Dermal fillers also known as skin fillers or facial/face fillers are one of the best non surgical treatment to add volume, fill up hollowness, contour, or plump up areas of wrinkles and folds which have occurred due to ageing or scarring. Care Well provides the best skin/face/dermal fillers in Delhi (CR Park, South Delhi). All treatments are carried out by an experienced dermatologist.

Dermal Fillers: Introduction

Perhaps nothing is more delightful for aesthetic patients than having an expeditious correction and improvement in their skin, skin elasticity, skin quality, skin conditions, scars, rhytides as an outcome of the injection of a dermal filler.

So! Pondering your thoughts on how dermal fillers work, how are they beneficial how long they last, risks and complications linked to dermal fillers, and when you should use them instead of (or with) Botox? Get the breadth of view on all of that and more...

What are dermal fillers?

Dermal Fillers are a classification of gel substances which are used in facial cosmetics to add volume, fill up hollowness, contour, or plump up areas of wrinkles and folds which have occurred due to ageing or scarring. Dermal fillers are generally based on Hyaluronic Acid (HA) which is naturally present in our skin and joints to hydrate and lubricate. Woefully we produce less and less of this Hyaluronic Acid as we age, which results in lack of volume, dehydration, sagging and deepening of wrinkles and lines. Hyaluronic Acid binds with water, thus increasing hydration.

What dermal fillers can do?

With the increasing age, our face start to naturally lose subcutaneous fat. The facial muscles are then functioning closer to the skin surface, so crow's feet and smile lines become more apparent.

The facial skin also stretches a little, supplementing to this loss of facial volume. Factors that affect the facial skin include excessive sun exposure, pollution, lifestyle, diet and genetic inheritance.

What dermal fillers can do?

  • Diminish facial lines and wrinkles
  • Restore volume and fullness in the face and sunken cheeks
  • Restructure less defined chin
  • Plump thin lips
  • Soften the appearance of facial wrinkles, folds and creases
  • Diminish the appearance of recessed scars
  • Reshaping the nose tip
  • Eliminate or decrease the shadow of the lower lids
  • Rebuild and correct contour irregularities in the face
  • Enhance shallow contours

Dermal fillers can prove to be very useful for those with early signs of aging, or as a part of value-added facial rejuvenation procedure.

Dermal Fillers Cost

The average cost of dermal fillers differs based on certain elements

Cost is always a consideration in elective procedure or treatment. The cost of dermal filler injections may vary based on the qualifications, skills, experience and renounce of the practitioner performing the treatment. The kind of fillers used, type of treatment, the area to be treated, the geographic location of the office, and time and effort the procedure requires also calculates your cost of treatment. However, health insurance plans do not cover dermal injections but some dermatologists or skin centers offer patient with financing plans, so make sure to ask.

Choose a Professional

Despite the fact that tissue augmentation with dermal filler injections is an instant, in-clinic procedure that can lead to a remarkable improvement in restoring facial fullness, desirable facial construction and a more youthful appearance, effective and safe use needs a practitioner to be board certified, qualified with specialized training and must have a thorough know-how of facial anatomy to advice and inject an appropriate filler. As with any medical procedure, minimal complications can occur with dermal fillers too, so being treated by a well trained and expert dermatologist or skin surgeon is crucial for your safety and positive results.

Dermal Fillers Candidates

You may be a perfect candidate for dermal fillers if you:

  • Are physically and mentally healthy and strong
  • Not breast feeding
  • Not pregnant at the time of receiving fillers or is even expecting
  • Not allergic to certain ingredients present in the fillers as it may cause some reactions
  • Do not smoke
  • Have an optimistic outlook and realistic goals in mind for the enhancement of your appearance
  • Are dedicated to keeping good skin health

Dermal Fillers Recovery

Recovery time varies for each type of filler injected as well as for each patient. Patients can resume most tasks right after, but it is generally advised that you keep away from vigorous physical activity for the following 1-2 day to belittle bruising, redness and swelling. Make it a point to discuss your particular recovery plan with your practitioner prior to organizing your injections.

Your initial appearance after any dermal filler treatment may include:

  • A "restocked" look to treated areas
  • Detectable bulges or concreted skin at the injection sites
  • Temporary redness or numbness
  • Bruising or swelling, ranging from mild to severe
  • Hypersensitivity that may appear like an allergic reaction with bumps and hives

Most of these reactions can be attenuated with topical icing and massaging and will diminish or disappear within a matter of hours or just a few days. Some reactive conditions may need more zealous treatment with medications. Be sure to discuss your treatment and recovery plan with your dermatologist or physician.

When your own fat is the injected filler, the healing process is extended and may take up to a few weeks.

Dermal Fillers Results

The outcome of soft tissue augmentation using dermal fillers are visible instantly and will be retained from a couple of months to a few years, depending on the type of filler used and the patient to whom it was injected. Maintaining overall good health and practicing healthy and strong skin care regimen with suitable skin products and treatments will improve the results and duration.

Dermal Fillers Procedure

A complete dermal fillers treatment procedure includes the following steps:

Step 1 – Facial evaluation and mapping

If you choose to use packaged soft tissue fillers, the physician, or his/her specially-trained assistant, will first assess your skin tone and facial appearance and analyze the areas of your face to be treated.

Strategic sections on your face may be pointed as the correct injection sites for the filler. Snaps may be shot of the areas to be augmented.

Step 2 – Cleansing, sanitizing and anesthetizing

The sites of the injection will be thoroughly cleansed with an antibacterial agent.

Pain and uneasiness at the injection site may be alleviated by the use of an intensely cold tool to chill the skin, anesthetic cream to numb the skin or injection of general or local anesthesia.

While not purely painless, the dermal filler injections are generally easily handled.

Step 3 – The injection

Dermal filler injection for soft tissue augmentation generally takes only a few jiffs per site. The process of injecting, massaging, and assessing the outcome is performed, and supplementary filler is added as required.

Depending on the number and size of areas to be treated, the entire procedure may be accomplished in as short as 15 minutes, or as long as 60 minutes.

Step 4 – Clean up and recovery

Once the outcomes are reckoned satisfactory, any markings will be cleared off.

You may be provided an ice pack to alleviate swelling, redness and attenuate discomfort. However the area may feel a little sensitive for 24 - 48 hours, it is generally not intolerably painful to necessitate any medication.

Dermal Fillers Risks and Safety

The mindedness to obtain facial fillers is immensely an idiosyncratic interest. You individually need to draw the inference if the advantages of fillers will help you achieve your aesthetic goals and if the associated risks and complications of dermal fillers are agreeable.

Your dermatologist, surgeon and/or staff will describe, in detail, any risks and complications.

You would also be asked to sign approval forms to confirm that you fully understand the process, as well as the potential complications and risks.

Serious risk factors and complications from dermal fillers are quite rare. Potential risks depend and differs based on the specific filler used, the expertise of the performing doctor and the relative permanence of the filler substance and include:

  • Bleeding or bruising or swelling at the injection site
  • Acne-like skin breakouts
  • Slight skin Damage that may lead to possible scarring and wounds
  • Irregularity
  • Infection at the injection site
  • Formation of Lumps
  • Palpability of the filler beneath the skin surface
  • Skin rashes with itching
  • Reddened Skin
  • Under- or over- fixation of wrinkles
  • Nausea
  • Skin necrosis (ulceration or loss of skin from blood flow disruption)

It is an essential thing on the part of patient to put forth all your questions and apprehensions directly to your dermatologist or surgeon. Although positive outcomes are conjectured from your procedure, there is no assurance that you will be fully pleased with your results. It is indispensable to be under the care of a well trained and a board certified dermatologist or a plastic surgeon who is prepared to deal with any kind of potential risk or complications that may occur, because in some cases noticeable complications can arise from dermal filler injections.

In some situations, it may not be feasible to obtain optimal results within a single procedure. Most fillers do dematerialize over time. To maintain your correction, you will be deemed for repeating the injection process at intervals.

Types of Dermal Fillers

There are different kinds of dermal fillers. The most common types of fillers are:

Hyaluronic acid (HA)

Brand names include: Juvederm, Restylane, Perlane, Puragen, Prevelle, Esthélis, Elevess, Captique, Hylaform

Hyaluronic is a compound which is found naturally in any living organism's body. The HA injections can be used to create and enhance the skin's contour and diminish depressions or deepening of the skin due to scars, wounds, injury or lines. You can realize a significant improvement for:

  • Cheek depressions and hollowness
  • Crow's feet (creases at the corner of your eyes)
  • Acne scars
  • Nasolabial lines or furrows (Deep smile lines that run down from the side of the nose to corners of the mouth)
  • Frown lines (creases in between the eyebrows)
  • Marionette lines at the corners of the mouth
  • Worry lines that run across your forehead
  • Redefining lip border
  • Smoker's lines; vertical lines on the mouth
  • Facial scars
  • Scars including acne, burns, and those caused by wounds

Hyaluronic acid is a natural compound found in your body and its highest concentration is present in the soft connective tissues and in the fluid encompassing your eyes. It is also found in some skin tissue, cartilage as well as in joint fluids. It is derived, refined and reformulated and now has gained the popularity of most favored kinds of injectable fillers. If the term sounds familiar, it is because the same compound is often injected into the aching joints of people with arthritis to relieve off extreme pain and offer extra cushioning.

Calcium Hydroxylapatite

Brand names include: Radiesse

Calcium hydroxylapatite is naturally found in the human bones and is a mineral-like substance. It is most commonly used for:

  • Softening Moderate-to-severe wrinkles such as marionette lines, frown lines and nasolabial folds
  • Fill up volume of the cheeks and figure other facial contours
  • Create fullness in areas of Facial Wasting

Calcium hydroxylapatite is a compound which is biosynthetically produced, that indicates that no animals or animal products are used in its production. This further decreases a patient's risk of getting an allergic reaction and hence no skin testing is needed. This type of dermal filler is known to render very natural looking result, does not drift and barely, there are any side effects. This dermal filler was first used in reconstructive surgery and dentistry and has shown a significant safety record.

Polylactic Acid

Brand names include: Sculptra

Polylactic acid based filler is synthetic skin filler and this type of dermal filler is referred to as a stimulator. It is known as a stimulator because when it is injected into your face, prompts your body's own production of collagen. This biodegradable, non-toxic material has been used for more than 40 years as stitch substance.

Polylactic acid is known to specifically function well in the lower half of your face, and is used to:

  • Soften and Fill the lines caused by laughing
  • Treat deep nasolabial folds
  • Plump thin lips

This material is different from other dermal fillers because it does not produce instant visible results. Conversely, it causes your own body's collagen production, so results are apparent steadily over a course of a few months.

You will plausibly require about 3 monthly sessions to obtain your desired results. With each session, there is re-stimulation of production of your own collagen. Then it can take about 4 – 6 weeks to notice the complete effect. While this kind of dermal filler is contemplated to be as semi-permanent, you may still have to take occasional touch-ups.


Brand names include: Aquamid

Polyalkylimide is semi-permanent dermal filler and is commonly used by dermatologists and plastic surgeons to:

  • Treat deeper wrinkles like nasolabial folds
  • Depressed scars
  • Treat sunken cheeks, enhance cheekbones, redefine the jaw line, and to restore facial volume loss due to aging
  • Treat facial wasting from HIV medications
  • Plump thin lips

Polyalkylimide pose rare or little reaction with human tissue, indicating that it is biocompatible, and no allergy test is needed. One more distinct feature of Polyalkylimide rests in its characteristic of transparency, meaning it would not interfere with x-rays.

After the injection, a thin layer of collagen gradually forms around it over a period of about a month. The gel is finally fully surrounded. A single procedure is able to infuse large volume. This product, which is considered to be quite balanced over time, can even be withdrawn if needed.

Polymethyl-Methacrylate Microspheres (PMMA)

Brand names include: Bellafill

Polymethyl-methacrylate microspheres are considered as semi-permanent skin filler and are most commonly used to treat moderate -to-deep wrinkles, crumples, furrows, folds, specifically nasolabial folds. This filler can also be used to fill out indented scars and to thicken thin lips.

When a more permanent solution to facial folds and creases is longed for, PMMA is most commonly used instead of hyaluronic therapy or collagen replacement therapy. PMMA has been used in permanent surgical implants for many years.

One of the stumbling blocks of PMMA is that a number of injections are required to create volume and it can take up to 3 months to outwardly feel the full effect on your face. It may also be discernible under the skin. To steer clear of any undesirable results, it is a key that your dermatologist is accustomed with the proper technique, which involves administering injection at the dermal subcutaneous conflux using threading or tunneling methods.


Dermal fillers vary in chemical makeup, durability, endurance and have oscillating level of softness. Softer fillers are used in the lips, for instance, while robust fillers might be yearning for to enhance cheekbones.

Your dermatologist or plastic surgeon will identify with you the most fitting type and volume of filler required for your specific areas of concern.

For many candidates, the use of "off-the-shelf" dermal fillers can be a simple clinic-based procedure that can delightfully improve their appearance. The dermal facial fillers are quite foreseeable and have relatively minimal side effects and complications as of other surgical and invasive procedures. These soft tissue fillers are usually injected in the surgeon's clinic or a medical spa.

What is the Difference Between Synthetic and Natural Dermal Fillers

Synthetic and Natural Dermal Fillers

There are 2 primary classifications of dermal fillers: natural and synthetic
Naturally-extracted fillers (the most commonly known is hyaluronic acid) have a minimal risk of bringing about any allergic reaction but reactions can happen in rare cases. Results are instant and will retain for 3 to 18 months (in some cases for up to two years) because the filler ultimately breaks down, taking the outcomes, for good or worse, with it. Once the filler begins to dematerialize, it becomes necessary for you to go back in and get injected more filler to maintain results. Most individuals who get fillers will require at least 1 follow-up injection within a year.

Besides from allergic reactions, natural fillers also bear the risks of migration and lumping, although this occurs sporadically. On the other hand, due to the reason that the results last a short duration of time so do the potential risks and complications.

Synthetic fillers are well known to last much longer than naturally-extracted ones and are regarded as semi-permanent fillers though there are many who would refer to them as permanent because they really do not exhaust. The wrinkles begin to return only because your face carries on with the natural process of aging or you get sun damage due to being heedless about protecting skin against the scorching sun with a daily sunscreen daily.

As with all soft tissue fillers, synthetic fillers have risks and complications which are almost the same as for naturally-extracted fillers except the difference that synthetic fillers are "permanent" & the prospective issue can be "permanent" as well and are difficult to correct.

Fat Injections as Dermal Fillers

Some patients may want to take up fat injections, which use fat collected from the patient's own body which can then be re-injected to supplement facial fullness, fill creases, diminish wrinkles or folds, or form shallow contours.

How Fat Injections are Administered

Fat injection relatively requires a more comprehensive procedure than "off-the-shelf" dermal fillers.

A "donor area" must be intended to (such as the buttocks or abdomen) and liposuction is used to remove out the fat. The suctioned fat can then be shifted to the face, as a graft.

The grafted fat, then has to reproduce a blood supply for the purpose to survive. Around 50% of the injected fat will pull through, and this surviving fat will last for always.

Fat Injection Results

Large amount or actually most of the transferred fat in the face generally survives, but anticipating the results can be a bit difficult. Usually, multiple fat transfer procedures will be required to reap wishful results.

The use of fat transfer as soft tissue fillers involves auxiliary uneasiness in the donor area. Fat injection procedure is a minor surgical process that can be performed in the surgeon's office or in an operating room.

Your Dermal Fillers Consultation

During your consultation for dermal fillers be prepared to discuss:

  • Your aesthetic objectives
  • Medical conditions, medical treatments and drug allergies
  • Vitamins, current medications, ayurveda supplements, tobacco, alcohol, and drug use
  • Any past treatment with soft tissue fillers, laser, botulinum toxin therapy, or any other non-surgical facial procedures, as well as any previous facial surgery

Your dermatologist or surgeon may also:

  • Examine your general physical and psychological health status
  • Evaluate for any pre-existing medical conditions or risk factors
  • Explore and suggest your available options
  • Scrutinize and measure your face
  • Take images of your face before injections
  • Recommend a course of treatment
  • Discuss possible results of using soft tissue fillers and any side effects or potential risks or complications

Your dermatologist or physician plastic surgeon will carefully explain:

  • The course of treatment
  • The type of filler recommended for your condition and why
  • Expected outcomes
  • The durability of the outcome

Make sure you do put across all your queries and knowledge you have regarding the procedure. For your help, we have prepared a list of questions to ask your Dermatologist during your dermal fillers consultation.

It's important you understand all aspects of dermal fillers. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of pre-treatment stress. Don't be shy about discussing these feelings with your Dermatologist.

Questions to ask your dermatologist

Use this checklist as a handy guide for your dermal fillers consultation:

  • Are you certified by the authorized body?
  • Are you well-trained and qualified in the specific field of dermatology? This question is relevant because there are lots of practitioners who are injecting soft tissue fillers without any proper training and expertise in the same.
  • Is there any kind of hindrance in receiving soft tissue fillers based on any medical or health condition?
  • Am I a good candidate for soft tissue fillers procedure?
  • What will be expected of me to achieve the best results?
  • How and where will you conduct my procedure?
  • How much time is required for recovery and what kind of help and precautions will I need during my recovery?
  • What are the likely side effects, risks and reactions associated with dermal fillers?
  • How are complications tackled?
  • How can I expect my skin to appear over time?
  • What are my options if I am not satisfied with the cosmetic result of my procedure?
  • Do you have before-and-after photos of prior patients I can look at for each procedure?
  • What results are reasonable for me?

Is it Possible to Combine a Dermal Filler Treatment With Another Procedure?

Yes! At the Care Well Medi Hub, we oftentimes recommend a combinational approach to aid patients in repairing their different kinds of cosmetic concerns at once. It's completely safe to "mix and match" soft tissue fillers or have them injected in combination or subsequently with BOTOX Cosmetic or Dysport in a treatment called a “liquid facelift”.

Use of Dermal fillers can also help improve the results of other cosmetic treatments, such as Thermage. Our highly skilled and efficient team of medical practitioners and staff make sure to help you offer the appropriate options to uncover your most beautiful skin.

What Actually Happens to The Dermal Filler Ingredients as it Wear Off?

Dermal fillers come along with time validity, they are not meant to be permanent. Based upon the type of filler used, as well as its placement, the outcome of the procedure can stay between several months to two years. The ingredients in dermal fillers steadily split off and eject out of the system through usual metabolic processes.

Sculptra® Aesthetic, dermal filler that contains poly-L lactic acid, comes with the added advantage of stimulating collagen production within the skin. Over time, the poly-L lactic acid is filtered out of the body while the newly generated, natural collagen stays behind.

For more information or consultation related to dermal fillers please call or visit our clinic in Delhi (CR Park, South Delhi)