Last updated date: 27-Apr-2023

Originally Written in English



People are looking for procedures to reduce the appearance of grins and crow's feet as well as to plump up their hands, cheeks, and lips. Dermal fillers can be injected into the face and hands to reduce the appearance of wrinkles and volume loss caused by aging or specific medical disorders. People generally state that they are satisfied with the results of their therapy in studies using dermal fillers that have been approved by the U.S. Food and Drug Administration.

Dermal fillers are not suitable for everyone, though. People with specific illnesses, such as bleeding disorders or certain allergies, may not be a good candidate for dermal fillers. If your doctor says dermal fillers are a choice for you, be aware that all medical products have advantages and disadvantages. The FDA suggests that you pick out a qualified medical professional who has expertise in injecting dermal fillers and is educated about fillers, anatomy, and handling issues. Most importantly, the FDA advises that you ask about the risks and benefits of the procedure before proceeding.


Filler Definition

Filler Definition

Dermal fillers aid in reducing facial wrinkles and restoring the fullness and volume of the face.

Our faces naturally lose subcutaneous fat as we get older. As a result of the facial muscles being used closer to the skin's surface, smile lines and crow's feet are more noticeable. This loss of facial volume is worsened by the little stretching of the facial skin. Sun exposure, genetics, and lifestyle are additional factors that have an impact on the skin on the face. Skin fillers are capable of:

  • Narrow, plump lips
  • Improving shallow contours
  • Reduce face wrinkles and creases
  • Enhance the look of recessed scars
  • Repair facial contour deformities
  • Reduce or get rid of the lower lids' shadow.

In people who are showing early indications of aging or as an added benefit to facial rejuvenation surgery, dermal fillers can be highly beneficial. The most effective option for some people may involve surgery, such as a facelift, brow lift, or eye lift. Treatments for minimally invasive rejuvenation, including soft tissue fillers, cannot produce the same outcomes but may help postpone the point at which a facelift should be considered. It's crucial to keep in mind that dermal fillers are only temporary solutions for facial aging and that continuing care is required for lasting effects.


Filler Lips

The popularity of lip fillers is continually growing and doesn't appear to be declining.  A form of injectable known as lip fillers adds volume to the lips to produce a fuller, plumper pout. Additionally, they help restore lost volume, reduce wrinkles around the mouth, and improve definition and contour. Fillers provide an instant way to plump the lips, and since they are temporary, they are perfect for people who want to enhance their appearance without committing to anything long-term.


Filler Under Eyes

Hyaluronic acid injections known as under-eye fillers (also called Restylane and Juvederm) can be used to correct volume loss underneath the eyes. The fillers typically last six to nine months, although they are ineffective for treating pigmentation (i.e., dark circles).


Filler Candidates

Filler Candidates

Dermal fillers might be a viable option for you if you:

  • Are in good health
  • Avoid smoking
  • Keep a good attitude and realistic objectives in mind while you work to improve your looks.
  • Are dedicated to preserving healthy skin

The best course of action for some people may involve surgery, such as a facelift, brow lift, or eye lift.


Filler Types

Calcium Hydroxylapatite

Calcium Hydroxylapatite

Natural calcium hydroxylapatite, a substance that resembles a mineral, is present in human bones. It frequently does:

  • Creases that range from mild to severe, including frown lines, marionette lines, and nasolabial folds.
  • Improve the cheekbones' volume and other facial features.
  • Regain volume when there is face wasting, as can happen in HIV-positive persons using certain drugs.

Since calcium hydroxylapatite is generated synthetically, no animals or animal byproducts are involved in its production. Your risk of an allergic reaction is reduced, and no skin testing is necessary. This kind of dermal filler is known for producing highly natural-looking outcomes, doesn't migrate, and seldom causes negative effects. This dermal filler has a long history of safety and was initially used in dentistry and reconstructive surgery.


Filler with Hyaluronic Acid

Injections of hyaluronic acid can help the skin's contour and lessen depressions brought on by scars, injuries, or lines. You could expect to see very significant improvements for:

  • Acne scarring
  • Depressed cheeks
  • Crow's feet at the outer corners of your eyes
  • Deep lines of smile that extend from the corners of the lips to the side of the nose (also known as nasolabial furrows)
  • Frown lines between the eyebrows
  • Mouth corners with marionette lines.
  • Redefining lip border
  • Scars, such as those from burns, pimples, and wounds
  • Vertical lines on the mouth; smoker's lines
  • Some scars on the face
  • Forehead wrinkles caused by tension

Your body naturally contains a chemical called hyaluronic acid. High concentrations can be discovered in the fluid around your eyes and soft connective tissues. Additionally, it is present in various joint and cartilage fluids as well as skin tissue. It is removed, reconstituted, and is now among the most widely used categories of injectable fillers. If the word seems familiar, it's because the same medication is frequently injected into arthritis patients' painful joints to reduce pain and add additional cushioning.




Plastic surgeons frequently employ the semi-permanent dermal filler polyalkylimide to:

  • Taking care of depressed scars and deeper wrinkles like the nasolabial folds
  • Narrow, plump lips
  • Improve the jawline and cheekbones, and restore facial volume that has been lost with aging.
  • Treatment for HIV medication-induced facial wasting

Because polyalkylimide reacts with human tissue relatively little, it is biocompatible and doesn't need to be tested for allergies. Since it is radio transparent, x-rays won't be impeded by it. Within a month of the injection, a thin coating of collagen gradually grows around it. Eventually, the gel is completely encircled. Large volumes can be injected in a single process. It is even possible to remove this substance, which is regarded to be quite stable over time.


Polylactic Acid

A synthetic dermal filler called polylactic acid is injected into your face to stimulate the body's natural production of collagen. A stimulator is a name given to this kind of dermal filler. This biodegradable, non-toxic polymer has been utilized as a suture material for more than 40 years. In the lower half of your face, polylactic acid is known to be effective particularly well and is utilized for:

  • Fill in the laughter-related lines
  • Narrow, plump lips
  • Taking care of deep nasolabial folds

This material differs from other dermal fillers in that it takes time to show benefits. Instead, it promotes your own body to produce collagen, so benefits take a few months to develop gradually.

To get the results you want, you'll probably require three monthly treatments. Your collagen is stimulated again after each treatment. The full effects may not be visible for another four to six weeks. Even though this kind of dermal filler is regarded as semi-permanent, you can still require periodic touch-ups.


Polymethyl-Methacrylate Microspheres (PMMA)

PMMA filler

Medium-to-deep wrinkles, folds, and furrows are most frequently treated with PMMA, a semi-permanent filler, especially nasolabial folds. Additionally, it can be used to thicken thin lips and fill out scars with pits.

In place of collagen replacement therapy or hyaluronic therapy, PMMA is frequently utilized when a more long-lasting treatment for face creases is needed. PMMA has long been utilized in surgical implants that last permanently. As a result, your surgeon will probably underfill during the initial procedure and add more if necessary.

One drawback of PMMA is that it requires several injections to increase volume, and it can take up to three months to see the full effects. It could also be visible through the skin. The right approach, which involves injecting at the dermal subcutaneous junction using threading or tunneling techniques, is crucial for preventing any undesirable effects.


Filler Preparation

Filler Preparation

Be ready to discuss the following during your consultation for dermal fillers:

  • Your goals
  • Drug allergies, health problems, and medical therapies
  • Alcohol, cigarettes, drug use, vitamins, herbal supplements, and current prescriptions
  • Any prior facial surgery, soft tissue filler treatment, botulinum toxin treatment, laser, or other minimally invasive facial treatments.

Your doctor might also:

  • Examine your overall health and any risk factors or underlying diseases.
  • Discuss the various options you have.
  • Analyze and take a face measurement.
  • Take pictures
  • Provide a plan of therapy
  • Examine possible results of employing soft tissue fillers as well as any dangers or issues.

Your plastic surgeon will explain each step in details:

  • Your chosen course of treatment
  • The kind of filler that is recommended for your instance and why
  • Expected outcomes
  • The durability of the outcomes

You must comprehend every aspect of dermal fillers. Whether it's enthusiasm for your anticipated new look or a little pre-treatment stress, it's normal to have some anxiety. Do not be afraid to express your emotions to your plastic surgeon.


Filler Injections

Filler Injections

Facial Evaluation and Mapping

The plastic surgeon or his professionally qualified nurse will assess your facial features, skin tone, and the areas of your face that need to be boosted if you decide to use packaged soft tissue fillers. The ideal injection locations for the filler may be designated at strategic points on your face. The areas that will be treated may be captured on camera.


Cleansing and Anesthesia

An antibacterial cleaner will be applied to the injection locations. Use of a very cold instrument to cool the skin, application of an anesthetic ointment to numb the skin, or injection of local anesthesia can all reduce pain at the injection site. Although not painless, the injections are typically not too painful.


The Injection

Each site's injection typically just needs a few seconds. The procedure involves injecting, massaging, assessing the outcomes, and adding more filler as necessary. The entire procedure could take as little as 15 minutes or as much as an hour, depending on how many areas need to be treated.


Clean-up and Recovery

Any markings will be removed after the results are considered satisfactory. An ice pack might be recommended to you to ease pain and minimize swelling. Even though the area may be a little painful for a day or two, it normally doesn't hurt enough to warrant taking any medication.


Filler Aftercare

Filler Aftercare

The amount of time required for recovery varies depending on the patient and the filler used. Most activities can be resumed soon away, however, it is typically advised that you avoid strenuous exercise for the first 24 to 48 hours to reduce swelling and bruising. Before scheduling your injections, be sure to go through your recovery plan with your doctor. Following dermal filler therapy, you may initially look like:

  • An appearance of overfill in treated areas
  • Varying degrees of mild to severe swelling or bruising
  • Temporary tingling or burning
  • Lumps or hard spots at the injection sites that can be felt
  • Hives and swelling from a hypersensitivity reaction that can resemble an allergic reaction

The majority of conditions can be treated with topical cooling and massage, and they usually get better within a few hours or days. Some reactions can necessitate more aggressive medication or injectable therapy. Visual disturbances can happen, however, they're uncommon. You must get in touch with your surgeon right once if you experience discomfort or weakness on one side of your body. When your fat is used as the injectable filler, the recovery time may be several weeks.


Filler Results

Dermal fillers are used to enhance soft tissue, and the results are instantly visible and remain for several months to many years, depending on the filler and the patient. The outcomes and longevity will be improved by maintaining good general health and strong, healthy skin with the right products and skin treatments.


Filler Risks

Filler Risks

The choice to employ fillers is quite personal. You must determine whether the advantages will help you reach your goals and whether the risks and potential side effects of dermal fillers are reasonable. All possible risks will be thoroughly explained by your plastic surgeon and colleagues. There are rarely severe side effects from dermal fillers. Potential concerns can include the following and vary based on the particular filler used and the relative durability of the filler substance:

  • Skin eruptions resembling acne
  • Asymmetry
  • Bleeding at the site of the injection
  • Bruising
  • Skin damage that leaves a wound and could leave scars
  • Infection at the injection site
  • Lumps
  • The potential to feel the filler beneath the skin's surface
  • Skin necrosis (ulceration or loss of skin from disruption of blood supply)
  • Skin rash that itches
  • Skin irritation
  • Swelling
  • Under- or over-correction of wrinkles

Rarely, the filler could unintentionally be injected into your blood vessels rather than beneath your skin. This might restrict blood supply. Depending on where the block is located, many things can happen if your blood flow is restricted. You may experience skin loss or sores if your skin is compromised. You could go blind or lose your vision if your eye is compromised.


Filler Cost

Filler Cost

According to 2020 data from the American Society of Plastic Surgeons, the following is a list of the average cost of numerous common types of dermal fillers, with prices shown as a per-syringe cost. To get the desired outcomes, the majority of patients require numerous syringes.

  • Calcium hydroxylapatite: $710
  • Fat grafting: $2,500
  • Hyaluronic acid: $680
  • Platelet-Rich Plasma (PRP): $980
  • Polylactic acid: $850
  • Polymethyl-methacrylate microspheres: $1,050

When receiving an elective procedure or therapy, the cost is always a factor. Dermal filler injection prices might change depending on the practitioner's experience and credentials, the type of therapy used, the amount of time and effort required, the location of the practice, and other factors.

Remember that the experience of the plastic surgeon and your comfort level with him or her are equally as significant as the ultimate cost of the treatment when selecting a cosmetic surgeon for dermal filler injections. Dermal fillers are not covered by health insurance; however, many plastic surgeons have patient financing options; be sure to inquire.

Although tissue augmentation with dermal fillers is a quick, in-office procedure that can significantly improve the appearance of facial fullness and youth, effective and safe use necessitates a doctor with specialized training and a thorough understanding of facial anatomy to recommend and inject a proper filler. Dermal fillers can have serious side effects, just like any other medical treatment, therefore it's crucial for your safety and successful treatment that you go to a board-certified plastic surgeon.



Dermal fillers vary in their chemical composition, duration, and degree of softness. For example, softer fillers are used on the lips, whilst stronger fillers may be preferred to enhance cheekbones. The optimal filler kind and the dose required for your specific problem areas will be decided upon by your surgeon and you together. The use of off-the-shelf fillers can be a quick office procedure that effectively improves many people's looks. The risks and adverse effects of these dermal fillers are very low and are highly predictable. These fillers are frequently injected in a medical clinic or the office of the surgeon.