Ageing is a gradual, continuous process of natural change that begins in early adulthood. For the face, there are several changes which take place, from the deep bony structures right up to the skin.

As seen in the picture above, there are multiple of such changes due to the natural ageing process. Despite the many variations, they all end with the same result – a face that looks visibly older, and in general, more tired, saggy, sad and angry.

This is where facial fillers come in. Facial fillers can help lift the saggy skin, providing support to the facial structure, while also volumizing certain areas of the face.

Used with permission from Allergan Aesthetics

So, what are facial fillers? 

Fillers are absorbable or temporary materials designed to be injected into the skin at different depths to add volume, promote fullness and augment facial features. They can be used to:

  1. Volumize – improve volume loss in areas such as cheeks or temples
  2. Lift – help lift saggy skin if placed at certain locations
  3. Contour – augment certain areas of the face such as the nose or chin

What are the different types of fillers? 

There are many ways to categorize fillers. One of the most common ways is hyaluronic acid (HA) fillers and non-hyaluronic acid fillers.

Hyaluronic acid is a naturally occurring polymer found throughout the body’s connective tissue. HA fillers work by replacing HA which is lost with aging and boosting the production of collagen. Common brands include Juvéderm and Restylane. It is important to note that HA fillers can be dissolved using hyaluronidase should there be any adverse events or should patients dislike the results.

Non-HA fillers are usually collagen stimulators. These fillers work by stimulating the dermal tissues to produce collagen. The stimulation process occurs subtly over a period of 2.5 to 3 months after injection into the skin, and the results can last 1 to 3 years.

The table below summarises the similarities and differences between HA and non-HA fillers.

  HA fillers Ellansé Radiesse Sculptra 
Composition HA –30% polycaprolactone –30% calcium hydroxylapatite (CaHA) microspheres + 70% carboxymethylcellulose (CMC) gel carrier Poly-L-Lactic acid (PLLA)
FDA approval Yes No, CE marking (approved for use in the EU) Yes Yes
Time taken for results Immediate Immediate Immediate Gradual
Longevity 6 months to 2 years 18 months to 3 years 12 months to 18 months 2 to 3 years (after 3-4 sessions)
Volume maintenance Gradual decrease Yes Yes Yes
Dissolvable Yes No No No

Where can fillers be used? 

Fillers can be used in many areas of the face depending on the concerns of the patients. Commonly injected areas include the cheeks, temples, tear troughs, forehead, nasolabial and marionette folds, jaw line, nose, chin and lips. However, the exact location and technique performed will depend on the needs of the individual patient. At TWC, we use a wide range of Juvéderm fillers to get the best results for our patients. Depending on the needs of the patient, there are different types of Juvéderm fillers that are used for different target areas. Speak to our doctors for a customized treatment for you.

Are fillers safe? 

Treatments using dermal fillers are generally safe. However, the procedure still requires injections. While most side effects are not serious and rarely occur, it is still our responsibility to share this information with you. The general complications of fillers include pain and bleeding. Bruising, infection and allergic reactions may occur, though uncommonly so. The specific complications of filler injections include overcorrection, under-correction or asymmetry, and filler migration. Extremely rarely, there may be delayed onset nodule formation or occlusion to blood vessels causing skin necrosis or blindness. Our doctors take extreme care to minimize these side effects by maintaining sterility while injecting fillers. They are also very well versed with anatomy, injecting only in safer locations while always aspirating to ensure there are no intravascular injections. More importantly, these HA fillers can always be dissolved using hyaluronidase should there be any adverse events.

What should I expect from the treatment? 

Treatment involving the use of dermal fillers is a simple procedure requiring needles or cannulas (blunt needles) to precisely place the fillers. There will be no separate anaesthesia injections needed – in fact most fillers already contain some lidocaine (aesthetic agent). There may be minimal pain during the procedure, and some numbing cream or ice packs may be used before the procedure to help you minimise that. There may be some temporary swelling and infrequent bruising after the procedure.

In general, we advise the following after your treatment:

  • Do not massage your face for a period of 2 weeks after the treatment
  • Do not apply any makeup for at least 24 hours after the treatment to reduce the risk of infection
  • Avoid any vigorous exercise for a few days and heat exposure such as saunas, for a period of 2 weeks after the treatment
  • Do not consume alcohol for 12-48 hours after the treatment

How long do the results last and can the treatment be reversed? 

Within the Juvéderm range, there are a wide range of fillers used for different purposes, and they usually last between 6 to 24 months. The results are usually immediate, and they can improve 1-2 weeks after the injection.

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501, Orchard Road #04-01, Wheelock Place Singapore 238880

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Tel: +65 67320812 | Mobile: +65 8377 1090

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