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Injection cosmetology

Dermal Fillers

What are HA Dermal Fillers?

Dermal fillers are injectable gels containing hyaluronic acid or HA. Fillers soften lines, build volume, and restore or enhance facial contours.


The body naturally breaks down hyaluronic acid, so the treatment is temporary and safe.

What Are Dermal Fillers

What is hyaluronic acid?

Hyaluronic acid is a naturally occurring substance that is a significant component of our skin and functions in wound repair, hydration and cell-to-cell communication. One of the main characteristics of hyaluronic acid is that it effectively binds water like a sponge, which is why it is an effective tissue filler.

What is Hyaluronic Acid

What can dermal fillers do?

Improve Facial Contours


Dermal fillers can enhance facial contours, correct facial asymmetry and balance proportions. 

Replace or Build Volume


Fillers can replace volume lost as a result of ageing.

Smooth Lines and folds


Expertly placed dermal fillers can improve facial lines and folds.

What Can Dermal Fillers Do

Common areas injected with dermal fillers

Where we can place fillers can at first seem overwhelming.


The common areas injected with dermal filler are:

  • The lips

  • The tear trough

  • The mid-face

  • The high cheekbone or zygoma

  • The jaw

  • The chin

  • The temples

  • The nasolabial folds (from the nose to the corner of the mouth)

  • The marionettes (a downturned mouth)

  • Around the lips (so-called smoker's lines)

Click if you want to learn more about Lip Fillers or the Tear Trough.

Common areas injected with dermal fillers

How are dermal fillers injected?

Dermal filler injections are injected using either a needle, a cannula or both. Syringes of dermal filler contain a clear gel.


These may have lidocaine [a local anaesthetic drug -] added to them to make the injection more comfortable.


The result is immediate, but it may take some time for any swelling and redness to settle.


Typically, the treatment should last 6 to 18 months, depending on the product used and which part of the body is being treated.

What results should I see with dermal fillers?

The effects can be as subtle or dramatic as required but should always be natural in appearance and proportion.


Treatments can range from the injection of dermal fillers superficially in the skin to smooth out fine lines to a deeper placement to support the overlying skin and enhance contours

How do brands and dermal fillers differ?

Individual brands differ in the properties of the filler, including particle size, concentration and cross-linking. Cross-linking affects the resistance of dermal fillers to breakdown and determines how long the filler will last, their elasticity and their volumising effect. Some fillers, called skin boosters, also contain additional substances (such as amino acids, antioxidants and vitamins) to help revitalise and repair the skin.

What are the brands of filler?

There are many different brands of filler available within the UK. Arguably, there are too many. For example, there are 140 injectable fillers in the UK/European market, and only six are approved for use in the US. Some have better safety profiles than others. We only use fillers whose companies have been approved by the FDA or have a CE kite mark. Although the FDA is an American system, they have been rigorously tested for safety and effectiveness

How do I know I am being given a genuine dermal filler?

Dermal fillers usually come packaged in a box with product labels. They should be opened from sterile packaging in front of you at the beginning of the treatment.


The product label will include the product's name, batch number, and expiry date. This should be documented on your treatment records and given to you on request.

Where do you get your dermal fillers?

Dermal fillers are considered safe when purchased from a reputable pharmacy or supplier and have a CE Kite mark. A CE mark is a symbol to indicate that a product conforms with relevant EU directives regarding product safety. Counterfeit products have been found in general circulation, which carries a much higher risk of adverse events, so it is essential to seek a practitioner who can demonstrate the source of the product from a reputable aesthetic pharmacy.

What are the side effects of dermal fillers?

Side effects are common and can include bruising, swelling, redness, infection and localised reactions to the product.  Dermal fillers can also inhibit blood supply leading to scarring if left untreated.  Treatments on or around the forehead, nose, lips and eyes are considered at the highest risk for this complication.

Frequently Asked Questions

  • Where is the tear trough?
    The tear trough is a groove between the lower eyelid at the inner corner of the eye and the upper cheek. A tear trough deformity (or hollow) is not a deformity but is used to describe the deepening of this groove. This occurs as a typical result of ageing or may be inherited. It is caused by changes in the bone, fat and skin. It is one of the first areas of the face to show signs of ageing
  • How does dermal filler work in the tear trough area?
    As explained, the tear trough is a depression in the skin, which can cause abnormal shadowing and the appearance of dark circles. Dermal fillers work by creating a lifting effect and are injected in small volumes using a needle or cannula. Most dermal fillers are supplied in 1ml syringes; however, injecting more than this in one treatment session is not recommended. If additional correction is needed, this can be performed at a later treatment session which should be discussed during your consultation.
  • Am I suitable for tear trough treatment?
    You may not be suitable for treatment if you: Are pregnant or breastfeeding. Are undergoing IVF. Suffer from keloid scarring Have active skin conditions, such as infection, acne or psoriasis Are suffering from any other infection, including COVID. Are unwell on the day of treatment. Are taking any medicines which thin the blood, such as aspirin or warfarin. Have taken Roaccutane or isotretinoin for the past 6 months. Have certain allergies Have had recent facial surgery or other dermal fillers in the same area. Have permanent implants, such as silicone implants in the face or pins and plates. Tear trough treatment may also not be suitable if: The cause of the problem is predominantly pigmentation and dark circles. If you have prominent eye bags If you are prone to puffiness under the eyes. Your skin is very lax.
  • Can any filler be used to treat the tear trough?
    No. The eye is a sensitive area to treat, and some fillers are highly unsuitable, especially if they attract water. This can make the appearance of the tear trough much worse. You should only have a specific type of hyaluronic acid filler, such as Teosyl Redensity II or Juvederm Volbella. A less water-attracting [hydrophilic ] filler should be used in the tear trough to prevent the risk of creating too much volume and unsightly bulging. One size does not fit all. Another safe alternative is to use liquid platelets or a gel made from your platelets called a bio-filler.
  • How long does tear trough deformity treatment take?
    Treatment of the tear trough area will often take between 30-60 minutes to perform. Following your procedure, the practitioner may massage the area and clean the skin. Some practitioners might apply a cream post-treatment. After the treatment, your practitioner will book a follow-up appointment. You should also receive aftercare information either in paper form or electronically before or after your treatment.
  • Is injecting the tear trough deformity painful?
    This area may be sensitive during the injection. Most dermal fillers contain a local anaesthetic which lessens the discomfort as they are injected. Usually, a topical anaesthetic, such as LMX4 or Emla™, is used to provide additional pain relief. This will be applied to the skin and left on the surface for 20-40 minutes. Also, your injector may be able to offer you a nerve block. Once the anaesthetic has worn off, there may be some expected tenderness. There should not be any significant degree of pain. If you are in much discomfort, you must contact your practitioner as this could indicate that you are developing a complication.
  • How long does tear trough filler last?
    Because the tear trough is not very mobile, it takes your body longer to dissolve the dermal filler naturally. Saying that longevity varies between products and between individuals. Most hyaluronic acid fillers will last between 6 months and 18 months.
  • What side effects should I expect after tear trough deformity correction?
    The common side effects after tear trough treatment are: Pain Minor tenderness or discomfort after your treatment is entirely normal. If you have more pain than expected, you must contact your treating practitioner immediately. Redness This is normal and usually resolves within 24 hours. If the skin becomes red and warm, this may indicate an infection. Again contact your practitioner straight away. Swelling [Oedema] Some swelling is normal after treatment and may worsen the next day. The tear trough is more prone to swelling than other facial areas. If the swelling persists, tell your practitioner. Bruising Bruising is common after tear trough injections. This can be anything from a small skin mark to extensive bruising that extends beyond the tear trough, such as a black eye. This can take up to 2 weeks to resolve. Rarely, bruising can lead to permanent staining of the skin. Infection SIgn s of infection include a warm, red, swollen area over the area that has been injected. This usually happens a few days after your treatment. If this happens, contact your practitioner for a review as soon as possible. Lumps and Bumps Lumps may be present immediately after treatment. This, to some extent, is normal. Bumps can also appear months later due to filler migrating. Lumps may appear as soft swellings or as hard nodules. If you develop a lump, ask your practitioner for a review. Extremely rare side effects are listed for completeness: Vascular Occlusion Occlusion or blockage of a blood vessel is a rare but severe complication from all dermal filler injections. A blockage results in an interruption of normal blood flow. If this is not correctly managed, the skin and tissue supplied by the blood vessel can die, resulting in scarring. It usually occurs immediately, so your injector should know immediately if this has happened. In most cases, this can be treated. Blindness This is another infrequent but devastating complication. If blindness occurs, it is likely to be permanent. Stroke Another extremely rare but documented complication of dermal fillers.
  • What should I do before my tear trough treatment?
    Ensure your practitioner is informed of any changes in your medical history or medication before receiving your injection. For one week before: Avoid sunbeds and tanning For 3 days before: Avoid taking anti-inflammatories (such as aspirin, ibuprofen, and naproxen) Avoid fish oils, St. John’s Wort, Ginkgo Biloba, garlic and Vitamin E If you are prone to bruising, taking arnica orally for a few days before treatment may lessen the risk, but this is not proven. Contact your practitioner before your appointment if: If you are unwell on the day of your appointment, contact the practitioner to reschedule. You have a social event and want to delay your treatment until after (usually, having the treatment two weeks before is sufficient to allow swelling or bruising to disappear). You cannot commit to a two-week review.
  • What is the downtime after?
    This varies depending on a few things; however, generally speaking, within 1 to 2 days, any swelling or redness should have subsided. Within a week, the signs of being injected should have entirely disappeared. Please not if you get a bruise. This can take up to two weeks to fully resolve.
  • What should I do and not do after my tear trough correction? [after-care]
    After treatment, most people can resume their normal daily activities. Some redness, tenderness and swelling at the injection sites are pretty normal. Bruising may be apparent immediately after treatment. The standard advice which is not proven is listed: Do not apply make-up for 12 hours after treatment (reduces the risk of infection). Avoid touching or rubbing the treated area. Until the swelling has settled: Avoid saunas, swimming pools and sunbeds. void extremes of hot or cold and vigorous exercise.
  • Is tear trough filler high risk?
    All treatments carry a degree of risk. All risks and complications should be discussed with you at consultation and before any treatment is agreed upon. Even though there are blood vessels in this area, the risk of a vascular injection is much lower than people or injectors think. Also, the risk of blindness is much lower even if the filler is injected into a vessel.
Frequently Asked Questions Dermal FIlers
Further Informaton About Dermal Fillers
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