Dermal fillers have come of age over the last decade. It was once thought that they were a one-trick pony that provided a temporary or semi-permanent solution for a frown line or wrinkle. But this is not the case and nowadays, dermal fillers have much more versatility than they did seven to ten years ago. Over 1 million people worldwide undergo fillers injections every year.
While these fillers are usually quite safe, cosmetic patients need to know the facts and check their skin first before proceeding. Most of the skin types have safe application rates, but some people will suffer an allergic reaction, bruising, bleeding, or even swelling and it is important to recognize these potential side effects.
This guide aims to explore the basics of dermal fillers, how they work, their risks and benefits and how to choose a reputable dermal filler injection.
What Are Dermal Fillers?
Fillers are non-surgical, non-invasive cosmetic products that are used to fill out sagging, wrinkles, contour problems and create a more youthful appearance. The injectable solutions are made up of inert substances, like hyaluronic acid or synthetic hydroxylated poly-L-lactic acid. Some fillers are made from body tissues (autologous fillers).
These fillers are ideal for people who are not ready to go under the knife for facial or body rejuvenation. It successfully reduces the appearance of wrinkles, crow’s feet, and other face damage caused by age, habits, or environmental conditions.
How Can Dermal Fillers Improve Facial Aesthetics?
Dermal fillers are used to replace lost volume in the cheeks, lips, jawline, and face. It is considered that volume loss begins with the commencement of ageing and that by the age of 30, a person’s skin has lost some considerable amount of skin elasticity. This continues annually at the rate of 1%. By 60, that volume loss reaches a plateau and they lose approximately 30% of the volume in their skin. These fillers do much more than simply fill out the volume in the skin. They:
- Plump and fine-tune the lips (texture, volume, and quality).
- Increase lip, mouth, and jawline definition.
- Enhance symmetry, proportion, and overall facial aesthetics.
- Alleviate the appearance of bags, hollows, and wrinkles under the eyes and smooth chin creases.
- Fill out forehead wrinkles, creases, folds, and furrows (crow’s feet).
- Add volume to jowly cheeks.
Treatment Areas for Improvement
Fillers aid in the creation of a wide range of aesthetic results. Some are better suited to certain target areas, especially when volume seems to be lacking or there are contour irregularities. The most common areas for improvement are:
- Nasolabial folds
- Marionette lines
- Chin wrinkles
- Lip volume
- Cheek volume
- Tear troughs
- The elevens
- Acne scarring
Cosmetic patients who are considering dermal fillers need to discuss their situations and preferences with a reputable clinician.

Photo by Atikah Akhtar on Unsplash
Eligible Candidates for Dermal Fillers
Cosmetic patients must first confirm their eligibility before proceeding with any treatment. This is to ensure that they get the best result with fewer to no adverse effects. Ideally,
- Candidates must be over the age of 21 and have one of the above-mentioned cutaneous conditions.
- They must have attempted different treatments for their ailments, which range from minor to moderate.
- They do not smoke cigarettes and other tobacco products.
Although dermal fillers address a broad range of skin conditions, they are not suitable for persons who have active acne, autoimmune illnesses, a history of anaphylaxis or severe reactions to any medications or injections. Likewise, pregnant women and nursing moms should seek medical counsel to determine if they can undergo dermal fillers or if other treatment methodsare better.
Types of Dermal Fillers
Top dermal fillers contain a wide variety of products, ranging from hyaluronic acid to autologous fat injections. These dermal fillers may be used alone or combined with other injections.
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Hyaluronic Acid (HA)
Hyaluronic acid, or HA, is a naturally occurring substance found in the body. It is an essential part of human life as it maintains structural integrity and hydration in tissues. Ageing causes this substance to break down, thereby increasing the risk of fine lines and wrinkles.
HA fillers are used to improve skin elasticity, smooth out facial wrinkles, plump lips, fill in folds, and raise cheek volume. HA filler injections take anywhere from 15 to 30 minutes and may last from 6 months to over a year, or more, depending on the volume and care.
Popular brand names within this category include Restylane, Juvéderm, and Revanesse Versa, to mention a few.
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Poly-L-lactic Acid
Poly-L-lactic acid (PLLA) is a biocompatible product that mimics the hyaluronic acid in the skin. It fills the wrinkles, sags, creases, folds and other facial deformities brought about by ageing, sun exposure, smoking, and lack of exercise.
Beyond filling deep creases, this collagen stimulator promotes the production of collagen in the body. This filler is a cross-linked product and lasts between six and twelve months. It is ideal for people over the age of 30 who do not want to undergo surgery. It dissolves days after application, leaving no trace behind.
This FDA-approved treatment produces results that can last up to two years. Sculptra® Aesthetic is one of the brand products that contain poly-L-lactic acid.
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Calcium Hydroxyapatite (CaHA)
Calcium hydroxyapatite, or CaHA, is a naturally occurring substance found in bone. It is one of the top potent dermal filler products. Due to its powerful, anti-ageing properties, CaHA injections last between 9 and 12 months. It comprises microscopic calcium particles that are dispersed in a gel-like structure.
CaHAsmoothes out skin texture, fills out hollows, adds volume to the cheeks, and eliminates sags and wrinkles from the mouth and neck. An example of a CaHA brand is Radiesse®.
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Autologous Fat Injections
Autologous fat injections are performed with a local anaesthetic on the face or another part of the body and are quite effective, lasting anywhere from 12 to 36 months. Despite being fairly invasive, they are a popular choice. These fillers are injected into the face, including the cheeks, nasolabial folds, tear troughs, and mouth and jawline areas.
The procedure is highly effective and can be performed at the same time as botulinum toxin injections. Autologous fat injections are perfect for fillers as the fat cell itself will eventually shrink, leaving only a minimal number of scars. It should only be performed by a doctor who is highly skilled and experienced in cosmetic surgery.
Summary
Fillers are the most advanced in recent years and with the arrival of hyaluronic acid, PLLA, and CaHA fillers, cosmetic patients can get the aesthetic results they seek without the pain of surgery. Importantly, professional consultation with an experienced cosmetic clinician is essential to the safe and effective use of dermal fillers. In turn, the surgeon can customise a treatment plan for the patient utilising the right dermal filler.