Dermal Fillers
Dermal fillers can restore lost volume, improve smoothness, and enhance definition. Like any medical treatment, they also carry risks. The outcome depends on the product selected, the area treated, and the training of the practitioner. A qualified cosmetic physician can determine whether treatment is appropriate and provide care under safe conditions.
In Australia, a range of dermal fillers is available. The most common are non-permanent fillers that resemble natural components of the skin and its supporting tissues. These fillers add volume to the injection site. Because they attract water, they also hydrate the surrounding tissue. Research suggests they may support collagen activity and improve skin quality where injected.
Non-permanent fillers are used to soften lines, replace lost volume, and provide lift. They are also used as “skin boosters” to improve surface texture and hydration. Fillers may enhance features such as lips or cheeks. They may also help address age-related changes in contour or firmness.
Although most treatments focus on the face, dermal fillers may also be used to improve the appearance of the neckline and the backs of the hands.
What are dermal fillers?
Dermal fillers are gel-like substances placed under the skin to restore volume, smooth lines, and refine facial contours. They are widely used in cosmetic practice to treat wrinkles, thinning lips, and hollowing of the face and hands. Fillers provide structure and definition in areas where natural support has diminished.
How do dermal fillers work?
Dermal fillers add support beneath the skin’s surface. This restores volume, reduces the appearance of folds, and enhances contour.
Anti-wrinkle injections reduce muscle activity. Dermal fillers work differently. They physically occupy space and provide structure. Because they act in separate ways, both treatments may be used together as part of an individualised plan.
Composition and function
Fillers are formulated from several materials, each with distinct properties.
Hyaluronic acid attracts water and provides hydration along with fullness. It integrates into tissue and gives a natural, supple quality to treated areas. Calcium hydroxylapatite is a mineral-like compound. It provides stronger structural support and stimulates collagen production, leading to firmer skin over time.
Poly-L-lactic acid promotes gradual collagen growth. It does not create an immediate effect but builds volume and texture improvements across several months. Polymethylmethacrylate (PMMA) fillers are considered semi-permanent. They contain small beads within a gel matrix to provide longer-lasting support.
The choice of filler depends on treatment area, desired outcome, skin quality, and patient goals. Medical assessment is required to match material to indication.
Areas of application
Dermal filler treatment is commonly used to treat the mouth and nose, the sides of the nose, and under the eyes. Lip and facial fillers add volume and definition. Soft tissue fillers can also enhance the cheeks, jawline, and hands. The depth of injection and type of injectable filler determine the final result.
Dermal fillers vs anti-wrinkle injections. What's the difference?
While both dermal fillers and anti-wrinkle injections are injectable treatments used to reduce signs of ageing, they work differently. Anti-wrinkle injections are drugs that temporarily relax muscles to smooth facial lines, such as frown lines and wrinkles. Injected dermal fillers, on the other hand, restore volume and plump the skin.
Benefits of dermal fillers on skin
Dermal fillers offer several benefits for skin rejuvenation and facial enhancement. Their effectiveness depends on the type of filler used, individual skin conditions, and the expertise of the cosmetic surgeon or health care provider. Here are the main advantages:
- Restores volume – Dermal fillers to restore volume help counteract age-related collagen loss and hollow areas.
- Reduces wrinkles and fine lines – Wrinkle fillers smooth creases around the mouth, nose, and eyes.
- Provides long-lasting results – Depending on the type of filler, results usually last from 6 months to up to 2 years.
- Minimally invasive with quick recovery – The injection of dermal fillers requires no surgery and has minimal downtime.
- Safe when administered by professionals – Fillers are approved as a medical device, and most side effects are only temporary.
- Reversible in some cases – Certain fillers are removed or reduced if necessary, offering flexibility in treatment.
While fillers provide non-surgical facial enhancement, patients should consult a qualified dermal professional to discuss risks and benefits before treatment.
Types of dermal fillers and their uses
There are several types of injectable filler options, each designed for different areas of the face and concerns. The most common types of dermal fillers include:
- Hyaluronic acid fillers (HA fillers) – These are the most widely used and include brands like Juvederm® and Restylane®. They provide hydration and volume and are fillers made with a substance naturally found in the skin.
- Calcium hydroxylapatite (CaHA) fillers include Radiesse® – These offer more structure and last longer than HA fillers. They stimulate collagen production and are used for deeper lines and wrinkles.
- Poly-L-lactic acid fillers include Sculptra® – These stimulate collagen growth over time, improving skin texture and restoring lost volume.
- Polymethylmethacrylate (PMMA) fillers – These fillers are considered semi-permanent and contain tiny beads suspended in a gel to provide long-term support.
- Fat grafting – This is a medical procedure where a person's fat is harvested, processed, and re-injected into the face.
Each filler type carries specific benefits and considerations. Selection depends on treatment goals, patient anatomy, and practitioner assessment.
TGA-approved uses of dermal fillers
The Therapeutic Goods Administration (TGA) regulates medical devices and medicines in Australia. Dermal fillers are approved for specific cosmetic purposes.
Approved uses include:
- Smoothing fine lines and wrinkles on your face
- Plumping thin lips
- Enhancing areas of the face such as the cheeks and jawline
- Filling wrinkles on your face, especially frown lines, lines around the mouth, and around the eyes
- Restoring volume loss in the back of the hands
TGA-approved dermal fillers are supplied by licenced manufacturers, ensuring safety and quality.
Common side effects and risks of dermal fillers
Dermal fillers are widely used and are generally considered safe when administered by qualified professionals. Still, as with any medical procedure, side effects and complications can occur.
Expected short-term effects
Most people experience temporary effects as part of the body’s natural response to treatment. Common reactions include mild swelling, redness, tenderness, or bruising around the injection site. These changes usually settle within a week. Because the skin can look different immediately after treatment, the final results are typically assessed after about two weeks, once any short-term swelling has resolved.
Reversibility of fillers
Many non-permanent fillers can be adjusted or dissolved if the outcome is not as expected or if issues arise. Other fillers work by stimulating the body to produce more of its own supporting proteins. These options are not immediately reversible. Some formulations are considered semi-permanent or permanent, which means the effects may last longer but cannot be quickly undone.
Possible complications
Complications are less common than mild side effects, but they can occur and may require medical care. Infection is a recognised risk, though it is rare when procedures are performed under strict infection control standards, such as those outlined by the Australian Guidelines for the Prevention and Control of Infection in Healthcare (NHMRC, 2010). If infection develops, it usually appears within a few days. Signs can include swelling, redness, warmth, or tender lumps under the skin. It is important to seek prompt medical review if these symptoms occur.
Another uncommon but serious risk is vascular occlusion, which happens when filler blocks or compresses a blood vessel. This can cause significant pain, blanching, or colour changes in the skin due to reduced blood flow and oxygen supply. Immediate medical attention is essential if this occurs.
In extremely rare cases, filler has been reported to block an artery supplying the eye. This can lead to sudden vision loss and requires urgent emergency treatment.
Dermal fillers are prescription-only products in Australia. By law, they must be prescribed by a doctor for a specific individual and treatment. For your safety, the CPCA advises that you have a face-to-face consultation with a doctor appropriately trained in cosmetic medicine, such as a CPCA member. The doctor may choose to delegate the procedure to a suitably trained nurse working under their supervision. Only a doctor is authorised to prescribe dermal fillers, and treatment plans should always be tailored to your unique needs by a qualified medical professional.
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Frequently asked questions about dermal fillers
How long do fillers last?
Fillers last depending on the type of filler used and the area treated. HA fillers usually last between 6 to 18 months, while CaHA fillers include Radiesse®, which can last up to 2 years. Fillers may require touch-ups to maintain results.
Can dermal fillers be removed or reduced?
Yes, certain fillers made with certain materials, such as hyaluronic acid-based fillers, can be dissolved using an enzyme called hyaluronidase. This allows for correction in case of overfilling or unwanted results. Other fillers, such as PMMA or calcium hydroxylapatite, are more difficult to reverse and may require surgical intervention if complications arise.
Are all dermal fillers TGA-approved?
No. Only TGA-approved dermal fillers are supplied by licenced manufacturers for FDA-approved uses of dermal fillers. The Therapeutic Goods Administration evaluates fillers for safety and efficacy before approving them for specific treatments. Unapproved fillers, often purchased online or from unregulated sources, pose serious health risks, including infections and permanent disfigurement.
How is the safety of dermal filler treatments evaluated?
While TGA-approved fillers undergo clinical trials to assess safety and efficacy, the safety of certain combination treatments has not been evaluated extensively. Some off-label uses, such as injecting fillers into high-risk areas like the nose or forehead, can increase complications. Patients should always seek treatment from qualified professionals in dermatology or plastic surgery to minimise risks.
Who can perform filler treatments?
Only a qualified dermal professional, such as a cosmetic surgeon, dermatologist, or licensed health care provider, should perform dermal filler procedures. Choosing an experienced injector reduces the risk associated with treatment and ensures TGA-approved fillers are used properly.
Can anti-wrinkle injections help when combined with dermal fillers?
Yes, anti-wrinkle injections can help complement the effects of dermal fillers by preventing muscle movement that contributes to wrinkles. This combination approach is often used for full-face rejuvenation while fillers restore lost volume. A skilled injector can use both treatments strategically to achieve a natural, balanced result.
What should patients consider before receiving dermal fillers?
Before receiving dermal fillers, patients should have a consultation with a qualified practitioner to discuss their goals, medical history, and the most suitable type of filler. Understanding how long the effects may last and the potential risks is crucial.
What to expect after dermal fillers?
After treatment, mild swelling, redness, and bruising are common. These effects usually resolve within a few days. Patients should avoid strenuous exercise, alcohol, and excessive sun exposure for at least 24-48 hours to reduce swelling and bruising. Results are often visible immediately but may take up to two weeks to fully settle. While most fillers are temporary, maintenance treatments may be needed to sustain results. In case of complications, patients should contact their provider immediately.
