Introduction
Dermal fillers have become the go-to solution for those wanting to look younger without going under the knife. It’s not just Hollywood’s best-kept secret anymore – it’s a global phenomenon reshaping how we approach anti-aging.
The numbers don’t lie—the dermal filler market is skyrocketing. We’re looking at a whopping US$6,411.8 million in 2024, set to soar past US$8,764.6 million by 2034. That’s a steady 3.2% growth each year. People are falling in love with the natural-looking results and innovative formulations these treatments offer.
Dermal fillers are usually made from substances like those already in your skin, like hyaluronic acid. They work by adding volume to areas that have become thin or sunken (hollow) with age.
Thanks to celebrities openly sharing their experiences, dermal fillers have stepped into the spotlight. They’ve shown the world that you don’t need invasive surgery to look your best. This openness has made these treatments more accessible and accepted than ever before.
In this article, we will explore how dermal fillers help with anti-aging, discuss why they are becoming so popular, and highlight why they are a great choice for improving your appearance. From adding volume to your face to smoothing fine lines, dermal fillers offer a flexible and powerful solution for anyone looking to stay youthful and vibrant.
What Are Dermal Fillers?
The Food and Drug Administration (FDA) defines dermal fillers as,
Dermal fillers, also known as injectable implants, soft tissue fillers, lip and facial fillers, or wrinkle fillers, are medical device implants approved for use in helping to create a smoother and/or fuller appearance in the face.
Over time, different materials (compounds) have been used for facial rejuvenation. Here is a quick list1 of the most commonly used dermal fillers:
Hyaluronic Acid (HA)
Hyaluronic acid is a natural substance in your skin that keeps it hydrated and plump. HA fillers like Juvederm and Restylane add moisture and volume to your skin, making it look smooth and full after the injection.
Calcium Hydroxylapatite (CaHA)
These fillers, like Radiesse, are made of tiny calcium particles in a gel. They add volume immediately and help your skin produce more collagen, which makes your skin look better over time.
Poly-L-lactic Acid (PLLA)
PLLA fillers like Sculptra are synthetic and safe for your body. They help your skin make more collagen, gradually restoring volume and firmness over a few months.
Polymethylmethacrylate (PMMA)
PMMA fillers like Bellafill have tiny beads in a gel. These beads stay in your skin and provide long-lasting support, making them good for deep wrinkles and folds.
Dermal fillers are picked based on what you need to get the best results without surgery.
How do Dermal Fillers Work?
Fillers do more than just fill space. Here’s how they work:
Volume Restoration:
As you age, your skin loses fat and collagen, ultimately causing it to sag and wrinkle.2 Dermal fillers injected into specific areas can restore this lost volume by lifting and smoothing your skin.
Wrinkle Reduction:
Fillers can correct wrinkles and fine lines by adding volume underneath them. This makes the skin surface smooth and reduces the appearance of wrinkles, giving you a more even skin texture.
Skin Hydration and Plumping:
Hyaluronic acid fillers attract water to your skin, keeping it hydrated and plump. This extra moisture makes your skin look fuller and healthier.
Collagen Stimulation:
Some fillers, like CaHA and PLLA, help your skin produce more collagen. Collagen is a protein that keeps your skin firm and elastic. More collagen means your skin will look better and stay firmer for a longer time.
Tissue Support:
PMMA fillers with tiny beads provide a strong support structure under your skin. This helps keep your skin lifted and smooth, especially in areas with deep wrinkles.
The Benefits of Dermal Fillers for Anti-Aging
Dermal fillers offer numerous advantages for those seeking a youthful appearance without surgery. Here are the primary benefits:
Immediate Results
Unlike many anti-aging treatments, dermal fillers provide instant visible improvements. You’ll notice smoother skin and reduced wrinkles right after your treatment.
Reduced Downtime
Most people can resume their routine activities immediately after getting fillers. There’s no need for extended recovery periods.
Long-lasting Effects
Depending on the type of filler used, you can experience the results for as long as 6 months to 2 years.
Customizable Treatment
Fillers can be tailored to address specific areas of concern, allowing you to opt for anti-aging solutions in line with your needs.
Natural-Looking Results
When administered correctly by a skilled expert, dermal fillers can provide subtle, natural-looking enhancements.
Versatility
Fillers can address various signs of aging, from wrinkle smoothing to restoring lost volume in cheeks or lips.
Non-Surgical Solution
Dermal fillers might be the perfect solution as they offer a gentle alternative to traditional surgical procedures:
Minimally Invasive
Fillers are injected with fine needles, minimizing discomfort and downtime. This means you can quickly return to your daily routine with minimal disruption.
Enhanced Safety
As a non-surgical option, fillers avoid the risks of general anesthesia and make the procedure safer and more comfortable.
Time-Saving Convenience
Most filler treatments take less than an hour. They are ideal for those with busy schedules who value their time.
Adjustable Results
Many fillers can be dissolved or naturally fade over time. This flexibility ensures you achieve the desired look with these safe cosmetic options.
Boosting Collagen Production
Some dermal fillers do more than just fill in wrinkles; they help your skin make more collagen. This is great news for keeping your skin looking young and healthy.
How Dermal Fillers Boost Collagen?
As we age, our skin loses collagen, which makes it less firm and elastic. Certain types of fillers, like poly-L-lactic acid (PLLA), polycaprolactone (PCL), and calcium hydroxylapatite (CaHA), can kickstart your body’s collagen production.2,3
When these fillers are injected, they act like tiny scaffolds in your skin. Your body sees them as something new and sends in special cells called fibroblasts. These fibroblasts are collagen-making cells. They start producing fresh collagen around the filler, which helps improve your skin’s structure over time.
Long-Term Benefits for Your Skin
The best part? This collagen boost isn’t just a quick fix. As your body keeps making new collagen, you’ll notice your skin becoming firmer and more elastic. This can last for months or even years after your treatment.
Studies show that fillers like Sculptra (made of PLLA) and Radiesse (made of CaHA) can keep improving your skin for up to two years or more.2 Apart from treating wrinkles, they can even help your skin look better overall by encouraging it to produce its own natural collagen.
Areas Commonly Treated with Dermal Fillers
Nasolabial Folds (Lines from Nose to Mouth)
These deep lines can be filled and softened. This reduces their prominence and creates a smoother transition between the cheeks and upper lip.3
Marionette Lines and Downturned Corners of the Mouth (Lines from Mouth to Chin)
Lifting and filling these lines can reduce the appearance of a frowning or sad expression. It also elevates the corners of the mouth for a more positive look.
Mental Crease (Chin Line)
This horizontal line between the lower lip and chin can be smoothed out. This creates a more balanced lower face and reduces the appearance of a prominent chin dimple.
Frown Lines (Lines between Eyebrows)
Softening these vertical lines takes away that angry or concentrated look, leaving the upper face looking more relaxed.
Cheek Flattening (Sunken Cheeks)
Restoring volume in the cheeks enhances facial contours, lifts sagging skin, and gives a more youthful, fuller-faced appearance.
Lip Lines (Vertical Lines around the Mouth)
Filling these fine lines smooths the skin, resulting in a less aged look and making lipstick application easier.
Lip Thinning (Thin Lips)
Enhancing lip volume creates fuller, more defined lips while maintaining a natural look. It can also improve lip symmetry and enhance the cupid’s bow.
Extended Mental Crease (Extended Chin Line)
Smoothing the entire area from the lower lip to the chin can improve the overall lower face contour. This results in a more youthful jawline appearance.
Chin Flattening (Flat Chin)
Augmenting chin projection improves facial profile and balance. This can also create the illusion of a slimmer face or a stronger jawline.
Scars (Indented Scars)
Elevating depressed scar tissue to the level of the surrounding skin reduces the visible impact of scarring. The result? A smoother overall skin texture.
In addition to the above regions, dermal fillers can also be used to rejuvenate earlobes and hands, although these treatments are less common than facial applications.
What to Expect During a Dermal Filler Session?
It is very natural to have thoughts before undergoing any cosmetic procedure, so understanding what to expect during a dermal filler session can significantly ease your anxiety.
Here’s a run-through of the typical steps involved:
Consultation
This is the most crucial step. Your doctor will discuss your aesthetic goals, medical history, and any medications you’re taking. They’ll examine your face to determine the most suitable type and amount of filler for your desired outcome. Be sure to ask any questions you may have about the procedure, potential side effects, and expected results.
Product Selection
Choosing the right dermal filler depends on a few key factors such as,
- Where it’s being used.
- How deep the wrinkles or volume loss are.
- How long do you want the results to last?
- What the doctor knows best.
Different areas of the face require different types of fillers. For example, lips and fine lines need softer, more flexible fillers, while cheeks and chin may benefit from firmer, more structural fillers. Superficial wrinkles require thinner fillers, while deep volume loss needs more substantial fillers.3
Different fillers last for different times:
- Collagen: About four months
- Hyaluronic acid: 4-12 months
- Calcium hydroxylapatite: 12-18 months
Preparing for the Procedure:
- Before the injection, you might be asked to stop taking some medications or blood thinners that can cause bruising.
- The area being treated will be cleaned well.
- A numbing cream is usually applied to reduce any discomfort.
- Tiny marks for injection sites will be made on your face.
- You’ll have a final opportunity to ask any questions.
The Injection Process:
- The practitioner will use either a fine needle or a cannula for injection. You may feel a slight pinch or pressure at the injection sites
- The filler is carefully placed in small amounts across the treatment area.
- The practitioner may massage the area to ensure even distribution.
- Most sessions last between 15 to 60 minutes, depending on the number of areas treated.
But how do the doctors achieve those natural-looking results? It’s all thanks to diverse injection techniques.3,4 They select the most suitable injection technique for your specific needs.
Some commonly used injection techniques are:
- Precision methods: Microdroplet, Cannula, and Micro-Papular for subtle, natural results.
- Volumizing approaches: Layering, Profiloplasty, and Depot for contouring and feature enhancement.
- Distribution techniques: Tunneling, Linear Threading, and Fanning for even filler placement.
- Combination strategies: Cross-Hatching, Sandwich, and Stretching for comprehensive treatment.
After the injections, your doctor might treat the area with ice packs to minimize swelling and discomfort. They’ll likely provide you with a mirror so you can see the initial results and address any questions or concerns you may have.
Post-Treatment:
Once the procedure is done, your doctor will provide you with special instructions to optimize your healing process and ensure the best outcome.
For the first few hours to days after treatment:
- Apply ice as directed to reduce swelling
- Try not to touch or massage the treated areas unless instructed otherwise
- Stay upright for several hours after the procedure
- Avoid strenuous exercise for 24-48 hours
- Skip makeup application for the rest of the day, if possible
The good news is you won’t have to wait long to see the full effects of your dermal filler treatment. Typically, any swelling subsides within 1-2 weeks, after which the final results are much clearer.
However, how long those results last depends on the type of filler used. Some fillers can work their magic for six months, while others offer extended benefits lasting up to 2 years. Your practitioner will discuss this with you and advise on the best timing for maintenance treatments to keep your refreshed look going.
Who is a Good Candidate for Dermal Fillers?
While dermal fillers can benefit many people, not everyone can benefit from their use. The American Society of Plastic Surgeons determines you may be a good candidate for dermal fillers if you,
- Have realistic goals and a positive attitude towards improving your appearance.
- Are in good overall health
- Are committed to preserving your skin’s health
- Are a non-smoker, or are ready to stop smoking for some time before the procedure.
- Are of any age, though most are in their mid-to-late 30s or older.
Here is a list of conditions where dermal filler treatments are best avoided:3
Pregnant or Nursing Women
The safety of filler use in pregnant or nursing women has not been established.3,5 Many medical professionals believe the hormonal imbalance during such periods and the use of such procedures can cause issues in the blood flow and affect the mother’s health.
Bleeding Abnormalities
These can result from conditions like thrombocytopenia (low platelet count) and anticoagulant (blood thinner medications) use.
Individuals with Active Infections
If you have an active infection near the intended injection site, you should postpone your dermal filler treatment. This is because injecting fillers into or near an infected area could potentially spread the infection or aggravate its symptoms.
People with Specific Allergies or Hypersensitivities
You should avoid dermal fillers if you have a known allergy or hypersensitivity to:
- The filler material itself.
- Lidocaine, which is often mixed with fillers for comfort during injection.
This is particularly important for fillers like Zyderm, Zyplast, Cosmoderm, Cosmoplast, some hyaluronic acid fillers, and Artefill. Always disclose your full allergy history to your practitioner before treatment.
Body Dysmorphic Disorder and Unrealistic Expectations
People with BDD often have a distorted view of their appearance and fixate on perceived flaws that may not be readily noticeable to others. Dermal fillers address physical appearance, but they won’t address the underlying psychological distress associated with BDD. In fact, the temporary nature of fillers can fuel anxiety as the perceived flaws “return.”
Patients with a History of Glabellar Skin Necrosis
If you’ve experienced skin necrosis in the glabellar region (between the eyebrows) after previous injections with Zyplast, you should avoid further filler treatments.
Certain conditions, which were previously thought to be strict no-nos, are now generally considered safe for dermal filler treatments:
- Autoimmune Diseases: Conditions such as dermatomyositis/polymyositis, lupus erythematosus, rheumatoid arthritis, or scleroderma. No causal relationship has been established between these conditions and complications from filler use.
- Immunosuppression: Being immunosuppressed does not generally increase the risk of complications with most fillers. However, it may be a concern with poly-L-lactic acid fillers specifically.
While these conditions are not strict contraindications, always share the details of your medical history with the doctor before proceeding with any cosmetic treatment.
Do Dermal Fillers Have Any Side Effects?
While dermal fillers are usually safe, they can sometimes cause problems. These problems fall into two main groups:6,7
- Non-blood flow related issues (non-ischemic)
- Blood flow related issues (ischemic)
Let’s look at each type in more detail:
| Category | Complication | Description and Treatment |
| Non-ischaemic Complications | Common Immediate Reactions | Redness, swelling, itching, bruising, and hardening at the injection site. Usually, go away within 72 hours. Can be minimized by avoiding blood thinners before treatment. |
| Persistent Reactions | Long-lasting redness, itching, lightened skin color, hardening, lumpiness, uneven contours, bluish discoloration (Tyndall effect), and inflammatory reactions. | |
| Infection and Biofilm Formation | Biofilms can occur days to months after injection and may appear as lump formations or abscesses. They are particularly resistant to antibiotics. Treatment may include antibiotics, an enzyme to break down hyaluronic acid (for HA fillers), and possibly surgical removal. | |
| Nodules and Granulomas | Can occur with various filler types. May need steroid injections directly into the nodule or surgical removal. Each filler type looks different under a microscope. | |
| Hypersensitivity Reactions | Can be immediate (Type I) or delayed (Type IV). Range from local swelling to whole-body reactions. May need antihistamines, steroids, or in severe cases, emergency treatment. | |
| Migration of Filler Material | Filler material can move from the original injection site months to years after treatment. Often requires surgical removal. | |
| Other Complications | Swelling under the eyes after correction, scarring (rare, about 2% with fat transfers), skin discoloration or darkening. | |
| Ischaemic and Visual Complications | Vascular Occlusion | Most severe early complication. Can lead to tissue death or vision loss. Happens in about 3 per 1000 injections (slightly less for HA). High-risk areas include between the eyebrows, nasal area, lips, lines from the nose to mouth, and temples. |
| Skin Necrosis | Signs include whitening, pain, mottling, blister formation, and bluish discoloration. Needs immediate treatment to prevent permanent damage. May need skin grafts or local flaps if severe. | |
| Visual Complications | Can include vision loss, reduced eye movement, drooping eyelids, or even stroke. Most cases of blindness are caused by fat and HA injections. High-risk areas include between the eyebrows, forehead, nasal region, lines from the nose to mouth, and temples. |
Conclusion
Dermal fillers are significantly popular among those seeking a youthful appearance without surgery. They offer quick results with minimal downtime, restore volume, and smoothen wrinkles in a natural-looking way. Many people appreciate the long-lasting effects and the boost in skin hydration that fillers can provide.
However, it’s important to remember that fillers are just one part of a comprehensive anti-aging approach. Combining them with other treatments like Botox, chemical peels, or laser therapy can often yield the best results. Every face is unique, so what works for one person might not be ideal for another.
That’s why it’s important to consult with a skincare professional before starting any treatment. They can offer a tailored plan addressing your concerns and goals.
Dermal fillers provide an excellent option for non-invasive facial rejuvenation. When used effectively, they can help you achieve a refreshed, natural appearance that boosts your confidence.
References
- Al-Ghanim, K., Richards, R., & Cohen, S. (2023). A practical guide to selecting facial fillers. Journal of Cosmetic Dermatology, 22(12), 3232-3236. https://doi.org/10.1111/jocd.15867
- Guo J, Fang W, Wang F. Injectable fillers: current status, physicochemical properties, function mechanism, and perspectives. RSC Adv. 2023 Aug 10;13(34):23841-23858. doi: 10.1039/d3ra04321e. PMID: 37577103; PMCID: PMC10413051.
- Small R. A Practical Guide to Dermal Filler Procedures. Hoang D, ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012.
- Sánchez-Carpintero I, Candelas D, Ruiz-Rodríguez R. Materiales de relleno: tipos, indicaciones y complicaciones [Dermal fillers: types, indications, and complications]. Actas Dermosifiliogr. 2010 Jun;101(5):381-93. Spanish. doi: 10.1016/s1578-2190(10)70660-0. PMID: 20525480.
- Trivedi MK, Kroumpouzos G, Murase JE. A review of the safety of cosmetic procedures during pregnancy and lactation. Int J Womens Dermatol. 2017 Feb 27;3(1):6-10. doi: 10.1016/j.ijwd.2017.01.005. PMID: 28492048; PMCID: PMC5418954.
- Witmanowski H, Błochowiak K. Another face of dermal fillers. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2020;37(5):651-659. doi:10.5114/ada.2019.82859.
- Vedamurthy M. Standard guidelines for the use of dermal fillers. Indian J Dermatol Venereol Leprol 2008;74:23-27
