Earlier this week I showed you why buying fillers over the internet is a big no-no. Missed it? Oh boy, jump over here right now!

For a long time I have wanted to cover off everything one could know about fillers, but it is a huge category. Where do I start? Well, after doing the post on Wednesday I thought I should start by asking an expert some basic questions. Seeing as though the Cosmetic Physicians Society of Australasia (CPSA) are the ones who care so much about keeping the industry safe, they would probably be my best bet.

Dr Susan Austin has a long list of credentials in dermatology and runs her own successful skin clinic in Sydney. She also happens to be the Public Relations Manager for the Cosmetic Physicians Society of Australasia (CPSA). So, who better to give us the low down on basic Filler knowledge?

These were the questions I thought were super entry level to learning about fillers, but I would love to hear from all of you what exactly concerns you about Fillers. What do you want to know? What are your questions? There will be many more posts on Fillers, I guarantee that, so why not get the answers you want.

Considering fillers? What should you expect during your initial consultation?

Not all treatments are suitable for every patient and the best results are achieved through a personalised treatment plan. The initial consultation with an appropriately trained cosmetic physician is critically important when considering cosmetic medicine. During an initial consultation a cosmetic physician should undertake a full medical history, discuss any concerns you may have and clearly explain your treatment options and to ensure the final result is what you’re aiming for. It’s also vital that you have a realistic expectation of what can be achieved.

Most non-surgical clinics will offer programs for remediation and then maintenance, which usually run for a period of up 12 months. It is also important to remember to look holistically at the program as it should ideally address three key issues: skin quality, wrinkles and volume.

Are all fillers the same? What options are available?

Fillers are becoming increasingly popular in Australia as when administered correctly they can deliver instant results with limited risks and minimal post-treatment downtime. They generally stay where put and the doctor will massage them on injection to individualise the placement to achieve the look you want. What’s also appealing is that some of the fillers last just three months, or can even be dissolved if you’re not happy with the result.Some individuals are extremely fast processors, which means the same filler will not last as long in their body as someone else’s. This is an individual thing and cannot be recognised in a first-time patient.

There are four main types of fillers available in Australia: hyaluronic acid (HA) preparations; Aquamid; Radiesse; and fat transfer. Technically fat transfer is not considered a filler, though it can be used in the same way. Collagen, which was once a popular filler product, is no longer available in Australia.

The most popular fillers used in Australia are HA products, which come in a variety of thicknesses and gels. In broad terms, the thicker the gel the longer the filler will last. HA fillers are made in a laboratory and mimic the hyaluronic acid that occurs naturally in our bodies. These fillers can be used for lip plumping, facial sculpturing or a whole cheek lift. They have an excellent safety profile and can easily be added to or dissolved if a patient does not like the effect. The two most popular brands of HA filler are Juvéderm and Restylane, which include an ingredient that aids in pain relief.

Fillers such as Juvéderm Ultra or Esthélis only last five to six months, so I often recommend these products if a patient is nervous about their treatment. For longer lasting results of up to 12 to 18 months, Juvéderm Ultra Plus, Perlane and Fortélis are suitable options. Some of the longest lasting HA fillers are Voluma and Sub-Q, which can last up to 18 months and are designed for deep placement to lift the cheeks and jowls. None of these preparations require allergy testing, though bruising, tenderness and redness are common post-treatment effects that generally subside quickly.Radiesse is a different type of filler, which does not contain HA and is suitable for most patients. However, it cannot be dissolved in the way a HA preparation can if the results are not as desired. Radiesse is suitable for the cheek region and the naso-labial fold (the two skin folds that run from each side of the nose to the corners of the mouth) but should not be used in the lips.

Aquamid is considered a permanent filler, with the manufacturer advising it can last for 10 years. It is injected using the same techniques as other fillers, however there can be complications and it is considered more of an ‘implant’ as it needs to be surgically removed if the patient does not like the results. As it is a “gel” it is also more difficult to remove.

Technically speaking, fat transfer is not a filler but it is often considered one because it can be used in the same way.  It can sometimes work very well, however it may also require more than one treatment. I would strongly recommend that anyone considering fat transfer seeks an experienced doctor to undertake this procedure.

Sculptra is another product that is not a filler but can be used to achieve the same effects. Sculptra encourages the individual to grow their own collagen and can be used by itself or slipped under a HA preparation to boost the results as the filler wears off.

Following the initial procedure, subsequent treatments are required after one and six months and then 12-14 month top-ups thereafter, so that it really never ‘wears off’. A lot of small injections are given and if bruising occurs it is likely to increase the amount of collagen.  A great result can be achieved if the patient also undertakes a laser treatment such as Pearl Fractional, one month after treatment. This will further encourage collagen to be naturally produced. Patients can sometimes feel small rice-like grains under the skin, however this doesn’t seem to bother most patients.

What can you expect following treatment?

Fillers generally stay put once administered.  Doctors will massage them on injection and may ask you to massage them but there is little risk of them moving around after treatment. As such, you don’t need to avoid every day activities such as exercise and facial expressions, though you might experience some discomfort.Some patients feel very little post-treatment, though it depends on a number of factors including the type and thickness of the filler, how much was administered and where it was positioned. Patients may  experience some tenderness, bruising and redness after treatment. These features may not appear in all individuals or in the same individual using different fillers.

Larger amounts, for example in the cheek area, obviously mean more injections so patients should prepare themselves for bruising.  If a cannula is used rather than a needle then there is usually no or minimal bruising.I recommend that patients plan a quiet night at home following treatment, drink lots of water and avoid aspirin-based medications and alcohol as both can extend bruising. Cool compresses can also help.  If everything goes to plan then there is no reason not to resume your normal program the next day. Many patients return to work immediately.


As always it is very important to choose a doctor with experience in this area such as those listed on the website of the Cosmetic Physicians Society of Australasia

All quotes are from Dr Susan Austin, Public Relations Manager for the Cosmetic Physicians Society of Australasia (CPSA).

Republishing of this content is strictly forbidden.

Did you find this post useful? Did you learn something you didn’t know? Are fillers something you would ever consider? Let me know by commenting below!

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