Facial fillers: What to consider before getting your first filler


By Wei Yeen Loh

Facial fillers: What to consider before getting your first filler

Looking to score a more lifted and youthful appearance? Or perhaps 3D cheekbones for the ‘Gram (real-life FaceTune, if you will)? If anti-ageing and lifting skincare isn’t quite cutting it for you—or you’re just too impatient to wait for long-term results—dermal fillers may be your answer.

Ahead, we address every question you have regarding dermal fillers, from the most common myths (duck lips are reversible, just FYI) to the differences between fillers, threads and Botox. Dr Lee Kim Siea, board certified plastic and reconstructive surgeon and the founder of M Clinic, weighs in on everything you need to know below:

What are dermal fillers?

Typically in gel-like form, dermal fillers are injected beneath the skin’s surface to add volume and fullness. There are temporary, semi-permanent and permanent fillers available in the market today, each containing different substances and to treat a range of cosmetic issues.

“The most commonly used is hyaluronic acid (HA) fillers that can improve the skin’s contour and plump up or restore volume. As we age, our body loses naturally-generated HA and collagen, which contributes to the formation of fine lines and wrinkles on the face. HA fillers can replenish lost HA and restore lost volume to suppress or reverse the signs of ageing. Certain HA fillers have formulation especially for the skin and can also improve the skin texture by plumping it up,” says Dr Lee.

What can you use fillers for?

Dermal fillers are designed to treat a variety of concerns, depending on the type of filler selected, such as:

  • Plump up thinning lips
  • Fill in or smoothen out static wrinkles, which are formed as a result of collagen loss and ageing
  • Minimise the appearance of fine lines, improve elasticity and hydration
  • Fill in or minimise the appearance of recessed scars
  • Enhance or plump up shallow areas on the face
  • Restore or create facial volume i.e. Juvederm’s Volux filler is known to sculpt and create definition for the chin and jawline area

Fun fact: thanks to advanced techniques in facial aesthetics, doctors are now able to change a person’s emotional expression, including negative expressions such as tired, sad, angry and tense expressions and even sagging.

“Filler injections can transform a person’s look into a younger, fresher, slimmer and prettier or more handsome version of themselves,” says Dr Lee. “In these kinds of cases, we are looking at an overall treatment and no longer looking at filling individual areas to achieve the desired positive outcome. As we advance, we also know that certain parts of the face can act as ageing trigger points; and so by treating these specific points, we can effectively slow down the ageing process. All these more advanced techniques will require a higher-level skill set from the injectors who have to be trained medical doctors.”

The difference between fillers and Botox

The key difference between dermal fillers and neurotoxins (like Botox) is that the latter works by ‘freezing’ specific muscles to reduce the formation of wrinkles, while dermal fillers fill out wrinkles to smoothen the skin.

According to Dr Lee, hyaluronic acid (HA) fillers like Juvederm® are popular because it doesn’t just restore volume and minimise fine lines, it also adds moisture to give the skin a plump, hydrated look.

In case you were wondering if you can opt for both Botox and fillers in a single treatment, the answer is: yes. “Botox might be used to correct deep furrows between the eyes while a filler may be used to fill the fine lines around the mouth,” says Dr Lee.

Dermal fillers, Botox or thread lifts?

Fillers are used for when the face requires volume replacement to achieve the desired results.

Botox is used mainly for wrinkle treatment especially the dynamic lines, or it can be used for facial reshaping and skin rejuvenation.

Threads are mainly used for lifting. Often times, all three are used in combination to achieve the best outcome.

Dermal fillers or implants?

“Unlike dermal fillers, implants are made of silicon or other safe materials that are inserted underneath the skin; these can last for a lifetime. Both fillers and implants can make your appearance fuller, plumper and more youthful, and both procedures are safe when performed by an expert,” says Dr Lee.

The choice of fillers or implants is dependent on the specific concerns or areas of the face that need to be treated and the patient’s preference. Dermal fillers may be more suited to individuals who:

  • Do not want to/unable to undergo surgery
  • Do not want a permanent implant in their face
  • Do not want a foreign substance inserted into their face (for religious reasons)
  • Are unsure if they will be happy with the outcome of the treatment/surgery
  • Cannot afford a long recovery time or downtime
  • Have a limited budget

Currently, there are dermal fillers in the market that can yield similar results as facial implants, such as Juvederm Volux which is used to create a more defined chin and jawline in patients.

Pain factor and downtime

If the question of pain is niggling in the back of your mind, worry not. According to Dr Lee, those with a lower pain threshold can request for the doctor to apply a local anaesthetic cream to numb the specific area before the procedure.

Also, some fillers like Juvederm Volux contain a small quantity of lidocaine (local anaesthetic) to reduce pain.

Recovery wise, filler injections typically have very minimal down time. “As with all injections, there is a small risk of bruising and some patients experience redness, swelling and some discomfort or pain. These side effects are usually temporary and resolve on its own. Some patients do not experience any bruising at all and can resume their normal routine after the injections,” says Dr Lee.


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Common myths about fillers

Myth 1: Fillers can make you look ‘overdone’

Want a Kylie Jenner pout but afraid that you may get duck lips instead? You may be worried for nothing! When expertly injected, a good filler should look natural. Most physicians today follow the ‘less is more’ mantra to achieve gradual and subtle-looking results.

“Overfilled ‘pillowy’ faces, trout pouts and duck lips are not the norm anymore, and this is partly because dermal fillers and filler techniques have gotten better and more sophisticated,” says Dr Lee.

Myth 2: Filler bumps and lumps are irreversible and dangerous

Filler lumps are a result of improper placement of fillers—yet another reason why choosing an expert physician is extremely important. Bumps can occur in some individuals who are more prone to swelling or bruising, and who might experience raised bumps at the injection sites. But fret not—this is usually temporary and should subside within a day or two. Dr Lee advises to consult with your physician if you notice that the bumps have not subsided after a week.

Lumps and bumps that result from the wrong placement of filler can also be dissolved with hyalase, an enzyme specifically made for HA fillers.

Myth 3: Fillers are permanent

The most common fillers now are temporary fillers, which are HA fillers like Juvederm.

The effects of temporary fillers last anywhere between six months to more than a year, depending on the type of HA filler injected. But the real reason temporary fillers are popular is because it allows individuals to test out how the filler affects the body before deciding on injecting it more often or permanently.

“You also have the option to discontinue the treatment if you don’t like the results. HA fillers in particular can also be dissolved with an enzyme making it a safer option,” says Dr Lee.

Semi-permanent fillers take longer for the body to break down and absorb. Typically used in the treatment of deeper laugh lines, marionette lines, wrinkles and crows’ feet, the results last for about 12 to 18 months.

Permanent dermal fillers on the other hand, aren’t easily decomposable, and they’re usually injected into parts of the body that consist of thick skin like the nasolabial folds (also known as “smile lines” or “laugh lines”). “It lasts up to five years or more in the body, and its usage is limited. A qualified and experienced physician should be able to advice patients on the different types of fillers available and the most suitable one for their specific needs,” says Dr Lee.

Myth 4: Fillers are only for older people to prevent the physical signs of ageing

This is not entirely true, according to Dr Lee. While most people in their 40s consider getting fillers when their faces start to show signs of ageing, Botox and dermal fillers are increasingly popular with women in their 20s and 30s now, as reported by the American Society for Aesthetic Plastic Surgery.

“This is a trend that will likely continue,” Dr Lee says. “The latest injectable treatments are safe, relatively affordable, have minimal to no downtime or side-effects, and are designed for subtlety—reasons why it is increasingly popular with younger women and men as well.”

How much filler is ‘too much’?

Dr Lee says: “It depends on where the injector placed the filler. 0.1 cc may be too much in a wrong place, while 10 cc (if placed in an appropriate area) could make a person look younger, prettier, and happier. In this respect, well-trained and experienced injectors can make a world of difference.”

Dos and don’ts after getting dermal fillers

While this may vary depending on the type of filler used, normal daily activities can be resumed after treatment. Note that you should avoid facial massages, saunas and excessive sun exposure for 48 hours post-treatment. Water sports such as swimming and diving should also be avoided to reduce the risk of infection at the injection sites.

Check out more skincare stories here.

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