Dermal Fillers

Written By: Dr Krisie McNealy                                Reviewed: 03 August 2010

As we age our skin cells begin to divide at a slower rate resulting in the dermis (the inner layer of skin) beginning to thin. Natural substances such as collagen, elastin and hyaluronic acid which give the skin structure and volume also begin to diminish.

The cumulative effect is that the skin loses its ability to retain moisture and loses elasticity. When pressed or pulled into different positions through smiling, squinting or frowning it no longer springs back as efficiently and lines and wrinkles form.

Dermal fillers typically replace levels of collagen or hyaluronic acid in order to plump up the skin, ad volume and restore a more youthful appearance.

• What is collagen? Collagen is a natural protein that occurs throughout the body. It’s the most abundant protein in the body making up about 25% of protein content. Collagen is one of the main components of connective tissue and is responsible for elasticity of the skin. As we age collagen breaks down leading to lines and wrinkles.

• What is elastin? Elastin is a protein found in the skin and helps to keep the skin flexible. Elastin provides a ‘bounce-back’ reaction when the skin is pulled out of place. Like hyaluronic acid levels of  elastin deplete as we age.

• What is hyaluronic acid? Hyaluronic acid (HA) is a natural hydrating substance which occurs throughout the body. Like a sponge hyaluronic acid attracts and holds water creating volume in the skin

What can dermal fillers do?

Dermal fillers are a proactive way to address the early signs of aging and primarily fall into two categories, temporary and permanent.  There is also a third category of dermal fillers that are considered long lasting, but still temporary.

Temporary fillers include collagen and hyaluronic acids. These fillers replace the natural levels of collagen or hyaluronic acid in the skin. They are injected into the dermal layer of the skin at focus points. The effects are noticed immediately and typically last for 3 to 6 months. Products like Restylane claim to last for longer but results will vary. Temporary dermal fillers are considered a safe and effective treatment for facial lines and wrinkles.

Permanent fillers are the most controversial. These include injectable liquid silicone and semi permanent fillers that combine hyaluronic acid or collagen with tiny particles that remain in the skin. Eg Artecole.

What is the procedure with dermal fillers?

Dermal fillers should only be injected by qualified medical professionals. Treatment usually takes place in a doctor’s office or cosmetic clinic.

Before treatment the doctor will examine your face to decide the best injection sites and may mark these with a pencil. The filler is then injected using a very fine needle. Several injections will be necessary. Treatment usually takes up to an hour  and most people return to normal activities immediately following treatment.

If your doctor is using a bovine based collagen filler you will need to undergo and allergy test prior to treatment. Results from the test are usually available in one month. Around 2-3% of people are allergic and won’t be able to undergo treatment.

The effects of treatment will be noticeable immediately but usually look best after about one week. There may be some swelling and redness straign after treatment but this should subside in around 48 hours.

Are there any side effects with dermal fillers?

On the whole temporary dermal fillers are considered a safe and effective treatment for lines and wrinkles. Complications are rare but can include redness swelling, itching and red or bumpy skin. Very rarely bumps may appear under the skin. The risk of bumps or complications increases slightly with the use of permanent and semi-permanent dermal fillers.

With the introduction of allergy tests allergic reactions are very unlikely but still possible in a minute proportion of people.

Is treatment with dermal fillers painful?

While treatment may be uncomfortable it should not be ‘painful’.  You will feel small pricks as the injections are administered. Treatment around the lip area may be more uncomfortable and an anaesthetic is normally applied.

What is the difference between Botox and dermal fillers?

It is inevitable that new dermal fillers will be labeled as the next Botox. However Botox is very different from collagen injections or hyaluronic acid fillers. Botox injections relax the facial muscles so that frown lines and wrinkles disappear and can slow down the development of new ones. Dermal fillers ad volume to the skin and temporarily fill lines, wrinkles and creases. However they won’t prevent new lines from forming.

Dermal fillers are used to ad volume to the skin which is something that Botox cannot do. Botox and dermal fillers can be combined for maximum results.

Next: Hyaluronic Acid Fillers

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Alternative Treatments 

• Collagen Injections: Collagen injections are used to remove crow’s feet, smile lines, nasolabial folds (under the nose) and frown lines.

• Botox Injections: Botox injections relax the facial muscles so that frown lines and wrinkles disappear and can slow down the development of new ones.

• Chemical Skin Peels: Skin peels are cosmetic procedures used to make the surface of the skin look smoother, younger and more evenly pigmented.

• TCA Peels: Trichloracetic acid peels are relatively aggressive chemical peels typically used for moderate to deep peeling.

• Laser Resurfacing: Laser skin resurfacing uses a laser to remove the outer layers of skin.  As the wound created by the laser heals, the skin becomes smoother, firmer and less pigmented.

• Dermal Fillers. Dermal fillers typically replace levels of collagen or hyaluronic acid in order to plump up the skin, ad volume and restore a more youthful appearance.

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Related Treatments

• Facelift Surgery
• Browlift Surgery
• Eye Lift Surgery (Blepharoplasty)
• Nose Reshaping / Nose Job (Rhinoplasty)
• Dermal Fillers
• Collagen Injections