Dermal fillers have revolutionised aesthetic medicine, offering instant volume restoration and facial rejuvenation without surgery. With over 2.5 million filler treatments performed annually in the UK, understanding the different types, applications, and safety considerations is crucial for anyone considering this treatment.
This comprehensive guide explores everything from the science behind different filler types to choosing the right treatment for your concerns. Whether you're researching your first treatment or looking to expand your knowledge, this evidence-based guide provides the insights you need to make informed decisions.
Quick Facts
Treatment Time: 15-60 minutes
Results Visible: Immediately
Duration: 6-24 months (varies by type)
Downtime: 0-7 days
What Are Dermal Fillers?
Dermal fillers are injectable gel-like substances designed to restore volume, smooth wrinkles, and enhance facial contours. Unlike Botox, which relaxes muscles, fillers physically add volume beneath the skin's surface, addressing static wrinkles and volume loss.
How Dermal Fillers Work
Fillers work through different mechanisms depending on their composition:
Immediate volume: Most fillers provide instant results by physically occupying space
Water attraction: Hyaluronic acid fillers draw water to enhance volume
Collagen stimulation: Some fillers trigger your body's natural collagen production
Tissue integration: Certain fillers integrate with your tissues for natural movement
Key Benefits of Dermal Fillers
Immediate Results
See improvements instantly after treatment
Reversible Options
HA fillers can be dissolved if needed
Natural-Looking
Modern techniques achieve subtle enhancement
Minimal Downtime
Most people return to normal activities same day
Types of Dermal Fillers
Understanding different filler types helps you make informed treatment decisions. Each type has unique properties, making it suitable for specific concerns and areas.
Hyaluronic Acid (HA) Fillers
The most popular and versatile filler type, HA is a naturally occurring substance in your body that attracts and binds water.
Hyaluronic Acid Fillers
Popular Brands:
- • Juvederm (Ultra, Voluma, Volbella, Volift)
- • Restylane (Classic, Lyft, Kysse, Defyne)
- • Teosyal (RHA collection)
- • Belotero (Balance, Volume, Lips)
Key Properties:
- • Duration: 6-18 months
- • Reversible with hyaluronidase
- • Different consistencies for various areas
- • Immediate results
Best for: Lips, nasolabial folds, marionette lines, cheeks, under-eyes, and overall facial contouring
Calcium Hydroxylapatite (CaHA)
A mineral-like compound found naturally in bones, CaHA provides immediate volume and stimulates collagen production.
Calcium Hydroxylapatite
Brand:
- • Radiesse
- • Radiesse+ (with lidocaine)
Key Properties:
- • Duration: 12-18 months
- • Thicker consistency
- • Stimulates collagen production
- • Not reversible
Best for: Deep wrinkles, facial contouring, jawline definition, hand rejuvenation
Poly-L-Lactic Acid (PLLA)
A biocompatible synthetic substance that works as a collagen stimulator rather than a traditional filler.
Poly-L-Lactic Acid
Brand:
- • Sculptra Aesthetic
Key Properties:
- • Duration: Up to 2 years
- • Gradual results over months
- • Requires multiple sessions
- • Stimulates natural collagen
Best for: Overall facial volume restoration, temple hollowing, cheek augmentation
Other Filler Types
Specialised Fillers
Polymethyl Methacrylate (PMMA) - Bellafill
Semi-permanent option lasting 5+ years. Contains collagen and PMMA microspheres. Requires allergy testing.
Polycaprolactone (PCL) - Ellansé
Biostimulator lasting 1-4 years. Immediate volume plus long-term collagen stimulation.
Autologous Fat Transfer
Uses your own fat cells. Permanent results where fat survives. Requires liposuction procedure.
Comprehensive Filler Comparison
This detailed comparison helps you understand the differences between major filler types:
| Type | Duration | Reversible | Best Areas | Cost Range | Key Benefit |
|---|---|---|---|---|---|
| Hyaluronic Acid | 6-18 months | All areas | £200-600/ml | Versatile & reversible | |
| CaHA (Radiesse) | 12-18 months | Deep wrinkles, jawline | £300-500/ml | Lifting effect | |
| PLLA (Sculptra) | Up to 2 years | Full face volume | £350-450/vial | Natural collagen | |
| PMMA (Bellafill) | 5+ years | Deep wrinkles, scars | £800-1200/ml | Long-lasting | |
| Fat Transfer | Permanent* | Large volume areas | £2000-5000 | Natural & permanent |
*Fat transfer: 30-60% of transferred fat typically survives permanently
Common Treatment Areas
Dermal fillers can enhance various facial areas, each requiring specific techniques and filler types for optimal results.
Upper Face Treatments
Forehead
Under-Eye (Tear Trough)
Mid-Face Treatments
Cheeks
Nasolabial Folds
Lower Face Treatments
Lips
Chin & Jawline
Marionette Lines
The Treatment Process: What to Expect
Understanding the treatment journey helps ensure optimal results and a positive experience.
Initial Consultation
Consultation Checklist
Treatment Day
Treatment Timeline
Injection Techniques
Modern injection techniques prioritise safety, comfort, and natural results:
Cannula technique: Blunt-tip cannula reduces bruising and vessel damage
Serial puncture: Multiple small injections for precise placement
Linear threading: Continuous injection while withdrawing needle
Cross-hatching: Layered approach for even distribution
Bolus injection: Deep placement for structural support
Results Timeline and Longevity
Understanding when to expect results and how long they last helps with treatment planning and managing expectations.
Immediate vs. Final Results
Results Timeline
Immediate
Visible volume improvement, some swelling present
Initial Settling
Swelling peaks then begins to subside
Integration
Product integrates with tissues, natural feel develops
Final Results
Optimal results visible, time for touch-ups if needed
Factors Affecting Longevity
Several factors influence how long your results last:
Product Factors
- • Filler type and brand
- • Cross-linking density
- • Particle size
- • Injection depth
Individual Factors
- • Metabolism rate
- • Treatment area movement
- • Lifestyle (exercise, sun exposure)
- • Skin quality and age
Safety Considerations and Risks
While dermal fillers are generally safe when administered by qualified practitioners, understanding potential risks ensures informed consent.
Common Side Effects
Swelling and Bruising
Management: Ice, arnica, avoid blood thinners pre-treatment
Duration: 3-7 days
Tenderness
Management: Over-the-counter pain relief if needed
Duration: 2-5 days
Lumps or Bumps
Management: Massage, may need dissolving if persistent
Duration: Usually resolve within 2 weeks
Serious but Rare Complications
Vascular Occlusion
Management: Immediate hyaluronidase, medical attention
Duration: Emergency - requires immediate treatment
Infection
Management: Antibiotics, possible drainage
Duration: Requires medical treatment
Allergic Reaction
Management: Antihistamines, steroids, emergency care if severe
Duration: Immediate medical attention needed
Warning Signs - Seek Immediate Help
- • Severe pain or skin colour changes
- • Vision changes or severe headache
- • Signs of infection (fever, spreading redness)
- • Difficulty breathing or swallowing
- • Any concerning symptoms
Essential Aftercare Guidelines
Proper aftercare maximises results and minimises complications. Follow these evidence-based guidelines:
First 24 Hours
DO:
- ✓ Apply ice wrapped in cloth for 10 mins at a time
- ✓ Sleep with head elevated
- ✓ Stay hydrated (2-3 litres water)
- ✓ Gentle cleansing only
- ✓ Take arnica if recommended
DON'T:
- ✗ Exercise vigorously
- ✗ Consume alcohol
- ✗ Apply makeup for 12 hours
- ✗ Massage unless instructed
- ✗ Expose to extreme temperatures
First Week Care
Days 1-3: Continue ice for swelling, avoid dental work
Days 3-7: Gentle facial massage if instructed, normal skincare routine
Week 1: Avoid facials, laser treatments, or other procedures
Week 2: Return for review appointment if scheduled
Cost Guide and Considerations
Understanding treatment costs helps with budgeting and avoiding suspiciously cheap offers that may compromise safety.
Factors Affecting Price
Treatment Factors
- • Type and brand of filler
- • Number of syringes needed
- • Treatment complexity
- • Combination treatments
Provider Factors
- • Practitioner experience
- • Clinic location
- • Included services (reviews, touch-ups)
- • Quality of products used
Typical UK Treatment Costs
Average Cost by Area
*Prices vary by location and practitioner. Multiple syringes often have package discounts.
Cost Warning
Be cautious of prices significantly below market rate. Cheap fillers may indicate:
- • Counterfeit or diluted products
- • Unqualified practitioners
- • Unsafe treatment environments
- • Hidden additional costs
Choosing the Right Practitioner
Your choice of practitioner is the most important factor in achieving safe, beautiful results.
Essential Qualifications
Practitioner Checklist
Medical qualification (Doctor, Dentist, Nurse, or Pharmacist)
Aesthetic training certification (Level 7 preferred)
Registration with professional body (JCCP, ACE, etc.)
Evidence of ongoing training and CPD
Clear complications management protocol
Red Flags to Avoid
Practice Red Flags
- • No consultation offered
- • Pressure to treat same day
- • No cooling-off period
- • Won't show qualifications
- • Home or hotel treatments
Product Red Flags
- • Won't name product brands
- • No product packaging shown
- • Unusually cheap prices
- • "Special formula" claims
- • Bulk buying pressure
Frequently Asked Questions
How do I know which filler type is right for me?
The best filler depends on your treatment area, desired results, and individual factors. HA fillers are versatile and reversible, making them ideal for first-timers. Your practitioner will recommend specific products based on your consultation. Factors include the area's movement, desired longevity, and your comfort with non-reversible options.
Are dermal fillers painful?
Most patients report mild discomfort rather than pain. Modern fillers contain lidocaine for comfort, and practitioners use numbing cream and ice. Lip injections tend to be more sensitive than other areas. Pain tolerance varies, but most find the procedure very manageable with proper numbing techniques.
Can fillers look natural?
Absolutely. Natural results depend on three factors: choosing an experienced practitioner, using appropriate products, and avoiding overfilling. Modern techniques focus on facial harmony rather than just filling lines. Starting conservatively and building gradually ensures natural-looking enhancement.
What's the difference between Botox and fillers?
Botox relaxes muscles to prevent dynamic wrinkles (lines from movement), while fillers add volume to treat static wrinkles and restore facial contours. They work differently and are often used together for comprehensive facial rejuvenation. Botox is ideal for forehead lines and crow's feet, while fillers address volume loss and deep folds.
How often will I need treatments?
This varies by filler type and individual factors. HA fillers typically need refreshing every 6-18 months, while stimulatory fillers like Sculptra can last up to 2 years. High-movement areas like lips may need more frequent treatment. Many patients find they need less product over time as some collagen stimulation occurs.
Can fillers be removed if I don't like them?
HA fillers can be dissolved with hyaluronidase enzyme, usually showing results within 24-48 hours. This makes them ideal for those worried about results. Other filler types (Radiesse, Sculptra, Bellafill) cannot be easily removed and must be allowed to break down naturally. Always discuss reversibility during consultation.
What age should I start getting fillers?
There's no "right" age - it depends on individual concerns and genetics. Some people benefit from preventative treatments in their late 20s, while others don't need them until their 40s or 50s. Focus on addressing specific concerns rather than age. Common starting points include when you notice persistent lines at rest or facial volume loss.
Making an Informed Decision
Dermal fillers offer remarkable possibilities for facial enhancement and rejuvenation when used appropriately. The key to successful treatment lies in:
Key Takeaways
Choose Quality Over Price
Invest in qualified practitioners and genuine products
Start Conservative
You can always add more, but overfilling is harder to fix
Research Thoroughly
Understand products, techniques, and potential risks
Follow Aftercare
Proper aftercare ensures best results and safety
Plan Long-term
Consider maintenance costs and commitment
Trust Your Instincts
If something feels wrong, don't proceed
Remember, the best results come from a partnership between you and your practitioner. Take time to find someone you trust, communicate openly about your goals, and maintain realistic expectations. With the right approach, dermal fillers can help you look refreshed and confident while maintaining your unique features.
Ready to Explore Your Options?
Connect with qualified aesthetic practitioners in your area. Our platform helps clinics manage treatments safely with digital consent forms, treatment protocols, and comprehensive patient records.
Ready to Transform Your Aesthetic Clinic?
Join 500+ UK aesthetic practitioners who save 15 hours weekly on admin tasks while growing revenue by 40%.