It’s clear to see that there is a marked shift in attitudes when it comes to aesthetic treatments these days. With cosmetic procedures becoming progressively safer, quicker, and more varied than before with regard to the results they are able to provide, consumers are now more accepting of said non-invasive options in the vein of body sculpting, microdermabrasion, and the like. There’s Ariana Grande, for instance, who spoke openly about her reliance on Botox; Kylie Jenner, who issued a statement on Keeping Up With The Kardashians admitting to fans that her plush, pillowy pout had been enhanced; as well as Korean rapper, Jessi, who went on variety programme Radio Star to address her past double eyelid procedures. The normalising of such conversations and treatments, however, does not equate to the dissemination of accurate or reliable information—of which is particularly prevalent when it comes to dermal fillers.
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Why is this so? Perhaps it has to do with the versatility of fillers, where it is employed as a solution to a multitude of issues such as sagging and fine lines. But its flexibility can also be the cause of confusion. “Dermal fillers essentially have two main functions,” states Dr Joyce Lim, Merz Aesthetics Key Opinion Leader and accredited dermatologist at Joyce Lim Skin & Laser Clinic. “They are gels injected beneath the skin to “fill” it—they can be used to replace lost volume, erase or smooth out skin wrinkles, and improve facial or body contours. In addition, dermal fillers can also improve skin quality by increasing skin hydration, improve skin firmness by stimulating collagen and elastin, as well as improve skin laxity and radiance.”
And that’s far from all. To save you from further research—and any potential medical-related misunderstandings—we got Dr Lim to answer your burning questions, from high-risk areas to avoid as well as complications that could stem from the different dermal filler types. Spy it all, below.
What are the types of dermal fillers out there, and how do they differ from each other?
“There are two main groups of dermal fillers. There are hyaluronic acid (HA) fillers, and biostimulatory fillers. Biostimulatory fillers are often called semi-permanent fillers or permanent fillers, as they stay longer in the skin—from two to ten years, or more—and they also stimulate new collagen and elastin which add on to the filler effect,” elucidates Dr Lim. “Hyaluronic acid fillers, on the other hand, are made of hyaluronic acid; a component of the skin that attracts more than 1000 times its molecular weight. Hence, they are good for skin hydration and also stimulates collagen and elastin tissues through mechanical stretching and cytokines.”
This means that beyond contouring and volumising, hyaluronic acid fillers can also be used for skin hydration purposes, where they are injected superficially into the skin to provide moisture and flow. “Some hyaluronic acid skin boosters contain other ingredients such as glycerol to further bolster hydration levels and glow,” states Dr Lim. “It should be noted, however, that these skin boosters do not fill or lift, with luminous-granting effects wear off within a few months.”
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Are there any specific risks or complications that come with fillers?
According to Dr Lim, typical complications have to do with injection related side-effects. “Think pain, bruising, swelling, as well as superficial lumps and bumps,” she points out. “These are self-limiting and easily managed by massaging the bumps or using lasers to remove the bruises.”
There are, however, more serious risks that could arise as well. This includes an allergic reaction to the products; infection; delayed nodules or bumps and vascular events that encompasses skin necrosis or blindness. “Very rarely, the filler gets into the blood stream, and the blood flow then brings the filler and lodges it in the retinal vessels. This then results in blindness,” explains Dr Lim. “This is considered a medical emergency. The doctor can do an ocular massage, infuse hyaluronidase, and quickly get an eye specialist to deal with the problem. There are other measures that must be followed to salvage the vision.”
Can the quality of fillers compromise your safety?
The quality of fillers depends on the manufacturer. Use only fillers that have robust manufacturing techniques and are USA, FDA, EU and Singapore approved,” advises Dr Lim. “Some fillers are known to cause allergic reactions more than others, and some are known to cause prolonged problems that require prolonged hyaluronidase treatments. So, the doctor must be familiar with the brand of fillers they are using. Generally, most of the side-effects are doctor and technique dependent.”
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Are there any high-risk areas on the face that should not be filled?
Any part of your face and skin that contains a high concentration of vessels and nerves. “This includes the cheeks, the temple, the nasolabial folds and nose, the brow or glabella area and the area around the mouth and chin. Hence, you can see that no area is safe,” finishes Dr Lim. “The injector must be very well-versed with the anatomy of where the vessels and nerves are located. Take note that patients who had rhinoplasty before are at a higher risk as the surgery may distort the anatomy and there may be fibrosis arsing after the surgery.”
Is there anything you can do to prepare yourself for dermal fillers?
“To reduce inflammatory nodules from forming, it is good practice to avoid any dental procedures two weeks before a filler injection,” says Dr Lim. “Delay filler injections if you are having a flu, or if there are active acne or skin infections in the areas where you want the fillers to be injected.” In terms of after-care, Dr Lim recommends avoiding high-heat areas such as saunas two weeks post-treatment, and not to massage injected areas unless advised by one’s doctor.
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Can patients observe results instantaneously, or are effects more discernible over a period of time?
It really depends on the type of fillers used. “Generally, for HA fillers and some non-HA fillers, patients will see improvement immediately after the procedure and they will continue to look better in a months’ time for HA fillers and after three months for biostimulatory fillers,” declares Dr Lim.
