Fillers

The most commonly used fillers in cosmetic treatments are Hyaluronic Acid (HA) fillers. These products are extremely popular due to their excellent safety profile. Allergic reactions are exceptionally rare, which marks a clear improvement from the older collagen fillers once used, where bovine or porcine proteins occasionally triggered adverse reactions.

A wide variety of HA fillers is now available, which ultimately benefits patients. Healthy competition among pharmaceutical companies encourages fair pricing and continued research and development. Provided a filler is CE-marked and supported by a reputable manufacturer, the best product is generally the one your practitioner uses most confidently and skilfully.

The range of HA fillers has expanded significantly and now includes almost pure HA formulations designed to hydrate the skin, softer fillers suited to delicate areas such as around the eyes (lasting approximately 3–6 months), and firmer, more cross-linked fillers that offer greater lift and structure (lasting around 6–9 months). At the top end are very dense fillers used for restoring larger volumes or for body contouring, including breast, buttock, and calf enhancement, which may last up to 24 months.

These fillers are also fully reversible through the use of an enzyme called Hyaluronidase, offering an additional level of reassurance and safety.

This category of fillers provides the same immediate volumising effect seen with HA fillers, but with the added benefit of stimulating collagen production through the presence of calcium microspheres (calcium hydroxyapatite). As a result, these treatments can offer longevity of up to 18 months.

Examples of these fillers include Radiesse® and Redexis®, both of which have versatile applications across the face. They are commonly used in areas such as the temples, cheeks, nose, nasolabial folds, the downturned corners of the mouth, the chin and the jawline, and are also well suited for rejuvenating the backs of the hands. This type of filler is often relied upon to improve contour irregularities or soften defects following life-saving surgery or injury. It remains precisely where it is placed, making it a highly effective option when used for the correct indications by an experienced practitioner.

This type of filler becomes a suspension once reconstituted and is not a gel like most other fillers. It is injected exclusively into the deeper layers of the tissue, where the PLLA stimulates collagen production from around six weeks onwards as it gradually breaks down within the body. In fact, the increase in volume can continue for up to a year after treatment.

During the first month, firm daily massage by the patient is essential to ensure the collagen develops evenly in a smooth, sheet-like manner and to reduce the risk of small nodules forming. This early aftercare plays a crucial role in achieving the best possible result.

The final effect of this treatment can last between 2–5 years. However, both practitioner and patient must be patient throughout the gradual transformation, and overcorrection should always be avoided, as this treatment cannot be reversed.

PLLA, with Sculptra® being a well-known example, is also suitable for rejuvenating the backs of the hands. It is commonly used in the temples, cheeks, nasolabial folds, the downturned corners of the mouth, the chin, jawline and the chest area.