Dermal Fillers

There are a variety of dermal fillers available in Australia. The most common dermal filler is a non-permanent filler that closely resembles a component of normal skin and its supporting tissues. It adds volume to the area where it is injected and as it attracts water, it hydrates the tissues. There is also some evidence that it can stimulate your skin’s structural protein production and improve the quality of the skin where it is injected.

Non-permanent fillers can be used to ‘fill’ lines, replace lost volume, provide lift, and are also used as ‘skin boosters’ to improve the quality of the skin, its texture, and luminescence. They may be used to enhance features such as lips or cheeks or may be used to try to improve the changes that occur through the ageing process. These fillers are primarily used on the face but can also improve the appearance of the décolletage and back of the hands.

What are dermal fillers?

Dermal fillers are gel-like substances used to restore lost volume, smooth fine lines, and enhance facial contours. These injectable dermal fillers are commonly used in cosmetic procedures to address facial wrinkles, thin lips, and volume loss in the face and hands.

How do dermal fillers work?

Dermal filler injections restore lost volume, smooth wrinkles, and enhance facial contours. Unlike Botox, which relaxes muscles, injectable fillers plump the skin by adding structure beneath the surface. They are used in cosmetic procedures to address signs of ageing or enhance facial features.

Composition and function

Fillers are made from different substances, including hyaluronic acid, calcium hydroxylapatite, and poly-L-lactic acid. These materials work in distinct ways. Hyaluronic acid attracts water, providing hydration and volume. Calcium hydroxylapatite stimulates collagen production. Poly-L-lactic acid encourages gradual tissue regeneration. The choice of filler depends on the treatment area and the desired effect.

Areas of application

Dermal filler treatment is commonly used to treat the mouth and nose, the sides of the nose, and under the eyes. Lip and facial fillers add volume and definition. Soft tissue fillers can also enhance the cheeks, jawline, and hands. The depth of injection and type of injectable filler determine the final result.

Dermal fillers vs botox… what’s the difference?

While both dermal fillers and Botox are injectable treatments used to reduce signs of ageing, they work differently. Botox is a drug that temporarily relaxes muscles to smooth facial wrinkles such as frown lines and wrinkles that Botox can target. Inject dermal fillers, on the other hand, restore volume and plump the skin.

Benefits of dermal fillers on skin

Dermal fillers offer several benefits for skin rejuvenation and facial enhancement. Their effectiveness depends on the type of filler used, individual skin conditions, and the expertise of the cosmetic surgeon or health care provider. Here are the main advantages:

• Restores volume – Dermal fillers to restore volume help counteract age-related collagen loss and hollow areas.
• Reduces wrinkles and fine lines – Wrinkle fillers smooth creases around the mouth, nose, and eyes.
• Provides long-lasting results – Depending on the type of filler, results usually last from 6 months to up to 2 years.
• Minimally invasive with quick recovery – The injection of dermal fillers requires no surgery and has minimal downtime.
• Safe when administered by professionals – Fillers are approved as a medical device, and most side effects are only temporary.
• Reversible in some cases – Certain fillers are removed or reduced if necessary, offering flexibility in treatment.

While fillers provide non-surgical facial enhancement, patients should consult a qualified dermal professional to discuss risks and benefits before treatment.

Types of dermal fillers and their uses

There are several types of injectable filler options, each designed for different areas of the face and concerns. The most common types of dermal fillers include:

• Hyaluronic acid fillers (HA fillers) – These are the most widely used and include brands like Juvederm® and Restylane®. They provide hydration and volume and are fillers made with a substance naturally found in the skin.
• Calcium hydroxylapatite (CaHA) fillers include Radiesse® – These offer more structure and last longer than HA fillers. They stimulate collagen production and are used for deeper lines and wrinkles.
• Poly-L-lactic acid fillers include Sculptra® – These stimulate collagen growth over time, improving skin texture and restoring lost volume.
• Polymethylmethacrylate (PMMA) fillers – These fillers are considered semi-permanent and contain tiny beads suspended in a gel to provide long-term support.
• Fat grafting – This is a medical procedure where a person’s fat is harvested, processed, and re-injected into the face.

TGA-approved uses of dermal fillers

The Therapeutic Goods Administration (TGA) has approved dermal filler treatment for specific cosmetic purposes, including:

• Smoothing fine lines and wrinkles on your face
• Plumping thin lips
• Enhancing areas of the face such as the cheeks and jawline
• Filling wrinkles on your face, especially frown lines, lines around the mouth, and around the eyes
• Restoring volume loss in the back of the hands

TGA-approved dermal fillers are supplied by licenced manufacturers, ensuring safety and quality.

What are the common side effects and risks of dermal fillers?

Most types of non-permanent fillers have the advantage that they can be reversed if the need arises either due to an undesired result or a complication, as explained below.

Other fillers available in Australia may work by stimulating the body’s cells to produce more structural protein and are not immediately reversible. Some fillers are classified as permanent fillers.

Side effects of any treatment are effects that occur just as a result of treatment and usually settle on their own.

Common side effects include swelling and bruising which generally settles within a week. It’s best not to rely on your appearance immediately after your procedure with dermal fillers as swelling can simply occur as a result of treatment and will not necessarily reflect the final outcome. You should allow two weeks for the final result to be known in most cases.

Complications are effects that are not expected to occur and may require treatment. Whilst infection is a recognised complication it is not very common when procedures are performed in accordance with Infection Control standards as set down by Commonwealth Health and Aging1. Should infection occur it would be within a few days of treatment. If you suspect infection you should return to your treating doctor immediately. Infections may present as a generalised tender swelling or nodules, and usually, there is warmth and redness around the area.

Rare but serious complications occur if the filler interferes with a blood vessel causing a blockage. Most often there will be significant pain in the area if this happens and cause an area of skin or tissue to look different to the surrounding areas. This is due to a lack of blood supply to the area and insufficient oxygen to the skin. It is essential to inform your treating doctor if this occurs.

In extremely rare circumstances, the filler has blocked the artery to an eye requiring emergency treatment2 because of the risk of permanent loss of vision of an eye. This is one reason why your prescribing doctor is nearby during procedures to best manage any complications should they ever occur.

1. Published on National Health and Medical Research Council (https://www.nhmrc.gov.au)
Generated on 6 September 2018 @ 12:03am
Australian Guidelines for the Prevention and Control of
Infection in Healthcare (2010)

2.CPCA doctors are conversant with management of these complications