What is filler?

“Filler” is short for dermal filler, which is a product that is injected into the skin to add volume. The most common type of fillers are made of hyaluronic acid, which is a naturally occurring molecule found in the skin. HA (hyaluronic acid) is a gelatinous matrix that surrounds the cells and when you are well hydrated, it retains fluid.  Each filler has a different thickness and the thickness determines where in the skin and where on the face it is placed. A thicker filler is placed on the cheek bones to add volume to the upper outer cheek, which in term reduces the appearance of the nasolabial folds (aka smile lines). The cheek fat pads dwindle as we age which causes the facial tissue and skin to start sagging towards the lower center of the face. Usually this is the first place we recommend treating before moving onto the lower face or injecting the nasolabial folds directly. Thicker HA fillers can also be injected into the jawline to give that ‘snatched’ or defined jaw appearance that many present-day celebrities exhibit.  Thinner HA fillers are more malleable and softer and can be used in the lips to add volume or to fill superficial wrinkles around the mouth and erase the “frown lines’ ‘ (marionette lines) beneath the corners of the mouth. Fillers can take years off your appearance and can look very natural. 

What’s the process?

What if I want to take 5 years off my appearance and would like to have filler injected? What does that appointment look like? First, you will have to complete a consultation with your injector to determine if you are a candidate for filler. Then, your injector will listen to your concerns and offer advice on what product they recommend and what locations to treat. The filler contains a numbing agent but sometimes you may receive a topical numbing cream prior to injections. The procedure is generally very well tolerated and not terribly painful. Obviously, a needle is used to administer the product so there will be a pinch of the needle. You may have swelling and soreness that peaks at 24 hours then starts to subside, Motrin and tylenol can be used for this. While results are immediate (you will leave with immediate correction), it can take 4-5 weeks for the product to completely settle into your skin. Until this happens you may notice some lumps and bumps. This is completely normal! Depending on the product used and your metabolism, results can last anywhere from 6mo- 2 years. 

Is it safe?

Filler is made of hyaluronic acid, which is a protein that is naturally occurring in your skin. The product is slowly dissolved by your own body in 6 months to 2 years, in the same manner your body dissolves your own hyaluronic acid.  The main risk of receiving HA fillers is the risk of arterial occlusion. This is when filler is injected into a small blood vessel, causing that vessel to become blocked and resulting in decreased oxygen to the skin that vessel feeds. untreated, this can result in severe pain, death of the skin, ulceration and infection. Luckily, there is a product that dissolves the filler, caller hyaluronidase, that can be injected to reverse the occlusion. Even the most experienced injectors can experience vascular occlusions, however, it is important to go to someone who is experienced with filler placement, has received certification in filler treatments and knows how to recognize an occlusion and treat it if it occurs. 


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