but the longevity of these fillers is likely to be significantly longer than the generally accepted 6 to 18 months they are believed to last for. It is important to use small amounts only at infrequent intervals to achieve natural-looking results.

Where can fillers be injected?

Dermal fillers are injected beneath the skin, usually in the subcutaneous fat layer or deeper. Areas or categories of treatment include;

Dermal fillers can also be used to smooth transitions between adjacent areas of the face. For example, they can be used to smooth the transition between the lower eyelid and cheek, also known as the tear trough. Another example is the use of dermal fillers between the jowls and the chin to help straighten the jawline.

Dermal fillers are also used to enhance and beautify the face and skin. A popular example of this is lip enhancement. Here, they can be used to outline and define the lip borders or in the lip body to enhance lip size and shape.

Dermal fillers are also commonly used for replacing facial volume after volume loss due to ageing or weight loss. Cheeks and temple treatment are key examples of this.

It is also possible to inject dermal fillers into wrinkles or fine lines to treat the signs of ageing.

What types of dermal filler treatments are available?

(Due to TGA regulations, the brand names cannot be mentioned)

The most commonly used dermal fillers are composed of hyaluronic acid. Hyaluronic acid is found naturally in our bodies, including in our skin, eyes and joints. Unlike our own hyaluronic acid, chains of hyaluronic acid in fillers are cross-linked or bonded together. The thick gel-like consistency of fillers is a result of cross-linking. The amount of cross-linking determines thickness and longevity. To learn more about hyaluronic acid.

Thicker fillers are firmer as a result of greater cross-linking and can be used to volumise an area. Finer fillers with less cross-linking are generally used in areas where the skin is fine and smoothness is critical, such as around the eyes.

Hyaluronic acid fillers are reversible by injecting the enzyme hyaluronidase. This is useful for the treatment of misplaced or excess hyaluronic acid fillers.

Permanent fillers are available, however, these are much less commonly used because they are not reversible unless surgically removed.

Dermal Filler Case Studies

Tear trough fillers

This is an example of dermal filler placed into the tear troughs to help smooth the transition between the lower eyelid and the cheeks. 

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Lip fillers

In this example, injectables have been used to create improvements in the shape and size of the upper and lower lips.

lip fillers

Forehead and frown fillers

This patient presented to the Victorian Cosmetic Institute concerned about her frown lines and forehead lines. Fillers were used to reduce the concavities in her forehead and improve the static fine lines. Anti-wrinkle injections were also used to relax muscles that caused creasing of the skin in the forehead and between the brows.

Frown and forehead before and after (1)

 

Eye rejuvenation

This patient presents to the Victorian Cosmetic Institute with concerns about looking tired. She was treated by Dr. Natasha Moscato who identified that she had some volume loss around the eyes. She replaced this volume in the upper eyelids and tear troughs using dermal filler with excellent and natural-looking results.

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How long do dermal fillers last?

The generally accepted longevity of temporary hyaluronic acid fillers is from 6 to 18 months. We recently challenged this by performing MRI scans of patient’s faces who had hyaluronic acid fillers several years ago. In the vast majority of these scans, we found the fillers persisted. Our findings indicate temporary hyaluronic acid fillers may last for over 10 years in many cases. This finding also correlates to our clinical observations. We have often found fillers to last in areas such as the tear troughs for over 10 years. The eye area has fine skin, making it possible to discern the presence of filler without an MRI scan.

Despite their unexpected longevity, the reversibility of hyaluronic acid fillers with an enzyme called hyaluronidase is still possible at any time.

Given the possible longevity of fillers, we consider it important to use smaller amounts at very infrequent intervals. This will prevent over-filling of the face.

Dermal fillers procedure

A consultation is required prior to having fillers done. This is to provide your treating practitioner with your history and allow for an assessment of your face. The volumes, areas to be injected and cost can then be planned in advance.

The treatment begins by cleaning the face using an antiseptic. Local anaesthesia is often used to numb the treatment areas. Filler can be injected with either a needle or a cannula. For most areas of the face, we prefer to use cannulas rather than sharp needles. Unlike needles, cannula tips are blunt. This helps to avoid puncturing blood vessels. We also utilise a device called an Accuvein prior to injection of fillers. This helps to detect the location of the veins and reduce the risk of bruising.

During the procedure, your practitioner will regularly assess the placement and effect of the filler in order to create the desired results.

Most filler injections take between 30 to 60 minutes to perform and are done in the clinic setting. 

What to 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. You will see some results immediately after the procedure, but you will not see the full results for a few weeks. During this time, the swelling subsides, the filler ‘hydrates’ and integrates into the tissues of the face.

Bruising can also occur, and if it does, it will normally take a week or two to completely disappear.

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 a different injectable product called hyaluronidase. For treatments around the eyes, puffiness can occur, and if present after one week, it will most commonly require hyaluronidase to correct. Corrections can be made in a subsequent follow-up visit and filler can be added or removed during this time.

Infection is a rare complication of dermal filler injections. Bacterial infections and viral infections (such as cold sore reactivation) can occur post-filler treatment. We help to prevent these complications through proper cleansing of the skin with antiseptic prior to treatment. 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.

Injection of fillers directly into a blood vessel, or occlusion of a blood vessel from filler injections is also a rare but serious side effect of dermal filler injections. To avoid this, we tend to use blunt-tip cannulas rather than needles to inject the filler product. Blunt-tip cannulas can actually help to avoid blood vessels by pushing them away instead of entering them. Unusual changes in the skin post-treatment, such as sudden blanching, redness, or even acne-like pustules are often signs of vascular occlusion.

Generally, dermal filler treatment is a very safe, non-surgical treatment for volumising and shaping the face. They have been used safely for cosmetic reasons for over 20 years.

Possible Complications

Severe complications as a result of dermal fillers are very rare, but some potential risks and side effects can include:

  • Redness
  • Pain
  • Bruising
  • Swelling
  • Itching
  • Infection
  • Leakage or migration of the filler
  • Injury to blood vessels
  • Asymmetries in the face

FAQs

How much do dermal fillers cost?

Our doctors will discuss this with you in your initial consultation as the cost of your treatment will vary depending on what area you are treating and how much filler is required.

Prices start from $875 for one 1ml syringe.

Click here for the full price list.

What is the difference between anti-wrinkle injections and dermal fillers?

Despite having different actions and results, they are commonly used in conjunction with each other.

Anti-wrinkle injections relax the muscles of facial expression that cause wrinkles in the skin and provide no additional volume to the face. The typical longevity of anti-wrinkle injections is from 3 to 4 months.

Conversely, dermal fillers are injected to shape, contour and volumise the face. The longevity of fillers is significantly longer than anti-wrinkle injections.

Why choose Victorian Cosmetic Institute as your provider of dermal fillers?

Our dermal filler injectors have many years of specialist experience. We allow you ample time to communicate your aesthetic goals to us, and use our expertise to help you achieve your desired outcome. Our goals for our patients is to achieve natural-looking results using the least amount of filler possible to achieve your result. 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
  • Create natural-looking enhancements using the smallest amount of filler possible
  • Cause as little bruising and swelling as possible
  • Ensure that your procedure is comfortable for you
  • Achieve the best aesthetic results possible

Simply click the “book online” button above and fill out the form.

Alternatively, call us on 1300 863 824 to discuss your filler needs.