Dermal fillers

Fillers are a bio degradable, non animal-based hyaluronic acid gel. During treatment the clear gel is injected into the skin in tiny amounts with a very thin needle. The gel gives natural volume to smooth out wrinkles.

Dermal fillers are frequently used in the correction of scarring, wrinkles and other depressions in the skin. They are a form of hyaluronic acid, a substance naturally found in the body, and can be injected into the skin to improve aesthetics. They are generally made of several types of synthetic, man-made and natural collagens. For anyone suffering from problems such as wrinkles, folds or depressions in the skin, dermal fillers may be the best solution to improve appearance. The procedure is quick, often taking just 30 minutes or less to complete, and many people experience no pain at all and minimum side-effects.

As the skin ages the major elements of the dermis are gradually lost. These elements include elastin, hyaluronic acid and collagen. Collagen is the major protein which supports the skin, while hyaluronic acid assists in adding volume and shape to the skin.

The main function of elastin is to allow the skin to stay firm and resist the development of wrinkles, depressions and folds on the skin surface. In general terms it could be said that these materials prevent the skin from becoming saggy. However, as they gradually decrease in the body the skin ultimately becomes thinner and lined with deep wrinkles. Dermal fillers provide a perfect solution to this problem by restoring such lost elements.

There are currently several types of dermal fillers available on the market. The most popular types of dermal filler are the resorbable hyaluronic acid fillers fillers. These come in different degrees of thickness, a factor which will determine how deep the injection goes into the skin. The thicker the filler, the deeper it can be injected.

Non-permanent dermal fillers have a shorter effect and will require replenishment once they have worn off. There are many brands of non permanent dermal fillers like Restylane, Juvéderm®, Belotero® to name but a few.

Dermal fillers FAQs

The most common use for dermal fillers has been to increase the volume and size of women's lips, with many types of dermal filler designed for this function due to the scale of the market. Women are looking to maintain their beauty and not let it lapse during their lifespan, which is why the option of dermal fillers to reverse or even postpone the unappealing signs of ageing is an advantageous choice. However, there are other popular uses of dermal fillers which are beneficial for both men and woman.

Facial lines are quite common due to advanced age and stress. These can also occur as a result of other factors and being include a side-effect of substances used in the body; prescription drugs, for example. Dermal fillers are effective in filling lines and improving facial aesthetics. One of the most common lines able to be filled in both genders is nasolabial lines, which are lines traversing from the nose to the corners of the mouth. These are commonly called smile or frown lines.

Wrinkles are an equally common condition which can be treated, and these include forehead wrinkles and wrinkles around the eyes, more commonly referred to as "crow's feet". Other commonly treated skin conditions are weak and sunken cheeks, acne scars and regular scars, and varicose veins in aged skin. Generally, the lines, wrinkles and folds able to be treated by the application of dermal fillers are lip lines, tear troughs (tired, baggy eyes), marionette lines (mouth to chin), frown lines, crow's feet (around the eye), and nasolabial lines (nose to mouth).

Other applications can be classified under skin rejuvenation or contouring and enhancement. For rejuvenation the various parts that can be treated include the face, neck and the back of the hands. Contouring and enhancement include eyebrow reshaping, chin enhancement, cheek sculpting for sunken cheeks, shaping saggy jowls, turning up the mouth corners, nose contouring and lip enhancement.

Should you desire to have fillers on the upper regions of the face, the general recommendation is that fillers should be used in conjunction with muscle relaxant injections. There are a wide variety of conditions which can be treated by dermal fillers, and these include larger skin defects in the rest of the body.

The fundamental working principle of dermal fillers is that they have a ‘plumping’ effect. This simply implies that they will plump-up the area which has received the injection, levelling it with other parts of the skin and making it look plumped out, even and no longer sunken. Ultimately, different fillers may achieve this goal in slightly different ways, but the result is that the skin will look plump and firm, young and refreshed.

The treatment is successful by taking advantage of the basic roles and functions of the skin, which can also help in fully understanding the procedure. The human skin is made up of two layers, namely the epidermis and the dermis. The outermost layer is the epidermis and its main function is to serve as protection against the effects of the environment and other components. It controls water loss from tissues and cells, thus serving as a barrier to the outside environment.

The dermis layer is right below the epidermis and constitutes the skin's structural elements, such as nerves, hair follicles and blood vessels. The growth of cells and blood vessels is enhanced through a framework provided by a network of fibres that is formed by protein.

The major component of the dermis is collagen which gives the skin its firm elasticity and strength, offering fundamental support to the skin. As one grows old the ageing process causes the upper layer (the epidermis) to gradually become thin and provides less protection to the dermis layer. In addition, collagen production in the body slows down considerably as the existing collagen becomes ineffective.

This then causes wrinkles, folds, depressions and other forms of skin abnormalities associated with old age. It is at this point that dermal fillers become necessary to reduce the consequences of the deteriorating epidermis and weakened collagen. Dermal fillers technically work as replenishment for the natural collagen which has been rendered less effective by the ageing process. They work as collagen and, depending on the quality of the system used, impressive results can be achieved.

The general working principle is similar for all dermal fillers, but may vary slightly from one type to another. Dermal fillers are usually designed to treat one area specifically, such as the lips. Often, various dermal fillers are marketed under a similar name with each treating a different area of the body, or providing a different level of treatment.


Most fillers have local anaesthetic as component so that as the treatment session progresses you become increasingly pain free. Additional pain relief with dental anaesthetic injections can be offered for treatment around the mouth and lips or topical anaesthetic for less sensitive areas of the face

Treatment usually lasts for 9 -12 months. It is not permanent. How long a treatment lasts is variable and depends on your life style and muscle activity. Most patients choose to have a follow up treatment around twelve months after the initial procedure.

Re treatment may be necessary after 9 months when very mobile parts of the face are being treated ie the mouth. In less mobile areas the filler will last for longer.

Dermal fillers price guide

0.5ml £200
1ml £300
2ml £500

British Lingual Orthodontic Society
British Orthodontic Society
Royal College of Surgeons