Updated: Feb 27, 2021
What are fillers or dermal fillers?
Dermal fillers are soft, gel-like substances that are injected under the skin for correct many common problem with the aging process. Dermal fillers injections are the most common cosmetic procedure performed in the United States. Fillers can help volumization, smoothing of deep under eye circles, nasolabial folds, temporal hollowing as well as augmentation of the chin, lips, jaw line, forehead, cheek and nose. The main advantage of dermal fillers is that they improve the facial features without surgery and with no downtime needed for recovery.
Dermal fillers is divided into 3 catagories
Permanent fillers : Considered less safe, these types of fillers mostly consist of silicones, paraffin or polymethylmethacrylate beats-PMMA (Bellafill®, Artefill). Since they can not be dissolved, there is a high risk of migration and infection in the long term. Permanent fillers don’t have FDA approval in Thailand, and we don't recommend the use of these types of fillers.
Semi-Permanent filler : Relatively safe, these are made from Calcium Hydroxyapatite-CaHA which is found in the bone (Radiesse®) or poly-L-lactic acid-PLLA (Sculptra®). They can last 2-5 years although there are potential complications such as forming lumps or being visible under the skin, autologous fat injections. They do not have FDA approval in Thailand.
Temporary filler : Considered very safe, these are made from Hyaluronic acid (HA) and typically last from 3 months to 2 years.
Which fillers is the best?
Dermal fillers can be composed of a variety of substances. One of the most common and the best is made from Hyaluronic acid.
Why Hyaluronic acid dermal fillers is the best?
Hyaluronic acid fillers are considered very safe. Hyaluronic acid (HA) itself is a polysaccharide. It is a natural component produced by the human body and can be found in your skin and cartilage. It is therefore less likely to cause an allergic reaction or have any serious side effects, so the long term safety is good. Hyaluronic acid can help the skin look plump and hydrated, and the effects can last from 3 to 24 months depending on individual reaction before the substance is gradually and naturally absorbed by your body.
After injection, HA fillers can also be dissolved by a special solution (hyalunidase) in case of any adverse events or if the patient is not happy with the results.
Most HA fillers are mixed with lidocaine (a numbing agent) for improved comfort during the treatment.
Are dermal fillers dangerous?
Dermal fillers are not dangerous as long as you keep in mind the following:
Ensure that the product is safe and FDA approved. The only FDA approved brands in Thailand are Juvederm, Restylane, Perfectha, Beletero and Neuramis.
Avoid black market dermal fillers: dermal filler treatment can be quite expensive. If a clinic is offering this treatment very cheaply (well below market price) that is probably not a good sign. Any problems are not likely to happen immediately after the injection, but may occur after some time. Possible issues include migration, infection or lumps, and if the product is not a genuine HA based filler, it can not be dissolved, so you have to be very careful about this. The product may be fake, contaminated or harmful.
Doctors have been trained properly to diagnose the problem and understand the aging process. The same amount of dermal filler can be more effective in the hands of the right person, so don't be afraid to ask about training, certification and experience.
What is the natural aging process?
The four major structural components of our face are skin, fat, muscle and bone. As we age, volume loss in these structures can result in many of the visible signs of aging - this is called the aging process.
When you’re young, fat in the face is evenly distributed with some pockets that plump up the forehead, temples and cheeks as well as areas around the eyes and the mouth. As we age, we start to lose some of this subcutaneous fat. As a result, the skin starts to lose volume and shifts downwards, becoming less smooth and getting increasingly more loose and saggy.
Age-related bone loss in the face can lead to retraction of the jawline, descent of the nose and loss of high cheekbones. The facial muscles also decrease in volume and elasticity, and deflation and movement of facial fat further accentuates the signs of aging. Finally, the skin stretches and loses elasticity — compounded by the loss of scaffolding provided by fat, muscle, and bone; this leads to wrinkles, sagging skin and other familiar signs of aging.
Which areas can be treated with dermal fillers ?
There are many areas of the face where dermal fillers can help with structural improvements:
Undereye hollows - many people will think it is eye bag problems
Are there any risks or side effects associated with dermal fillers?
The most common side effects are bruising, swelling, redness and pain which should go away within 2 weeks.
A few days after treatment, there may be a few lumps and bumps. These can usually be gently massaged to break them down in the first 2 weeks.
In rare cases dermal fillers can accidentally be injected into arterial blood vessels which can lead to permanent blindness (intra arterial occlusion). If you feel severe pain, your skin suddenly turns blue or you notice any pus around the injection area, please contact your doctor immediately. These are signs of an emergency situation, so the faster you can be treated the better.
There is no available research or data to show whether dermal fillers are safe for pregnant women or during breastfeeding, so should be avoided in such cases.