Filler
What Is It?
Filler is a gel-like material we place under the skin. We use it to replace lost volume, soften lines and tidy up the contours of the face. The group we use most is hyaluronic acid. This molecule also occurs in the body’s own tissue, and it binds water.
Filler is really the name of a family of products, grouped by firmness. With the more structured ones we build support over the bone. With the medium-density ones we add volume. The fluid ones go into thin areas close to the surface. They are all called filler, yet they go to different depths and do different jobs. So “I want filler” doesn’t tell us which product goes where, and in what amount.
How Is It Done?
First we look at your face and find where the complaint comes from. Is the shadow caused by volume loss, by loosening skin, or by the mimic muscles at work? If you put filler into a line that comes from muscle movement, you won’t get the result you expect. So we don’t choose a product until we have made that distinction.
Once the area and depth are set, we work with a cannula or a fine needle. Before that we apply a topical anaesthetic cream to your skin. Most hyaluronic acid products also contain a local anaesthetic of their own. The procedure takes 15-30 minutes depending on the number of areas. When it’s done, we check the symmetry together in the mirror.
Who Is It For?
We offer it to patients who notice volume loss, deepening lines, shadowing or asymmetry in the face and who don’t want surgery. The areas we plan most often are the cheeks, temples, chin, lips, under-eye area and the nasolabial folds that run from beside the nose down to the corners of the mouth.
In a face with advanced sagging, filler alone is not enough. Adding volume does not gather up loose skin, and sometimes it makes the face look heavier. We don’t treat during pregnancy or breastfeeding, when there is an active infection or inflamed lesion at the site, in bleeding disorders, in uncontrolled autoimmune disease or with a known allergy to the product. If you take blood thinners, bruising becomes more likely, and we take that into account at the consultation.
Process & Recovery
Consultation and analysis
We talk about your expectations and medical history and note any treatments you use regularly. After the facial analysis we decide together which product goes into which area. We take photographs for your record.
Treatment day
We cleanse your skin and leave the topical anaesthetic cream on for 15-20 minutes. Then we treat the points we planned. It takes 15-30 minutes depending on the number of areas.
First 48 hours
Redness, mild swelling and bruising may appear at the needle points. These are expected and temporary. On the first day we ask you to avoid heat, strenuous exercise and alcohol, and not to press on the area.
First two weeks
Filler is a gel, and for the first ten days, while it integrates with the tissue, it can still change shape. During this time the swelling goes down and the product settles in. Because the look takes 10-14 days to settle, we don’t judge the result before then.
Review
We ask you back for a review at the end of the second week. We check the symmetry and the transitions and do a small top-up if needed.
Results & Duration
You see the volume effect right after the treatment. The final look becomes clear once the swelling settles, in about two weeks on average. How long it lasts depends on the product, the area, the amount used and your metabolism. The range generally reported for hyaluronic acid fillers is 12-18 months.
In mobile areas such as the lips and around the mouth, filler breaks down faster; at static support points it stays longer. With cross-linked hyaluronic acid filler, it takes about a year on average for half of it to leave the body. So if you had 2 millilitres, your body brings that down to roughly 1 millilitre over a year. The effect fades over time and needs renewing. We don’t leave anything in the tissue for life; it takes roughly five to six years for the filler to be fully broken down and cleared.
What Is Not Promised
Filler does not replace a facelift. In advanced sagging it doesn’t remove excess skin. It doesn’t correct pigmentation or skin quality. And on its own it doesn’t give the expected effect on lines caused by muscle movement.
We don’t promise you a particular look, a particular duration or that it will be “done in one session”. If your expectation doesn’t match your anatomy, I tell you so at the outset and I don’t recommend the procedure. How much change a given amount of product will make depends on the facial analysis, and we discuss it openly at the consultation.
Key Benefits
- Instant volume
- Line softening
- Natural look
“Filler fills things and adds volume. But we don’t use it only for volume. When you lift sagging structures back up and place filler beneath them like a wedge, you stop them from dropping.”
— Dr. Sinan Akyürek
Frequently Asked Questions
Is filler painful?
Most of my patients describe pressure and a slight stinging. We apply topical anaesthetic cream beforehand, and most products also contain a local anaesthetic.
Can I return to work the same day?
Yes, most of my patients go back to daily life the same day. Swelling or bruising can appear in the first days, so if you have an important event coming up, I’d suggest having the treatment a few days earlier.
Will my face look puffy?
Not with measured treatment. A puffy look comes either from swelling in the first days or from using more product than needed. Filler repeated again and again because “the effect has worn off” can also build up, since half of the first filler is still there a year later. That is why we keep the amount to the plan.
When will I see the final result?
You see the first effect straight away. The look settles as the swelling goes down, and we wait about two weeks before assessing it.
How long does it last?
The range generally reported is 12-18 months. It can be shorter in mobile areas such as the lips and longer at support points.
Is it reversible?
With hyaluronic acid fillers, yes. We inject an enzyme called hyaluronidase where the filler is, and the filler dissolves. Products with a different composition can’t be reversed this way, which is why we discuss product choice at the consultation.
Is it the same as Botox?
No. Filler adds volume and fills a hollow. Botox temporarily reduces muscle movement and doesn’t add volume. They are separate treatments for different problems, and we plan them together when needed.
Who is it not suitable for?
We don’t treat during pregnancy or breastfeeding, when there is an active infection or an inflamed lesion in the area, or in bleeding disorders, uncontrolled autoimmune disease or known allergy to the product.