Dermal Fillers

Dermal fillers are gel-like substances injected under the skin to replace volume lost with age, soften lines and balance the features of the face; the most commonly used is hyaluronic acid. They are used in areas such as the lips, cheeks, under-eyes, nasolabial lines, chin and the backs of the hands. It is a non-surgical method, the effect is not permanent, and every treatment is planned individually after an examination by a doctor.

What do dermal fillers do?

A dermal filler restores lost volume, which softens lines and balances hollows and asymmetry in the face. The most common uses are:

• Adding volume and shape to the lips; details are on our lip filler page
• Softening the lines that run from the side of the nose to the corner of the mouth (nasolabial filler)
• Reducing marionette lines that run down from the corners of the mouth
• Filling hollows under the eyes and in the cheeks; for the under-eye area, see our under-eye filler page
• Supporting the cheekbones, temples and jawline, and defining the chin with chin filler
• Correcting depressed scars and volume loss on the backs of the hands

For forehead lines and crow's feet caused by muscle movement, botulinum toxin is usually preferred over filler; the two can be planned together when needed.

Why does the face lose volume and elasticity?

With age, the skin's hyaluronic acid and collagen decrease, facial fat thins and bony support changes. Hyaluronic acid helps the skin hold water; when it declines, the skin looks dull and loses its suppleness. Collagen is the skin's supporting tissue and breaks down faster with sun exposure and free radicals. As fat diminishes and gravity takes effect, the temples, cheeks and under-eyes sink and lines become more pronounced. Dermal fillers aim to make up for this loss of volume.

Which types of filler are used?

The doctor chooses the filler according to the area and what is needed. The main options are:

• Hyaluronic acid fillers: The most widely used type. They are based on a substance found naturally in the body, are broken down by the body over time and, if necessary, can be dissolved with a special enzyme.
• Calcium hydroxylapatite and poly-L-lactic acid: Mostly used for deeper volume loss and to support collagen production.
• Your own fat: In suitable patients, fat is harvested, processed and transferred to the area that needs volume.

For first-time patients, hyaluronic acid fillers are usually recommended: the result is easy to assess and, if necessary, can be reversed quickly.

How is treatment planned and carried out?

Planning starts with an examination in which your face is assessed from different angles, and it is based on your needs rather than a standard protocol. At our clinic in Etiler, we first listen to your expectations, identify lines, hollows and asymmetries, and agree on priorities together. The type and amount of filler are decided separately for each area. A numbing cream is applied before the procedure, and the filler is injected with a fine needle or cannula. Including numbing, the procedure takes about 30 minutes, and the effect is visible immediately afterwards. For a more harmonious overall result, fillers can be combined with other treatments that improve skin quality.

How long do dermal fillers last?

Hyaluronic acid fillers usually last 6–18 months, but this varies from person to person and from area to area. The product used, the area treated, age, skin type, metabolism and lifestyle factors such as sun exposure and smoking all affect longevity. In mobile areas such as the lips, the effect may wear off sooner. To maintain the result, top-up treatments are done at intervals, and follow-up appointments are planned with your doctor.

What are the possible side effects and risks?

The most common are mild swelling, redness, tenderness and bruising at the injection site that last a few days. Applying something cold at intervals in the first days helps reduce swelling; bruising and swelling can take a week or two to clear completely. Less often, unevenness, small nodules, infection or an allergic reaction may occur. A rare but serious risk is filler entering a blood vessel and blocking blood flow; this can damage the skin and, very rarely, cause vision problems. That is why fillers should be done by a doctor who knows facial anatomy well, under sterile conditions.

Who should not have fillers, and when should you see a doctor?

Dermal fillers are not given during pregnancy or breastfeeding, or while there is an active infection in the treatment area.

• Pregnancy and breastfeeding
• Active cold sores, an acne flare or another infection in the treatment area
• A known allergy to the filler or to ingredients of the numbing cream
• An autoimmune disease during a flare
• A bleeding disorder or use of blood thinners (to be assessed with your doctor)

If after the treatment you notice severe or worsening pain, whitening of the skin, a purplish discolouration or any vision problems, contact the clinic or the nearest emergency department without delay. You should also come in for a check if swelling, firmness or redness lasts longer than two weeks.

Frequently asked questions

Do dermal fillers hurt?

Because a numbing cream is applied beforehand, most people feel only mild discomfort. Sensitivity varies from person to person and by area.

When will I see the result?

The effect is visible immediately after the procedure. Once the swelling of the first days settles, the final look usually becomes clear within a week or two.

Are dermal fillers permanent?

No. Hyaluronic acid fillers are broken down by the body over time; their effect usually lasts 6–18 months and varies from person to person.

What if I am not happy with the result?

Hyaluronic acid fillers can be dissolved with a special enzyme if necessary. This is why they are usually recommended for people having filler for the first time.

What should I look out for after filler?

It is advisable not to press or massage the area on the first day, and to avoid strenuous exercise, saunas and excessive heat for a few days. Your doctor will also give you personal aftercare advice.

This content is for information only and does not replace an examination by a doctor. To decide on the right type of filler and a plan for you together, get in touch with us.