Dermal Fillers: Who Should Consider this Procedure?

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Collagen, elastin, and hyaluronic acid are the substances present in your body responsible for smooth, wrinkle-free skin. The consequence of their loss: the elasticity of your skin decreases, and wrinkles on the forehead, around the eyes, and mouth become more and more noticeable. 

The aging process of the skin begins as early as the age of 25. Fortunately, it can be slowed down using dermal fillers. Read on to find out what these injectable fillers are, how they work, and whether you should consider this procedure.

What are dermal fillers 

When it comes to wrinkle reduction, dermal filler injections have become the gold standard over the past ten years — but they can do more than that. In short, dermal fillers are substances injected under the surface of the skin to:

  1. smooth out wrinkles;
  2. smooth expression lines and scars;
  3. harmonize the face by adding volume and contour to specific areas. 

The products most used for this purpose are composed of hyaluronic acid and, as mentioned above, work by restoring lost volume in specific areas and can also be used to enhance some of them. 

At VIVAA, we have the expertise and proper education to deliver high-quality results that allow clients to achieve a more natural and youthful look. Dermal fillers are most commonly used for treating the following:

  • Brow wrinkles
  • Crow's feet
  • Forehead wrinkles
  • Fine lines under the eyes
  • Acne scars
  • Pronounced nasolabial folds
  • Lip wrinkles
  • Signs of aging on the hands
  • Vertical lip lines
  • Cheek enlargement

What are the different types of dermal fillers 

Dermal fillers can consist of different components and can be classified in different ways. Depending on the depth of the injection, wrinkle injections can be distinguished as follows:

  • Superficial injections: They use lower density fillers (mostly hyaluronic acid) that are injected into the upper layers of the dermis to fill in fine wrinkles;
  • Deep injections: They use higher density fillers injected into the lower layers of the dermis; they are suitable for correcting dents, clearer wrinkles, and furrows.

Depending on the filling substance used, wrinkle injections can be distinguished as follows:

Temporary dermal fillers: Hyaluronic acid, Collagen, Agarose gel: Suitable for treating wrinkles, furrows and small dents. The higher molecular fillers can be used to lift lips, cheekbones and other areas of the face.

Slowly absorbable: Calcium hydroxyapatite, Polylactic acid, Polyvinyl pyrrolidone, Autologous fat: More suitable for deep blemishes that need to be filled up more; for example, to restore facial volume, even in patients with pronounced atrophy. Generally not suitable for lips and superficial wrinkles.

Semi-permanent or Permanent: PMMA or polymethyl methacrylate, HEMA or hydroxyethyl methacrylate, and PMA or polyacrylamideThose are the best dermal fillers for reconstructing skin volume and correcting serious skin defects. Little use is found due to increased side effects and complications, and the difficulty of correcting errors or undesirable results.

At Vivaa, we use products from the Juvéderm collection of dermal fillers (FDA approved). Each of them gives volume to different areas of the face with natural and long lasting results. The Juvéderm fillers consist of synthetic hyaluronic acid (HA) - the natural substance in the skin that provides nutrients, helps the skin retain moisture and suppleness, and keeps it voluminous. Compared to the natural hyaluronic acid, the synthetic version comes with other benefits such as a better capacity of holding water and being highly hypoallergenic. 

In addition to their filling effect, Juvéderm fillers have a moisturizing , facial rejuvenating and bio-stimulating effect (the hyaluronic acid fragments seem to stimulate the activity of the fibroblast). The three Juvéderm products we use to treat our patients are:

Voluma - It was developed to reshape the contour of the face and restore volume following weight loss or age-related loss of facial fatty tissue. With this product, the facial features will be rounder and fuller and the skin will look plumper and younger.

Unlike other products from competitors, Juvéderm Voluma uses the latest technology "Vycross". In the context of this technology, not only do long polymer chains of the active ingredient 'bind' together, but they also short-circuit one, thereby increasing the viscosity of the gel and providing a more permanent effect. Voluma restores facial volume in the following areas: cheeks, temples, cheekbones, and chin. The effect lasts approximately 24 months with a touch-up treatment after 12 months to improve longevity. 

Ultra Plus - This filler is thicker than other products in the Juvéderm  collection, making it an excellent choice for more pronounced wrinkles and deep nasolabial folds. Juvéderm Ultra Plus is used to treat the following areas: the smile lines and wrinkles around the nose, deep nasolabial folds, bags under the eyes, cheekbones, and chin enlargement. 

Juvéderm Ultra can also treat wrinkles caused by movement of facial muscles due to expressions such as smiling and frowning.  In general, Juvederm Ultra and Juvederm Ultra Plus work well for wrinkles in the nasolabial folds and other areas of the lower half of the face, and can also help fill the lips or cheeks. The effect lasts approx. 12 months, with possible rework after 6–9 months. 

Volbella - This product is recommended for those looking for dermal fillers for lips, because it was specially developed to improve contours, support the build-up of lip volume and even out asymmetrical lips, but it can be also used, among other things, to reduce perioral and nasolabial wrinkles. The specialty of Juvederm Volbella is the contained lidocaine, which is a local anesthetic. As a result, the treatment is generally less painful, less stressful and more pleasant for the patient to endure. The effect lasts approximately 12 months. 

The procedure explained

Typically, the dermal fillers procedure is divided into the following three steps:

1. Before the session: the first step in having a dermal filler, of course, is to consult a specialist. With it, you will establish which areas of the face will be treated and how many syringes will be needed.

Afterwards, a series of instructions will be given so that everything happens in the best possible way, guaranteeing good results. However, recommendations may vary from case to case.

2. During the procedure: before administering the injections, the specialist will clean the area that will receive them. Depending on the case, a topical anesthetic can be applied for greater patient comfort.

The session itself takes 15 to 60 minutes, depending on the area to be treated.

3. The Recovery: the patient can return to normal activities as soon as they leave the clinic. However, it is normal to feel a little swelling, tenderness and redness at the injection sites.

Depending on the case, the patient may need to take cold compresses at the treatment site every half hour (only on the day of the session). In addition, it is noteworthy that heavier exercises and very hot places (saunas, spas, etc.) should be avoided for 24 hours after application. The use of sunscreen is mandatory.

Benefits of dermal fillers

The dermal filler injections are very popular because of their quick process and instant results. Be it signs of aging or sunken areas, fine lines or wrinkles, thin lips or wrinkles, dermal filler injections can repair anything. Here are some of their greatest benefits:

Immediate results - Unlike other skin treatments, such as HIFU (High-intensity focused ultrasound), which can take up to 2 to 3 months to produce definitive results, dermal fillers have instant results. Immediately after filler injection, a clear change in facial contours can be seen. The filler instantly adds the volume of the injected area and reduces wrinkles and fine lines in the skin of the injected site. The entire process can be done in at least 10 minutes, and there are no scars or healing. The skin swells a little, but it subsides within a few days.

Long-lasting effect - Another great advantage of dermal fillers is the long-lasting results. The effect of these filler injections lasts for at least 6-18 months. The duration of action also depends on the fillers' composition, the treatment area, and the patient being treated. The long-lasting results save you both money and time that you would otherwise spend on other beauty treatments.

Minimal risks - There are minimal risks associated with dermal filler injections. In addition, the effects are not permanent. Although redness, swelling, and/or easy bruising may occur at the injection site, these effects will subside within a few days.

No downtime - The procedure is very quick and does not take much time. You don't have to be absent from work and go without treatment for hours. In fact, you could save yourself a few minutes off your lunch break and have this non-invasive treatment done. It will take at least 10 minutes to finish. However, the duration also depends on the number of injections to be given per visit.

Natural results - Dermal filler injections are the most suitable rejuvenation treatment for those looking for subtle and natural results. As a result of this treatment, the facial features will not acquire an artificial appearance, as with other methods of correcting wrinkles or enlarging the lips.

Improved self-confidence - Self-confidence is often related to one's own appearance. After the fillers and the immediate results, people feel good, comfortable in their skin, love their facial features, and acquire a new sense of confidence and beauty.

Risks and side effects 

The treatment is generally well-tolerated, and possible side effects are usually mild and only temporary. Immediately after the injection, slight discomfort may occur, such as local bruising, headache, nausea, flu-like symptoms, and swelling, but these will subside after two days.

Less common side effects can include:

  • Allergies (depends on the preparation)
  • Hematomas (small bruises go away on their own within a few days)
  • Granulomas (nodules)
  • Indurations (encapsulation in the tissue)
  • Necrosis (occurs very rarely and occurs when the filler has been injected directly into a vessel (artery) or too much material is squeezed off the vessel.
  • Infections usually only occur if the work has not been carried out properly. 


After taking blood-thinning medication, such as aspirin, you should wait a week before starting treatment, otherwise the risk of a bruise may be increased. If the skin has been overstretched for several months due to too much hyaluronic acid, the wrinkles may become more pronounced after dissolution. This should usually decrease significantly after a few weeks.

Filler treatments during pregnancy are also not recommended. Allergic reactions can (rarely) occur, which must be treated depending on the severity.

Who should consider dermal fillers injections? 

Dermal filler injections are recommended for both women and men. Most patients choose dermal filler treatment because they are dissatisfied with their appearance. You may have lost your confidence after seeing the signs of aging on your skin, and you feel like restoring a more youthful look and filling in fine lines and wrinkles will bring some of your confidence back. Whatever the reason, dermal fillers will reverse the signs of aging and give you a more youthful and fresher look.

You can start treatments with hyaluronic acid fillers as soon as the first and expressed wrinkles appear, which some people experience at an earlier age (late twenties) and others at a later age, depending on genetics and lifestyle (alimentation, smoking, insufficient sleep, daily stress, and more). From the appearance of the first wrinkles, hyaluronic acid fillers can be replenished about every year in order to keep the youthful appearance longer and to maintain a good facial shape.

Recovery is very easy. The post-treatment redness will go away after a few hours. Initial results are visible after a few days. Complications should be reported to your doctor to prevent any long-term issues. 

If you are wondering how long dermal fillers last, the average life of the treatment is approximately 12 months. It is then recommended to repeat the treatment. Lip fillers typically last six months.

Dermal fillers vs Botox 

In summary, the differences between Botox and fillers are:

Botox -> the botulinum toxin is a substance that acts directly on facial muscles, paralyzing them. This is an appealing option for those who want to soften the signs of age because, once applied, it prevents wrinkles produced by facial expressions from forming.

Dermal fillers -> These use hyaluronic acid and similar substances to fill areas that have lost volume and smoothness. These include wrinkles around the mouth, thin lips, and cheeks that have lost fullness. They can also be used on forehead wrinkles, scars, and other areas that need extra volume for a smoother look.

While Botox results last 3 to 4 months, dermal filler results will vary depending on the filler used, with results lasting between 6-18 months. In the long run, Botox and dermal fillers are not interchangeable - you cannot substitute one for the other. They complement each other and are often used together, for example, with the marionette fold, the nasolabial fold, or the cheek folds.


As with all cosmetic surgical procedures, dermal filler treatments require an initial consultation with your doctor before you can undergo the procedure. Your doctor will advise you on what type of dermal fillers to use, address all your concerns, and give you information and advice on how best to achieve the results you want. 

Although dermal filler treatments are a very popular and non-invasive procedure, educating yourself about the risks and possible side effects is vital before starting this treatment. 


Do dermal fillers look natural?

After treatment, the patient looks completely natural because the skin gets back the part that it has lost over the years. The facial expressions remain the same, the lips look more sensual, the face regains volume, and the skin looks youthful. 

Do dermal fillers hurt?

Unlike surgical facelifts or implants, dermal fillers don't require any incisions or stitches, which means the pain won't be significantly felt. Most patients describe it as a tiny scratch when the needle goes in, with a slight prick when the filler is applied. However, for those feeling anxious, a local anesthetic can be used.  

How long do the fill results last?

Dermal fillers last between 12-18 months. It is important to remember that everything varies according to the patient and, of course, the region that was treated.

Visit our Dermal Fillers Before and After Gallery


Dr. Sidhu
Dr. Ramandeep Sidhu

Author - Dr. Ramandeep Sidhu

SPECIALTIES: Percutaneous aneurysm repair, endovascular treatment of peripheral arterial disease, treatment for varicose veins, open vascular surgical procedures, deep vein thrombosis/pulmonary embolism treatment and aesthetic services.


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