Dermal Filler Selection

Dermal fillers are medical prescription products used to treat volume loss, fine lines, wrinkles, and repair facial imperfections, eg hollow cheeks or scars. 

If you are interested in dermal fillers as a treatment option, it's important to first understand the different types of dermal fillers, how treatment is administered, and the possible side effects.

We would like to share 2 most important tips on filler selection.  

What are the qualities of a good/safe dermal filler?

    • Proven Safety Record
    • Reversible If Problematic
    • Visible Result
    • Reasonable Longevity

An ideal filer would be one that has 

Proven safety record

    You would like your filler from a reputable company which produce their product with the highest quality. The product must have undergone vigorous studies to ensure its effectiveness, safety and stability. The manufacturer should have the strictest production standards to ensure that their product has consistent, reproducible results and importantly, the defect rate or the rate of the results its product gives deviating from the expected is close to zero. The product has to stand the test of time. It has to show that the product does not cause problems after administration today, and in days to come if used within the prescribed way. 
    These products may not come cheap but you know that these products share a common idea with you - no compromise in terms of quality when it come to your health.  
    You don’t want to be the first person to use a certain product and end up being scared.

Reversible If Problematic

There is no one in this world who can promise you that the injection material and the injection technique will be the perfect one every time you undergo any procedure. You would like to know that when somethings goes wrong, your doctor would be happy to assist you with the correction without having to go through the knife.

  Permanent lip filler

Patient : Doc, i don’t like my lips, it’s getting bigger over time.
Doctor : Oh dear, you are the one in a million to have this reaction. I will schedule you for a lips filler removal operation. The cost is USD 20000, a discounted price.
Patient  : Why is the correction so much more expensive then the filler, you charged me USD 2000 2 years back?
Doctor  : ... ...

Many people fall trap into being prey of permanent / semi permanent filler. The injector may sell you the idea that permanent filler lasts longer and hence you do not need to undergo repeated injections. The fact is, human ages with time. No matter how permanent a filler is, volume loss is ongoing and there will be constant need for further volume replacement. Even after permanent filler injection, one would still require future volume touch up from time to time. So with and without permanent filler injections, one would still require the top up treatment. The apparent saving is not there.  

But what you were not told was the fact that once the permanent filler is injected into your body, your body will not have any mechanism to dissolve it. The permanent filler ended up staying in the body for the rest of one’s life. To remove it, one will have to seek the help of a plastic surgeon to remove it surgically. The process of filler removal is a tedious job and even in the best hands, the fillers may not be completely removed in toto. 

The other risk is, permanent filler is being recognized as foreign body and in some patients, it attracts inflammation. Chronic inflammation forms granulation tissues or scar tissue which increases the actual “volume” of the fillers over time. One may find the areas treated with permanent filler growing over time and the 
treated area may disfigure.  To rectify this problem, surgery, will be required. 

Visible result 
Filler is a substance that is introduced by means of injection into the face to corect signs of aging. There are many ways to classify fillers. Time and again, I have emphasized the benefit of non permenanr filler over its permenant counterpart. I would like to introduce a new classification ie volumetric filler vs stimulatory filler.

Almost all registered fillers in the Malaysian market will have volumetric filling effect. Which means that immediately after the injection, our body will react towards the filler and create a volume effect to the targeted area, giving the treatment area a fuller contour, more supple skin. The more void to fill, the more volume is required.

Some of the commonest fillers are HyaluronicAcid Filler and Calcium Hydroxyapatite

On the other hand, new discovery allows us to manipulate the fillers in such a way that they create a stimulative effect. Which means the filler encourages generation of new collagen while improves blood supply to the skin, giving the skin a its glow. Unlike volumetric filler, the effect is not immediate. What more is that the treatment has to be done in a series of injections. This is because different people react differently to the treatment. The same treatment may cause overstimulation in one but under stimulation in another. That's why this treatment needs to be meticulously tailored to individual skin response in order to get the optimal results. After the treatment, patients do experience improvement in the skin texture and there is a gradual lifting effect, improving the sagging of the skin.

Most stimulatory fillers are semi permanent/permanent filler.

The commonest filler in this group being Poly-L-Lactic Acid.

As an advocate of biodegradable filler, I tended to do things differently. Imagine getting yourself injected with something that stay forever and getting it done under multiple sessions. I would still stick to non permanent/biodegradable filler. The longevity is reasonable, lasting 9 months to a year. More importantly, it is safe and degradable. Patient still enjoys good looks and has the ability to adjust his/her facial contour according to his/her age.In contrast if permanent filler is being injected into the face, we will have difficulty in adjusting the treated face end up having to go for surgical removal of the permanent fillers.

Small tips on filler injection. 
Do ask for reputable doctor to do the injection. And do keep a record of the filler injected to your face. It’s consider as a part of your medical record and you have to know it.

As the closing of the chapter in Dermafiller sellection. Many have fallen trap thinking and I do not want you to be part of it.


by Anna Hoo