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Ins and outs of dermal fillers
Skin Institute
March 30, 2017

Have you seen photos in the media of women with big lips and puffy faces, and thought that’s what dermal filler treatment looks like? We can assure you, dermal filler treatments should not look like that. But you’re not alone in thinking they might. Dermal fillers have come such a long way in recent years that you might not be aware of how they can be used, or how natural they can look.

Many of our clients are worried about looking “overdone”. We understand. These days, filler is not just placed in lips and cheeks, but used carefully over the entire face to give a balanced, subtle look without over-plumping any single feature. Our experienced team will carefully and holistically assess your face, and use gradual, step-by-step treatments to achieve a beautifully rejuvenated, refreshed looking you. We aim to make you look like the best version of you, not a different person.

To help you understand more about dermal fillers, we’ve put together answers to common questions we get asked during consultations.

What are dermal fillers?

Dermal fillers are clear gels made from hyaluronan, a natural carbohydrate already present in your skin that declines with ageing. Hyaluronan is a powerful hydrator and is clinically proven to increase your skin’s collagen levels, so is ideal for skin rejuvenation. Thinner fillers have a lower concentration, or smaller particles of hyaluronan and are used for treating fine lines and wrinkles, while thicker fillers have high levels of hyaluronan, and are used to re-sculpt the cheeks, jawline, temple and chin.

How do dermal fillers work?

Performed skilfully, dermal fillers are an effective way to recontour sagging skin, improving your natural contours and proportions, leaving you looking refreshed and fantastic for your age. Treatment with thicker fillers replaces the loss of fat and bone that occurs with ageing. Lips can be restored to a youthful shape and hollows under the eyes can be reduced. Fillers are clinically proven to increase hydration and collagen production in your skin, so not only do they physically lift facial contours, they also enhance and nourish the skin itself.

 How do I achieve a natural result?

Did you know that the three sections of the face (upper, mid and lower) age at different rates? In your 30’s you may start to see signs of ageing around your eyes and lips; in your 40’s you’ll lose fat around the mouth, cheeks, and chin, and in your 50’s and beyond, you might observe hollowing at your temples, upper eyelids and at the sides of your face. These changes are due to “volume loss” caused by resorption and deflation of fat and bone, deep under the skin, as we age. Creating a natural result is achieved by addressing volume loss in all areas of the face, giving balance and harmony across all three sections, focusing on the whole face rather than just one part in isolation. Treating the face holistically is an important way to ensure a natural result.

It is also important to choose the right dermal filler for your needs and place it at the correct depth. Thicker fillers are injected deeper to give contour, while thinner fillers are placed right in the skin’s surface. Skin Institute’s advanced injectable Appearance Medicine team are trained in correct dermal filler selection and placement.

What is the best age to start dermal fillers?

“The signs of ageing vary between individuals, but the laughter and concentration lines of our 30’s tend to turn into permanent visible creases in our 40’s” explains Clare Gallie,  Appearance Medicine nurse at Skin Institute Remuera Clinic.  As we age, the skin’s texture, tone and plumpness reduces. The effects of collagen loss, fat pad deflation, bone resorption, sun exposure and genetic factors all contribute to wrinkles and hollows forming.  Most of our filler clients are women in the 35-60 age bracket, although we are seeing increasing numbers of women in their 20s requesting lip enhancement.

The decision to have a treatment like dermal fillers should be based on your specific needs.  The best place to start is talking to an experienced practitioner who can assess your face as a whole and make expert recommendations on the best treatments for you.

Can you use dermal fillers under your eyes?

Yes, it is possible, this is an advanced area to treat as they hydration effects of the filler can be too great, leading to puffiness. At Skin Institute, we know that if we treat the cheek and surrounding areas first, this can be enough to improve under the eyes. Very occasionally we will then place filler in the tear trough to reduce hollowing and smooth the area.

Will I see results straight away and how long will the results last for?

You will see a change immediately after treatment, although it will likely look a little red and swollen. Most swelling settles over a couple of hours, with subtle swelling lasting a week or two. It takes 4-6 weeks for the dermal filler to soften and integrate with your own tissues, giving the final result. Fillers last between 6 – 24 months depending on the product and area it is used in. In general, thicker fillers last longer than thinner fillers. The longest lasting filler is Juvederm Voluma® which is FDA approved to last 2 years. Fillers are broken down more quickly in areas with constant movement or if you have a rapid metabolism. “I have seen patients who do a lot of exercise burn through their filler really quickly”, says our Dr Sarah Hart.

Will it hurt?

Dermal filler is injected with a fine needle and contains a local anaesthetic, so most people find treatment surprisingly comfortable. If you wish, numbing cream, ice or extra local anaesthetic can be used to maximise your comfort.

Is there much downtime from dermal fillers?

You may experience some minor swelling or bruising after the treatment. Bruises can last up to two weeks, so if you have a big event, you’ll need to leave enough time for treatment beforehand. We don’t advise last minute treatments for important occasions like weddings. Bruising can be covered up with makeup as it fades.

Can you remove dermal filler?

Yes.  If for any reason your dermal fillers need to be adjusted or removed, we can use an enzyme called hyaluronidase to dissolve it.

 Can anyone have dermal filler?

Dermal fillers are suitable for most people, with a few exceptions. We don’t recommend pregnant or breast feeding women having treatment, for example. A consultation with one of our Appearance Medicine nurses will tell you if dermal fillers are right for you.

How much do dermal fillers cost?

Dermal fillers range from approximately $530 to $930 per syringe, depending on the thickness and longevity of the filler being used. A simple lip treatment usually requires just one syringe, while cheeks usually need at least two syringes of thicker filler. Individual needs and results vary and your Appearance Medicine nurse can provide an estimate during your consultation.

Why choose Skin Institute for dermal fillers?

If you’d like to talk to one of our team about dermal fillers and how they can help you achieve a refreshed and rejuvenated appearance, book a 45-minute consultation with one of our experienced Appearance Medicine nurses.  You’ll receive expert advice about whether dermal fillers are right for you, as well as a complete face assessment and personalised recommendations on treatments and skin care.

Want to know the difference between dermal fillers  like Restylane and Juvederm, and Botox® injections? Read our latest blog on the ins and outs of Botox®