Dermal Fillers

What are dermal fillers?

Dermal filler injections are a type of nonsurgical cosmetic procedure. Dermal fillers plump up wrinkles, smooth lines and restore volume in your face. Your healthcare provider injects these substances just under your skin.

People choose to get dermal fillers to enhance their facial features or gain a more youthful appearance. This elective treatment usually takes less than half an hour, and recovery time is minimal. Results are seen right away and last months to years depending on the type of filler and the location.

There are several kinds of dermal fillers. Your healthcare provider will discuss your options with you. As with any cosmetic procedure, there are risks, including infection, bleeding and bruising. Health insurance plans generally don’t cover elective cosmetic procedures such as filler injections.

Why are dermal fillers used?

As you age, your body starts to lose collagen. Collagen is an important substance that exists all over your body, including in your skin, muscles, bones and connective tissues. Decreased amounts of collagen in your skin causes skin laxity (loose) and loss of volume. Skin becomes thinner, loses its elasticity and starts to sag.

You may choose to get dermal fillers to:

• Add volume to sagging skin.
• Make your facial features more symmetrical.
• Plump up lips and cheeks.
• Smooth wrinkles and creases in your face.

Some medications prescribed to treat medical conditions such as HIV and AIDS can cause thinness in your face. Some people choose to get dermal fillers to restore volume to their face after taking these medications.

How common are dermal fillers?

Dermal fillers are very common. Every year in the United States, more than 3 million people choose to get dermal fillers.

What are the types of dermal fillers?

There are many types of dermal fillers. In addition to “off-the-shelf” fillers that use synthetic (manmade materials) and substances that naturally occur in your body, healthcare providers can use fat from your own body. Healthcare providers call this procedure “autologous fat grafting,” where they remove fat from one part of your body and inject it into your face.

The types of off-the-shelf fillers include:

• Hyaluronic acid (HA)is a naturally occurring acid in your skin. It gives your skin volume and keeps it hydrated. With age, your body stops making hyaluronic acid. Results from HA injections usually last six months to a year. Restylane® is a commonly used type of HA filler.
• Calcium hydroxylapatite (CaHA) is a type of filler that consists of a substance you have in your bones. Results from these fillers typically last around a year. Healthcare providers usually use CaHA fillers for deeper wrinkles. Examples of CaHA fillers include Radiesse®.
• Poly-L-lactic acid (PLLA) is a substance that helps your body create its own collagen. Healthcare providers usually use poly-L-lactic acid to smooth deep wrinkles on your face. The results can last two years or more. Types of PLLA fillers include Sculptra®.
• Polymethylmethacrylate (PMMA) fillers consist of collagen and very small balls that stay under your skin after your healthcare provider injects them. The balls give your skin volume and keep it firm. Bellafill® is one type of PMMA filler.

Your healthcare provider will review the types of dermal fillers and discuss the right option for you. Talk to them about setting realistic goals and the results you can expect after getting injections.

What happens before a dermal filler procedure?

Before you get dermal fillers, you’ll have a consultation with your healthcare provider. You may wish to see a dermatologist, a healthcare provider who specializes in caring for skin. They’ll examine your face and ask about your goals and what areas you’d like to enhance.

They may mark your face with a pen or marker to show where the injections will be. They may also take pictures of your face. Your healthcare provider will recommend a specific type of filler or fillers and review possible side effects and recovery time.

During this consultation, your healthcare provider will also ask about your medical history. It’s important to tell them if you’re taking any medications, as some drugs can increase the risk of complications after getting fillers. Tell your healthcare provider if you have:

• Allergies.
• History of bruising or bleeding after similar procedures.
• Neurological problems.
• Skin conditions.

What happens during a dermal filler procedure?

You can get dermal fillers in your healthcare provider’s office. Some people choose to get dermal fillers in a medical spa (also called a medspa or medispa). This is a medical clinic that delivers cosmetic procedures in a spa-like environment. Your healthcare provider cleans your skin and may apply a lotion or cream with an anesthetic. The anesthetic numbs the area so the treatment will be more comfortable.

Using a thin needle, your healthcare provider injects small amounts of fillers under your skin. The needle will pinch or sting, but most people don’t experience much pain during these injections. Your healthcare provider may inject the fillers in several areas. The whole process can take a few minutes or up to an hour.

What happens after a dermal filler procedure?

After receiving dermal filler injections, your healthcare provider will cleanse your skin. They may give you an ice pack to ease pain and swelling.

You may have bruises, swelling or discomfort after getting the injections. Usually, these side effects are mild and go away in a few days.

Many people see results right away after getting these injections. But everyone’s results are different. How long it takes to see results (and how long they last) depends on several factors, including the type of treatment you received.

What’s the process for a facial fat grafting procedure?

The process for facial fat grafting is a little different. First, your healthcare provider removes fat from your own body using liposuction. After purifying the fat, they inject it into your face. This is usually an outpatient procedure (you go home the same day).

Because a fat grafting procedure requires an extra step, the process is more complicated than receiving off-the-shelf dermal fillers. Following liposuction and facial fat grafting, you may need to rest for up to two weeks. Ask your healthcare provider about the recovery time and whether this procedure is right for you.

What are the advantages of dermal filler procedures?

Many people see results of dermal fillers right away. The injections usually take less than an hour, and you can get them right in your healthcare provider’s office. Because it’s a nonsurgical treatment, recovery time is minimal.

Depending on the type of filler, results can last months or even years. Some fillers work for more than two years. Dermal fillers are also typically less expensive than elective surgical procedures.

What are the risks or complications of dermal fillers?

Serious complications are rare, and some of these side effects are only temporary. But as with any cosmetic surgery procedure, there are risks. They include:

• Asymmetrical appearance.
• Bleeding, bruising, redness, pain and swelling.
• Damage to your skin, which can cause scars.
• Infection, which can lead to necrosis (death of the infected skin) in severe cases.
• Lumps or bumps under your skin.
• Numbness.
• Pimples that look like acne.
• Rash and itching.

Rarely, people have vision problems following dermal filler injections. If you have problems with your eyesight, along with weakness, discomfort or pain on one side of your body, get immediate medical help.

What is the recovery time after getting dermal fillers?

Everyone’s recovery time is different. Your recovery time depends on:

• How many areas your healthcare provider treated.
• The type of filler you got.
• Your overall health.

Most people can get back to the activities they enjoy right after getting dermal filler injections. Your healthcare provider may recommend taking a break from rigorous exercise or physical activity for a day or two, though.

When should I see my healthcare provider about dermal fillers?

After getting dermal fillers, call your healthcare provider right away if you have:

• Bleeding or pain.
• Signs of infection, including fever or redness and swelling at the injection site.
• Symptoms of an allergic reaction or anaphylaxis, such as difficulty breathing or shortness of breath (dyspnea).

A note from Cleveland Clinic

Dermal fillers smooth wrinkles and restore volume to sagging skin. Many people choose to get these injections because results are noticeable right away and recovery time is minimal. As with any elective cosmetic procedure, there’s a risk of side effects. Talk to your healthcare provider about the risks and benefits, as well as the best type of dermal fillers for you. After getting these injections, call your healthcare provider if you have bleeding, pain or swelling or signs of an allergic reaction.