Dermal Fillers: facial injections. Enhance lips, cheeks, jawlines, and around the eyes

Dermal fillers are most commonly used in the lips, jawlines (to hide jowls), cheeks, chins, temples, (the fold from the nose to the corners of the mouth), and in permanent frown lines.

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 dermal fillers. 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.

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 a thicker gel or Radiesse. The gel fillers 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.

Finer lines are usually harder to fill with dermal fillers, and require finer fillers.  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.

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.

A large number of our dermal fillers options are made from a clear gel composed of a substance that is naturally found in skin. The main differences between the 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.  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 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.

Collagen stimulators, although technically not dermal fillers, are also facial volumisers. Unlike dermal fillers, they actually stimulate the skin to produce more collagen and therefore thickness and volume. This process takes several months after the injections.

One of the collagen stimulators is based on calcium microspheres. This is combined with a short-acting dermal filler, methycellulose, that immediately and temporarily fills whilst the calcium microspheres stimulate new collagen production. Collagen stimulators are particularly suited to replenishing facial volume in those with global volume loss.

How much dermal filler is required for each treatment area?

This is dependent on each individual and can only be determined during a consultation with one of our practitioners.

How much does dermal filler cost per ml?

This patient presented to Victorian Cosmetic Institute with concerns of the way her frown lines and forehead lines made her appear. She is a happy and joyful person and wanted her face to reflect her kind nature. The results is a youthful and natural appearance with no surgery. The static lines have been smoothed using dermal filler and reduced the cause of her frown lines with anti-wrinkle injections. Furthermore, fillers have been used to improve the contours of her forehead (not just the lines), by placing filler deeply in forehead concavities.

This patient selected Victorian Cosmetic Institute for treatment with dermal fillers. She had treatment of the full face. 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

This patient presents to 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.

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  0.8mL of dermal filler. The after picture was taken approximately 2 weeks after the treatment.

This lady was concerned with the wrinkles around her mouth. A total of 2 mL filler was injected into the wrinkles around the mouth, including some into the corners of the mouth to help turn the corners up.

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.

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. Conversely, dermal fillers often take up to a week to ‘hydrate’. They are very hydrophillic, which means they are attracted to water. Final results from fillers therefore take about a week or more, which is the time it takes for any swelling to subside and the dermal filler to hydrate.

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. To avoid bruising, we generally use blunt-tip cannulas rather than sharp needles to avoid puncturing blood vessels. We 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.

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.

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 actually can help to avoid blood vessels by pushing them away instead of entering them. Practitioner knowledge of the vascular anatomy of the face can also help in avoiding accidental injection into blood vessels. 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 very safe, non-surgical treatment for revolumising and shaping the face. They have been used safely for cosmetic reasons for over 20 years.

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.

This patient presented to Victorian Cosmetic Institute with concerns of her eye area and that her lips are dropping down. She also has a considerable concern to her loss of volume in her face. The patient was treated with anti-wrinkle to the forehead and dermal filler around eyes, lips and jawline.  You can see the significant improvement made to her entire face, it is subtle work however the patient looks rejuvenated and more youthful.

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
• 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.

For estimate volumes and costs for dermal filler and or anti-wrinkle injections please visit the Cosmetic consultation and treatment pricing page.