Dermal Fillers


When we are younger we see ‘dynamic’ lines in parts of the face where there is lots of muscle movement. Over time, these might linger a little longer, or become a little deeper, even when your face is at rest (referred to as ‘static’ lines).

Also, you may see changes to the curves and contours of your face due to volume loss. Areas prone to skin volume loss include the cheeks, lips, brows, temples and jawline.

Dermal fillers treatments efficiently reduce lines, folds and wrinkles, create fuller lips, enhance contours and facial volume, as well as improve skin structure and elasticity. Dermal fillers are a safe and natural way to enhance your looks.

More and more people are turning to cosmetic treatments to enhance and rejuvenate their face. So to help you understand how dermal filler treatments work, we have put together answers to the most commonly asked questions.
Q – What is a dermal filler?

A dermal filler is a smooth injectable gel made from natural complex sugar called hyaluronic acid. It is injected below the skin’s surface to ‘fill-in’ wrinkles, ‘plump-up’ small areas such as lips and ‘re-volumise’ large areas like cheeks and temples.

Q – How do dermal fillers smooth out wrinkles?

A ‘dermal filler’ is an injectable dermal filler gel. It’s made from the same naturally occurring sugars (called hyaluronic acid or HA) that provide the skin with volume and hydration. Dermal fillers are placed below the skin’s surface to ‘fill in’ or ‘plump up’ static facial wrinkles and folds.

Dermal fillers create natural-looking and feeling results that can last up to 24 months. A number of different dermal fillers are available. Some are used for subtle correction of facial lines where others are used for the correction of more severe facial lines and folds.

Q – What is hyaluronic acid?

Hyaluronic acid is a sugar molecule that exists naturally in almost all living organisms. It binds water and can act as a lubricant and shock absorber in movable parts of the body such as joints. It is also important for the transport of nutrients and in regulating water balance in skin.

Q – What areas can be treated?

Dermal fillers can be used to smooth away facial lines and wrinkles, create fuller lips and shape facial contours, such as cheeks and chin, and rejuvenate the skin.

The most common areas treated are:

  • nose to mouth lines (the nasolabial folds)
  • between the eyebrows (the glabella lines)
  • lips (adding volume and shape)
  • cheeks and chin (shaping and contouring)
  • back of the hands, décolletage, face, neck (skin rejuvenation)

Q – What does dermal filler treatment involve?

Prior to your treatment:

During a free consultation you will be asked to discuss your individual wishes and expectations. Next you will receive recommendations of which filler treatment is most suitable for you. This will be based on what you wish to achieve, your features and individual life style factors.

During your treatment:

The dermal filler is injected into the skin in small amounts using a very fine needle. The gel provides natural volume to smooth away the appearance of lines and wrinkles, enhance facial shape, or create fuller lips, and improve the elasticity and texture of skin, and restores and maintain the skin hydrobalance.

The treatment is quick, typically taking about 30 minutes. The treatment does not affect facial expression and the benefits can normally be seen instantly.

Following your treatment:

Dermal fillers are biodegradable, which means they will naturally disappear in the body. A follow-up treatment is usually needed after 6 to 12 months depending on individual factors, area treated and type of dermal filler used. Discuss with your specialist when a follow-up might be needed.

After a treatment some reactions might occur. Most common is slight redness, swelling, itching, bruising, pain and tenderness. The reactions are generally mild to moderate and usually disappear shortly after injection. They usually resolve spontaneously within one or two days after injection, but for some treatments they may last longer.

Q – Does dermal filler treatment need pain relief?

Generally, pain relief is not necessary when injecting into the skin to correct wrinkles. Dermal fillers contain a local anaesthetic agent. Some people may experience the treatment as a mild discomfort. Prior to treatment a local anaesthetic cream can be applied to the area, or alternatively a local anaesthetic injection can be given to avoid pain.

The lips are a highly sensitive part of the body and, therefore, anaesthesia is usually recommended before lip enhancement. This is achieved most effectively by using a dental block or local anaesthetic.

Q – When will I see results and how long will they last?

Results can be seen immediately, and the majority of people resume their normal activities immediately after the procedure. In its natural form, HA is a single chain sugar that is broken down naturally by the body within days. Depending on the type and brand of filler results can last up to 24 months

Q – What should I bear in mind when considering a treatment?

First of all you should always contact a qualified specialist to be assured that the treatment will be performed correctly. For your safety, be prepared to discuss your medical history during your pre-treatment consultation.

Q – Are there any possible side effects?

Dermal fillers have been used for many years and are generally well tolerated. While you may experience no side effects at all, as with all medications, side effects can occur. Reported dermal filler side effects include injection site redness, pain, firmness, swelling, lumps and bumps, bruising, itching or discolouration. In the vast majority of cases, these effects are temporary and should resolve within a week.

It is recommended that you avoid massaging and/or applying pressure to the treated area for a few days following treatment. It is also recommended that you do not wear make up for 12 hours following your treatment and that you avoid lengthy exposure to the sun, UV rays, and extreme temperatures.

Q – Are there any risks with dermal fillers?

Product related reactions are rare. There are some injection related reactions, which may occur after any injection; they typically resolve spontaneously a few days after injection to the skin, within one to two weeks after injection into the lips. These reactions include redness, swelling, pain, itching, bruising or tenderness at the injection site.

After a lip enhancement, your lips may be swollen for up to a week. In case of more pronounced reactions or if they last longer than a week contact your specialist.

As with all skin injection procedures there is a small risk of infection. Local inflammatory reactions described as mild to moderate and usually self-limiting within 2 weeks have rarely been reported.

Q – Can dermal fillers be used if I have had laser treatment or a chemical peel?

If you have recently had a laser or chemical peel treatment, it is recommended you wait until the area is totally healed and the skin is back to its normal condition. Consult your specialist.

Q – Can everybody use dermal fillers?

Most people can benefit from dermal filler treatment. If you want to reduce lines and wrinkles or create more defined or fuller lips, dermal fillers can help. Also if you want to define the contours of your face, such as chin or cheek, or rejuvenate the skin in your face, on your hands, neck or décolletage, dermal fillers a good option for you.

Dermal fillers should not be used in or near areas where there is or has been skin disease, inflammation or related conditions. Dermal fillers have not been tested in pregnant or breast-feeding women. Individuals with medical conditions that lower the body’s immune response or individuals undergoing therapy that is immunosuppressive may be more prone to infection by a skin injection procedure.

During your pre-treatment consultation, you should thoroughly discuss your medical history with your practitioner.

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Temple Volume

Most people may not realise that they naturally lose volume from the face over time. What they may notice, though, is a gradual change in facial shape over time due to the natural loss of facial volume (collagen, hyaluronic acid and fat).

One of the places the face naturally loses volume from over time is the temples. Facial volume loss from this area may change the contour of the face and make the underlying bone more obvious. The loss of volume in the temple area may also result in a drop in height of the end of the eyebrow. These changes may make the face look less youthful.


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Tear Troughs (Circles under Eyes)

Tear troughs are often recognised as darkness or ‘circles’ under the eyes that can make you appear tired or older than you feel.

The development of tear troughs is caused by a loss of volume around the lower eye area, which forms a ‘trough’ or area of less volume between the lower eyelids and the cheeks.


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Cheek Volume

The cheeks are a very important feature of the mid-face. Your eye is naturally drawn to the cheek area because it connects the eyes and the lips – the two most important structures for communication and expression.

If you compare the faces of people in their 50s or 60s to photos of them in their 20s, you are likely to notice a difference in their cheeks right away. Cheeks in a youthful-looking face have smooth contours and are full of volume. In fact, our cheeks are generally at their most voluminous and smooth when we are babies!

However, the shape of the cheeks changes with age due to a loss of facial fullness and facial volume redistribution. Over time, the amount of soft tissue volume over the cheekbones decreases. In addition, the ligaments that hold soft tissue in place weaken naturally with age and, together with the effects of gravity, result in the soft tissue moving downwards.

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Nose Shaping

According to a cosmetic and plastic surgery consumer survey, many Australians would like to change the size or shape of their nose.

While it is difficult to describe the ideal nose, it has been claimed that it is the one that `most harmoniously relates to the other facial features’. Straight, symmetrical noses with no obvious bumps or dents complement an attractive face. Even small changes in the nose can have a major impact on how you look overall.


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Nasolabial Folds

The nasolabial fold is a natural feature of the face that may be seen in people of all ages. It is a groove or fold of skin that runs from the edge of the nose to the corner of the mouth.

Deepening of the nasolabial fold is one of the facial changes that you would probably notice in your 40s. It occurs because the fat and other soft tissue that normally sits high on your cheeks starts to move downward.


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Lip Volume & Definition

If you have used lipstick or gloss before, chances are you probably understand the impact your lips can make on your overall look. This is because the lips are a key focus point when communicating.

How would Australian women describe their ideal pair of lips? A survey indicated that natural-looking, full lips with defined borders or a strong Cupid’s bow (the v-shaped area of the upper lip) were considered most attractive.

However, over time, the outer layer of the lips can become thinner and the Cupid’s bow begins flattening out, causing the lips to become elongated and lose their youthfulness.


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Vertical Lip Lines

Vertical lip lines are lines that run at a right angle to your lip border. These lines are caused by the regular movement of the muscles around the mouth, volume loss in the upper lip and sun damage which reduces the elasticity of the skin.

When you are young, your skin easily ‘springs’ back to its rest position after you purse your mouth around a straw or pucker up for a kiss. However, as time goes on, your skin may become less supple and lines may start becoming evident, even when you are not pursing your mouth. If they become deeper, you may notice your lipstick bleeding up into them.

Vertical lip lines tend to be more common in people who smoke or used to smoke, which is why they are also known as ‘smoker’s lines’. So if you smoke, you may want to consider quitting for many health reasons including skin health!

The diagram below shows the muscle around your mouth pulling towards your mouth when you purse your lips (red arrows). This causes the skin around your mouth to bunch together, hence creating vertical lines (black lines).


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Mouth Frown

Some people develop a slight droop in the corners of their mouth, which can give their expressions a hint of sadness or disapproval. This is referred to as a mouth frown.

A mouth frown develops over the years because of an imbalance in the muscles surrounding the mouth. The muscles that naturally pull down the corners of the mouth are stronger than the muscles that pull them up into a smile.


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Marrionette Lines & Jowls

Marionette lines refer to the lines or wrinkles that extend from the outer corners of the mouth down towards the chin and jawline. If you have deep marionette lines, they may cause you to appear unhappy, even when you’re not!

How do marionette lines form? Over time, ligaments that hold skin volume in place may weaken, causing volume from the midface to descend towards the jawline. The muscles that naturally pull down the corners of the mouth (shown in the diagram below) may accentuate the accumulation of skin around the jawline. This creates marionette lines (shown by black lines radiating from the mouth corners towards the chin and jawline). The excess skin in the lower face may create a jowly look.


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Mental Crease

If you have noticed the beginnings of a horizontal indentation in your chin, you may have wondered why.

A ‘mental crease’, or the horizontal groove between your lips and chin, is actually a natural facial change over time. It is called ‘mental’ because it is formed near the top of the chin (mentalis) muscle. The action of the mentalis muscle combined with changes in the distribution of fat in your lower face causes the mental crease to develop. The changes in fat distribution plus a loss of collagen in the skin may also lead to the chin having an ‘orange peel’ appearance (sometimes called popply chin or ‘peau d’orange’).


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Chin and Jaw Definition

Have you ever noticed the difference in facial shapes between people from different generations?

The young-looking face has a fine, defined jawline with smooth contours. It can be compared to an egg, with the narrower part of the egg pointing down. Over time, the overall shape and contour of the face changes with age – and the egg can start to turn upside down. The mid-face loses volume, while the lower face gains volume with the formation of jowls.

Losing definition in the chin and jawline is common and a natural facial change. It is a result of the gradual loss of facial volume. In addition, the loss of support from weakening facial ligaments causes the descent of soft tissue, which causes the chin and jawline to look less defined.


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Rejuvenation of Neck, Décolletage and Hands

Volume loss of the neck, décolletage and back of the hands can contribute to giving away our age, especially when all other areas remain fresh and young looking. Dermal fillers can restore the volume loss and rejuvenate the treated area(s).