What it is
Hyaluronic acid occurs naturally in skin and holds water. The products used are sterile gels made in different firmnesses, chosen according to the area and the aim; what is right for supporting a chin is not right for a lower eyelid.
Filler adds volume or supports structure. It does not relax a muscle and does not treat movement lines — that is what botulinum toxin does.
Where it is used
- Cheeks
- The nasolabial fold
- Chin and jawline
- Lips
- The under-eye area — delicate, and not suitable for everyone
- Backs of the hands
How long it lasts
This varies with the product, the area, individual physiology and metabolism. Areas that move a great deal consume it faster than static ones. There is no single figure that fits everyone, and we do not give one before an examination.
Who it suits
- Those with volume loss that is evident on examination
- Those whose expectations are realistic and specific
- Those whose general health allows it
When we advise delaying or not treating
- Pregnancy and breastfeeding
- Active infection in or near the area
- Certain autoimmune conditions in an active phase
- Known allergy to a component
- Marked skin laxity — filler does not treat it, and adding volume can add weight and worsen the appearance
- Under-eye hollowing accompanied by fluid retention or obvious morning puffiness; the result usually worsens rather than improves
- Dental work or a vaccination due soon — we arrange the timing rather than take the risk
- A pattern of asking for repeated additions without stopping. Here we stop, explain, and decline to continue
How the session goes
- Examination of the features at rest and in movement, with a review of medical history and medicines.
- Local anaesthetic; a numbing cream, or anaesthetic within the product itself.
- Injection by needle or cannula, depending on the area and how close it lies to blood vessels.
- Immediate assessment and small adjustment if needed.
- A review at around two weeks, once swelling has settled and the result has stabilised.
Afterwards
- Avoid pressing or massaging the area unless asked to
- Avoid high heat and strenuous exercise for a short period
- Sleep with the head raised on the first night
- Swelling and bruising are possible and settle gradually
Possible effects, including the rare and serious
This section is deliberately long. Filler is a medical procedure, and treating it as a simple beauty service is the root of most problems that arise.
- Swelling, bruising and local tenderness — common and temporary
- Asymmetry or small lumps, usually adjustable
- Nodules or a delayed inflammatory reaction — uncommon
- Vascular occlusion: the most serious complication. It occurs if product enters an artery or compresses one. Signs include pain out of proportion to the procedure, pallor or mottling of the skin, or a change in vision. It requires immediate attention and must not wait until morning.
This is precisely why hyaluronic acid is preferred: it can be dissolved with hyaluronidase when needed. Having a plan for managing a complication, and knowing the vascular anatomy of the area, matters more than the name of the product.
A note on darker skin
The filler itself is unaffected by skin tone. The needle and any bruising, however, can leave temporary post-inflammatory pigmentation more readily in deeper skin tones. That is reduced by using a cannula where appropriate, minimising entry points, and treating bruising early.
Filler and botulinum toxin are not alternatives
| Botulinum toxin | Dermal filler | |
|---|---|---|
| What it addresses | Lines formed by repeated muscle movement | Lost volume, or a feature needing support |
| How it works | Reduces contraction of a specific muscle for a limited period | Adds volume or structure beneath the skin |
| Common areas | Forehead, between the brows, around the eyes | Cheeks, chin, jawline, lips |
| When it shows | Gradually, over days | Visible immediately, settles as swelling subsides |
| Reversibility | Wears off on its own | Hyaluronic acid products can be dissolved |
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Common questions
Does it hurt?
Local anaesthetic is used, and many products contain anaesthetic within them. Sensation varies between people and between areas; lips are more sensitive than cheeks.
Will it look artificial?
That is a result of quantity, placement and product choice, not of filler itself. The aim is to support an existing feature, not to change the face.
How long does it last?
It varies with product, area and individual physiology. Areas that move a great deal consume it faster. No single figure fits everyone.
Can it be removed if I dislike it?
Hyaluronic acid products can be dissolved with hyaluronidase. That is a genuine advantage and a principal reason for preferring them.
When will I see the final result?
The effect is visible immediately, but judging it requires swelling to settle and the product to stabilise, usually within about two weeks.
Does it suit the under-eye area?
Not for everyone. The area is delicate, and where puffiness is caused by fluid retention or eyelid fat, filler makes it worse. Examination settles this.
Does filler drop or migrate?
The wrong product or the wrong tissue plane can give that impression, as can excessive quantity. Follow-up catches it early.
Does it suit darker skin?
Yes. The only consideration is possible temporary pigmentation from the needle or bruising, managed as described above.
Can I combine it with botulinum toxin?
Sometimes, when the examination calls for it. Sometimes it is better to separate the two sessions.
What if a complication occurs?
Contact us immediately, particularly with severe pain out of proportion, a change in skin colour, or any change in vision. These do not wait.