Dermal Filler

Dermal filler is a gel, in most cases hyaluronic acid, injected into a specific layer of the face to replace volume that has been lost or to define a contour that was never especially defined.

Hyaluronic acid is a substance the body already makes and already holds in the skin, which is why it is the material used for the overwhelming majority of facial filler treatment worldwide. The result is visible immediately, which is unusual among aesthetic treatments and is a large part of why people choose it.

It is a prescription medical treatment. At IDUNN it is assessed and performed by a doctor, not delegated, and the assessment can end with us saying that filler is not the right answer for what is bothering you.

It restores volume in areas that flatten with age — the mid-face and temples in particular — and it defines contours such as the chin, jawline and lips. It softens folds that exist because the tissue above them has descended, and it corrects small asymmetries.

It does not tighten loose skin, it does not improve skin texture, tone or pigmentation, and it does not stop the changes that brought you here. Adding volume to skin that has lost its elasticity does not restore the elasticity, and past a certain point filler makes a face heavier rather than fresher.

That last point is the one worth taking seriously, because the faces people describe as looking obviously treated are almost never the result of one careful session. They are the result of volume being added repeatedly to an area that needed something else. If that is the situation, we will say so.

Bruising, swelling and tenderness for a few days are common and expected. Small lumps that settle or can be smoothed are not unusual. None of that is the reason this section exists.

The serious complication is vascular occlusion: filler entering or compressing a blood vessel and interrupting the blood supply to the tissue it feeds. It is rare, but it is a medical emergency, and it is the reason facial filler belongs with a practitioner who knows the anatomy of the face and has hyaluronidase — the enzyme that dissolves hyaluronic acid — on the premises and knows when to use it.

That same enzyme is why hyaluronic acid filler is, in practical terms, reversible. If you do not like the result, or if too much was placed, it can be dissolved. Very few aesthetic treatments offer that, and it is a reasonable thing to ask any clinic about before you agree to anything.

The assessment looks at your face at rest and in movement, and at what is actually causing what you see — because volume loss, skin laxity and pigmentation produce different complaints that can look similar in a mirror.

If we proceed, the area is cleaned, topical anaesthetic is usually applied, and the filler is placed. Most appointments run 30 to 45 minutes. You will see the result before you leave, though the first days include swelling that is not the final outcome.

We treat conservatively and prefer to review and add rather than place more than is needed in one sitting. Filler cannot be un-injected on the spot, but it can always be built on.

How long it lasts depends on the product, the area and your own metabolism, and is generally measured in months rather than years — commonly somewhere between six and eighteen. Areas that move a great deal, such as the lips, tend to be at the shorter end.