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What are dermal fillers?

There are different types of dermal fillers. Permanent, semi permanent and long lasting HA fillers.  Essentially fillers consists of synthetic molecules- some resemble natural skin matrix, others resemble bone, and some are totally synthetic like silicone. The majority of my work is with Hyaluronic acid. This is a gel-like substance that is a molecular makeup of sugar molecules.  This gel-like substance is found in between the scaffolding of collagen and elastin.  Over time, one has a decrease in both the scaffolding but also most importantly the gel namely hyaluronic acid.  Fillers are a synthetic variant of hyaluronic acid.
 
What aspect of skin rejuvenation can fillers address?

Dermal fillers can address key areas of skin ageing.  These include:

1.  The nasolabial lines.  These are the lines that run from the nose to the corners of your mouth.  Over time these lines deepen and add to the aged and tired look.

2.  Tear troughs.   Over time fat loss in this area would account for deep tear troughs and hence dark circles. 

3.  Cheek bones.  Time takes its toll with fat loss in this area as well as bone a decrease in bone density.  Dermal fillers can replace lost fat and bone creating a higher cheek profile and a better light reflex.

4.  The marionette lines.  These lines run from the corners of the mouth downwards.  Using fillers in strategic locations can help diminish these lines and decrease the ‘sad and tired look.’

5.  Chin and jawline contouring.  Dermal fillers are excellent for contouring the chin area.  If you note for the female chin this is tapered at the line drawn from your nasal (nose) edge.  Having a tapered chin softens the overall features of your face and creates a more triangular look.

6.  Brow volumisation and eye opening.  This is an advanced procedure and is conducted by only the most experienced specialists. Volumising the area as well as the brow can help open up the eyes.  As one ages you will notice that shadows appear around the temple areas.  This is due to loss of fat.  If you put gentle pressure around the temple area you will notice that you will get an opening of the eyes and an elevation of the brows.

7.  Correction of the nose lumps and bumps.  Once again, this is an advanced technique to remodel the nose and is what is known as a dermal filler rhinoplasty.
 
8. The treatment of acne scars, as well as chick pox scars.

How long do fillers last?

This depends on the type, as well as the location of which fillers are placed in.  The more fluid a filler is, the more malleable the filler is.  A more fluid filler is advised for treating areas such under the eyes.  In this context a filler may only last between 12 to 14 months.  Lip fillers often last between 12 to 14 months, fillers for revolumising the cheek as well as jawline contouring will often last two years or longer. 
 
Can fillers be combined with other treatments such as antiwrinkle injections?

Absolutely.  Remember, it is the balance between texture, tone and volume, which gives you the best and most harmonious result.  Certainly by relaxing muscles that create tension, the addition of fillers can augment facial harmony. 

I often combine lasers Botox, surgical eye lid surgery, face lifts, and energy devices with fillers to give the best results. Treating texture, tone and volume is essential for facial harmony.

Dr Davin S. Lim, Laser and aesthetic dermatologist. Brisbane.

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