Dermal Fillers

Dermal fillers are minimally invasive procedures that can magically remove the fine lines and wrinkles, to plump up your cheeks and lips. In skilled hands, it is one of the safest procedures to improve facial appearance temporarily and find its use in several applications. The side effects of this treatment are also temporary. The maximum harm you can get from using dermal filer injections is swelling, bruising and redness, all of which go away in a few days.

Dermal Fillers
To describe few of its applications, the dermal filler procedure can:
• Restore volume to the face
• Fill in the shallow contours
• Remove wrinkles, frown lines between the eyebrows and fine lines
• Get rid of crow’s feet
• Plump the lips
• Decrease the appearance of scars
• Remove the laugh lines at the corner of the lips
• Rejuvenate the entire appearance of the face.

What Dermal Fillers Can and Cannot Do?

Dermal fillers can restore the volume to your face for a short period. As we age, our skin starts to lose its elasticity even before we hit our 30s. Due to this natural occurrence in our body, our face starts to show signs of ageing – fine lines, wrinkles, crow’s feet and so on.
The treatment involving dermal fillers can temporarily remove these wrinkles and fine lines but it is not a permanent solution. These fillers are merely temporary means to maintain your youthful appearance till the point arrives when surgical correction through plastic surgery becomes inevitable. The latter has better lasting effects. A mini or full facelift is the most pleasing and lasting procedure.
Moreover, dermal fillers last only for six months to 18 months after which your skin will go back to its current condition. They can just delay the process of going for a more permanent solution to do away with the signs of ageing. In a way it dets back the clock, does not stop the clock from ticking!

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Where Can You Get Injectable Dermal Fillers?

The first rule of the thumb is to not go for dermal filler injections in any beauty salons or spas. Dermal fillers are a part of cosmetic surgery and therefore, only certified cosmetic surgeons can perform this procedure.
During the initial consultation with the surgeon, talk about your goals and expectations from this surgery. Since this is a gradual process, it is essential to discuss your long-term plan with the surgeon. He will take into account your physical condition, medical history, current medications and allergies to suggest further steps.
The surgeon will also discuss the type of dermal fillers based on your expectations, possible side effects and the duration of the lasting results. Make sure to ask all your questions during the consultation about the recovery and potential complications.

What Are the Common Types of Dermal Fillers Used?

The different dermal fillers can bring the best results for specific applications. Here are some of the common dermal fillers used:
Hyaluronic Acid
A widely used dermal filler, Hyaluronic acid is a sugar, naturally found in our body that gives elasticity, moisture and volume to the skin. This is the reason why a lot of cosmetic products include Hyaluronic acid. As we age, the amount of Hyaluronic acid in our body reduces, which makes the skin lose the elasticity. This in turn gives rise to wrinkles and sagging skin. When the Hyaluronic acid gets injected into the skin, it attracts the water content resulting in plumping and smoothening the skin.
As the main advantage of using hydraulic acid as dermal filler, we do not need to worry about allergic reactions, since it is already present in our body. You can use Hydraulic acid to:
• Remove all signs of ageing,
• Remove acne scars, scars from burns and wounds,
• Plump the face and lips,
• Define the lip contours,
• Remove the crow’s feet, and
• Cheek depressions.
The most popular brand that manufactures Hyaluronic acid fillers is Juvederm, Restylane and Captique.
Polylactic Acid
Polylactic acid is a synthetic material that encourages the formation of collagen in our body. As it stimulates the body to form a collagen, you cannot see immediate results. It can take around a month to visualise the effects of these polylactic acid dermal fillers.
This dermal filler is mainly used to:
• Build up the cheeks,
• Fill in the hollow, sunken areas near the eyes,
• Reduce the appearance of folds, and
• Plump thin lips.
The most popular brand for polylactic acid dermal fillers is Sculptra.
Calcium Hydroxylapatite
Calcium Hydroxylapatite is a material, naturally found in our bones and teeth. When used as a dermal filler in a gel form, it metabolizes the body with the calcium present in the gel and generates collagen naturally. This collagen will immediately plump up your skin and get rid of the hollow contours.
Calcium Hydroxylapatite-based dermal fillers are best used to:
• Fill up the hollow contours
• Attain a smooth and even facial contour, and
• Get rid of the fine lines and folds that are otherwise hard to remove using the other fillers.
The effects of this dermal filler can last easily up to a year or more and require minimal touch-ups. Radiesse is a widely used brand that manufactures dermal fillers with Calcium Hydroxylapatite.
The polyalkylimide-based dermal fillers are semi-permanent and can last for a long time. You can even remove them when needed. When the patient gets injected with Polyalkylimide dermal fillers, the latter start the formation of collagen, which gradually increases in a month. Soon after, the skin acquires a fine layer of collagen that lasts for a long time.
The best thing about Polyalkylimide dermal fillers is that, these are not allergic to humans and doesn’t interfere with the human tissues. Polyalkylimide dermal fillers can be used to:
• Plump the lips,
• Replenish the lost facial volume,
• Treat deep wrinkles, and
• Enhance cheekbones.
Aquamid is a brand that produces Polyalkylimide-based dermal fillers.

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Fat Dermal Fillers
This is different from any of the other commonly used dermal fillers. Instead of using any man-made chemicals as injections, you can use your fat or a donor’s fat and injects it into the face. This can bring the same results as any other chemical dermal fillers, although sometimes, it can be unpredictable.
The fat is taken through liposuction from your own body or a donor and prepared for the injection. The fat is then injected like any other dermal filler into the face. Based on the effects of the fat fillers, you may require multiple fat transfers to achieve the expected results.

How Are Dermal Fillers Injected?

Dermal Fillers Procedure
This procedure takes not more than two hours and you can get back to your home right after this.
• The surgeon will mark the injection points of the dermal fillers.
• The surgeon or the nurse will clean the injection sites with an antibacterial cleaning agent.
• On request, the surgeon may administer local anesthesia; else, the pain is bearable.
• If it is a bit painful, the surgeon may use an ointment to numb the area or a cold compress.
• The surgeon will inject at the marked point, massage it and if it is a filler that shows immediate results, then the surgeon will observe the effect and inject additional fillers if needed.
• The surgeon will then proceed to the next injection site and repeat the same procedure.
After completing the injections, the surgeon will take one look, make some adjustments if necessary. Next, the surgeon will ask you to place ice packs on the injected areas to reduce the pain and swelling and discharge you soon.

How Is the Recovery Like?

There isn’t any elaborate recovery process for dermal fillers. You can get back to your normal life immediately, although it is best to avoid any extreme physical activities for the next two days. The swelling and bruising on the injected areas will fade off soon in a day. Make sure to keep a cold compress on it as much as possible.
If you have fat dermal fillers, then the recovery process can be a bit longer depending on the location of the fat collected.
At all times during the recovery period, it is best to avoid direct sun exposure as much as possible and prevent any unwanted damages to the face.


Dr. Tejinder Bhatti, Plastic Surgeon
Dr. Kulwant S Bhangoo, Plastic Surgeon


The information is being provided by and have no intention to replace the medical advice of your doctor. Please consult your doctor directly for advice about a specific medical condition. This document was last reviewed by Dr. Tejinder Bhatti, Plastic Surgeon on: 20-JUN-2020
Dr. Tejinder Bhatti is a cosmetic plastic surgeon by training but now completely dedicated to the art and science of minimally invasive hair restoration surgery. He also runs a hospital, the Five Rivers Hospital in Mohali, Chandigarh where junior plastic surgeons perform esthetic plastic surgery under the overall supervision of Dr. Kulwant S Bhangoo who is the Chairman of the Program. Dr. Bhangoo is certified by the American Board of Plastic Surgeons. He is an internationally renowned top cosmetic surgeon and chief of Plastic Surgery in Buffalo NY, USA.”

Surgery Before & After Photos