What is dermal filler? Hyaluronic acid explained

Dermal filler is a soft, injectable gel used to add volume, shape or support to areas of the face. It's often confused with anti-wrinkle injections, but the two work in completely different ways. Anti-wrinkle injections relax muscles. Filler sits beneath the skin and physically fills or lifts.

Most dermal fillers used today are made from hyaluronic acid. Here's what that means.

Hyaluronic acid in plain English

Hyaluronic acid (often shortened to HA) is a sugar molecule that occurs naturally in the body. It's found in your skin, joints and eyes. Its main job is to hold water. A single molecule can attract a large amount of moisture, which helps keep skin plump and hydrated.

As we get older the body makes less of it. Combined with changes in collagen, fat and bone, this is part of why the face can lose volume over time.

How filler works

The hyaluronic acid in filler is made in a lab rather than taken from animals. It's "cross-linked", which means the molecules are bonded together to form a gel. This makes it last much longer than the natural HA in your skin, which the body breaks down within days.

Different fillers have different thicknesses. Softer gels suit delicate areas such as the lips. Firmer gels are used where more lift and structure are needed, such as the cheeks or chin.

Areas it can treat

• Lips, to add shape, definition or volume
• Cheeks, to restore lost volume or add contour
• Chin, to improve projection and balance
• Profile balancing, where lips and chin are treated together for overall harmony

How long it lasts

Hyaluronic acid filler is not permanent. The body gradually breaks it down. As a rough guide it lasts around six to eighteen months, depending on the product, the area treated and your own metabolism. Lips often break down faster than cheeks because they move so much.

It can be dissolved

One of the big advantages of HA filler is that it can usually be dissolved if needed. An enzyme called hyaluronidase breaks down the gel. This is a prescription medicine and should only be used by a suitably trained practitioner. It's an important safety option, especially in an emergency.

Possible side effects

Most side effects are mild and temporary. They include swelling, bruising, tenderness and redness. Small lumps can sometimes be felt in the first couple of weeks and often settle.

Rarely, filler can block a blood vessel. This is serious and needs treating straight away. Signs include severe pain and skin that turns pale, blotchy or dusky in colour. This is why it matters to choose a fully qualified and insured practitioner who knows facial anatomy well and can act quickly if needed.

Who can have it

In England it's illegal to give dermal filler for cosmetic reasons to anyone under 18. Filler isn't recommended during pregnancy or breastfeeding. It may not be suitable if you have certain medical conditions or an active skin infection in the area.

If you're wondering whether filler could help with a particular concern, Lucy is happy to talk it through at a free 15-minute consultation in Addlestone.