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Dermall fillers uncovered, your skin is constantly under attack, why do we get wrinkles?

Dermall fillers uncovered, your skin is constantly under attack, why do we get wrinkles?

2011, DesireView PDF

RestylaneSculptraPerlane filler

These internal and external attacks combine to weaken your skin’s structure and appearance at the level of the dermis; the deeper living layer of the skin. When vital components of the dermis such as collagen fibres, elastin and hyaluronic acid become less abundant, the dermis is weakened, causing a noticeable impact on the appearance of the skin.

Fillers and volumisers are injected at variable depths in the dermis and help to replenish all these vital components. Their mode of action varies as well as the duration of their effect on the skin.

Hyaluronic Acids for hydration and volume

Hyaluronic Acids are sugars that naturally occur in the skin and appear to bind water in the spaces between skin cells forming a gel-like substance to hold these cells together. Most dermal fillers on the market today are synthetically produced, hyaluronic acid based, non-animal products which mimic this action and plump the skin making the skin smoother by ironing out wrinkles and lines. Some brands are more familiar than others but there is no ‘right or wrong’ dermal filler and you will find that every doctor has his or her own favourites. Some are classed as short acting with an effect that lasts up to 6 months and others long lasting which produce a desired effect for a year or so.

What is the procedure?

After a personalised consultation and diagnosis, your practitioner will propose the most suitable treatment for you, depending on the types and severity of wrinkles to be treated.

The treatment itself takes about 30 minutes and involves injecting the filler into the dermis with a very fine needle, typically only a few millimetres beneath the surface of the skin. The process is almost painless although an anaesthetic may sometimes be used for increased comfort. Occasionally the two sides of the face are not symmetrical and a repeat visit in two weeks may be necessary to correct any remaining asymmetry. In the hours following injection, small red marks or swelling may appear temporarily. The beneficial results are visible immediately and last around 6 to 9 months as the product is absorbed naturally over time. To maintain the benefits simply pop into your practitioner about once or twice a year and pamper yourself with a repeat treatment.

What are the side effects?

Hyaluronic Acids are suitable for all skin types and they very rarely cause severe side effects – most of the problems associated with them are caused by inexperienced practitioners. As with any cosmetic intervention you must thoroughly investigate your chosen doctor, ask to speak to previous clients to put your mind at rest. The most common problems are swelling, redness, bruising and small lumps which can often be dispelled by gentle massage.

Excessive use may lead to unnatural results often seen with lip enhancement- the trout pout effect!

Some well established products include:


Restylane is a hyaluronic acid gel which closely resembles the body’s own hyaluronic acid. It restores the skin’s volume, creating softness and fullness. Treatment usually fits in well with busy lifestyles, with minimal downtime and gives results that can be seen instantly. Ideal for fine lines around the mouth, which can be especially noticeable in smokers.


Softline is ideal for lip augmentation or lip definition. When injected into the lips it replenishes natural hyaluronic acid and hydrates by imprisoning the water molecules and giving back volume and initial form. In this way the lip border is instantly lifted and increased, so helping to preserve and restore a youthful and attractive look.


Perlane is a thicker and longer lasting hyaluronic acid and is ideal for filling the nose to mouth lines and folds. It is also very efficient for the corners of the mouth, providing support and lifting. Treatment starts from £350.00.

Sculptra for sculpting and lifting

Sculptra is intended for patients who want to restore the contours of their face or compensate for gradual signs of ageing, such as loose, wrinkled skin and jowls. It is particularly effective for thin, tired faces with sunken eyes and cheeks to repair contour defects in the face. Poly-L-lactic acid, the main ingredient of Sculptra, has been used successfully in surgical procedures for bioresorbable sutures for more than 25 years. Sculptra requires two or three treatments and takes time to work; results should be noticeable after approximately 6 weeks and are long lasting - two to three years. Sculptra is also extremely effective in plumping up other areas such as the hands for example. Treatment starts from £450.00.

Radiesse for support and contour

Radiesse® is a safe, longer lasting cosmetic dermal filler used to correct deeper facial folds. The results are immediate and typically last a year or more. Radiesse is made of unique calcium-based microspheres suspended in a water-based gel carrier. As the product is injected, the gel and microspheres form a "scaffold", stimulating collagen production and encouraging tissue growth in and around the injection area. Over time, your body absorbs the gel carrier while collagen starts to grow infiltrating the area and ultimately replaces the gel with your own natural tissue. It offers a great option for enhancing a weak chin or cheeks and correcting imperfections of the nose. Treatment starts from £450.00.

Permanent fillers: the controversy

Permanent injectable fillers have been used for many years for deep folds, acne scars and facial depressions. There is some uncertainty regarding the long-term effects of such fillers, such as significant hardness around the injected substance making removal extremely difficult without producing noticeable scarring. Some products have been shown to move in time and others form lumps, unfortunately overcorrection cannot be rectified easily and will remain.


Artefill consists of natural atelocollagen and coated polymethylmetacrylate (PMMA) microbeads and is used for the long term correction of lines and wrinkles. Over time connective tissue forms which makes wrinkles disappear but the tissue needs time to develop, so full results aren't seen for a few weeks. It often requires two treatments before the desired effect is achieved. PMMA was approved last year in the USA for nasolabial fold correction and is available in Europe as Aphrodite Gold. Treatment starts from £450.00.

Any new fillers?


For a long time now animal based collagen has taken a back seat behind the synthetic hyaluronic acids but is now enjoying a resurgence in the UK's aesthetic industry, which is great news as it is an extremely effective filler. Evolence contains unique Glymatrix™ technology which effectively mimics the action of the body's own collagen – providing the strength and elasticity found in young skin yet breaking down slowly and naturally over time leaving no harmful residue. The result is a collagen substantial enough to fill even deep facial contours instantly but with a low viscosity making it easy to inject. Treatment starts from £450.00.

New uses for dermal filler

Tear trough correction

Hollow and dark circles under the eyes can make you look exhausted all the time and are caused by lack of "padding" under the eyes. Injection of hyaluronic acid to the "tear trough" area adds substance between the upper layer of skin and underlying tissues reducing the dark appearance. This is a simple concept but in the right hands can produce dramatic and pleasing results.

Feet pillows Often associated with "Park Avenue Princesses" that love high heels this great application for Sculptra is catching up in the UK. The process involves injections to cushion tired and aching feet; the Sculptra increases the amount of soft tissue in the injected area. Local anaesthetic makes sure it's painless!