Dermal fillers: types, uses and risks
Where dermal fillers are used on the face, how long each type lasts, what the risks are and who they are not suitable for.
Dermal fillers are injectable substances placed into the layers of the skin to shape the contours of the face, soften lines and folds, and restore volume lost with age. Because they can be applied quickly and without anaesthesia compared with surgery, they are often chosen.
Where and why they are used
- Nasolabial folds: filling the folds running from the side of the nose to the corner of the mouth
- Cheeks and cheekbones: restoring lost volume and supporting the face upwards
- Lips: adding volume, defining the border, correcting asymmetry
- Chin and jawline: defining the contour
- Under the eyes: addressing hollowing and shadowing, with very fine, soft fillers
- Temples: filling lost volume
- Scars and acne marks: raising the base of depressed scars
The forehead and the area between the eyebrows are considered high-risk for injection because of the dense network of blood vessels there, and require particular care. Injecting dermal fillers into the body to enlarge the breasts or buttocks is not an approved use.
The materials, and how long they last
Temporary (biodegradable). Hyaluronic acid is a natural component of connective tissue; because of that natural structure no allergy test is required, and if something is not as intended it can be dissolved with a specific enzyme and reversed. It generally lasts 6-12 months. Collagen-based fillers are shorter-lived (3-4 months) and some types require a skin test.
Semi-permanent. Substances such as calcium hydroxylapatite (12-18 months) and poly-L-lactic acid (1.5-2 years) act less by adding volume directly than by stimulating the body's own collagen production. Fat transfer, using the person's own fatty tissue, can also be considered in this group.
Permanent. Some synthetic materials last more than 5 years and cannot be reversed; for that reason the decision to use them needs careful thought.
Risks and complications
Temporary effects at the injection site — mild redness, swelling, tenderness and bruising — generally settle on their own within 7-10 days. Injection at the wrong depth, or in excessive quantity, can cause nodules (firm lumps). Rarely there can be infection, movement of the filler over time (migration), or serious circulatory problems caused by accidental injection into a blood vessel; that last situation requires emergency medical attention.
Results of any surgical or interventional procedure can vary from person to person. It is advisable to obtain a detailed opinion from your doctor before the procedure.
Who they are not suitable for
- women who are pregnant or breastfeeding
- those with a known allergy to the filler or its components
- those with an active infection, an open wound or active acne in the treatment area
- those with a bleeding disorder, or taking blood-thinning treatment
- those with an autoimmune connective tissue disease
- those prone to keloid or excessive scarring
- those with uncontrolled diabetes or an active cancer history
Frequently asked questions
Are fillers permanent?
It depends on the material used; temporary fillers are absorbed by the body over months, while some types last considerably longer or are permanent.
Is the result visible immediately?
With volumising fillers the effect is generally visible at once; with collagen-stimulating types the result appears gradually over weeks.
Can they be used for everyone?
No — not in the situations listed above; suitability is determined by medical examination.
See also dermal fillers.