What Is Filler?
Filler is a Hyaluronic Acid (HA) based filling substance, created to mimic a substance that occurs naturally in the human body. Its purpose is to replace key components of the skin's structure, collagen and hyaluronan, which the body loses as it ages. It therefore helps address skin concerns, whether filling in wrinkle lines and deep folds or reshaping the facial structure. It is a non-surgical aesthetic procedure with immediate results and no downtime.
How Many Types and Forms of Filler Are There?
Filler is categorized by the substance used into 4 types, and there are 3 forms of filler, which ILLUM Clinic explains as follows:
Filler Is Divided Into 4 Types by the Substance Used:
- Hyaluronic Acid (HA) is a substance found in many organs of the human body, mostly in the skin, eyes, and joints. Naturally, the body produces less of it with age. Hyaluronic Acid filler helps fill the skin so that wrinkles and deep folds look smoother
and shallower, with skin looking more hydrated and immediate results after the procedure. It can be injected at many points across the face and is highly safe. Hyaluronic Acid filler is the most popular type, and each injection lasts 6-24 months. - Calcium Hydroxylapatite (CaHA) is a substance found in human bone. Once injected, it helps fill the skin, reducing the appearance of wrinkles, and stimulates long-term collagen production. It lasts no more than 2 years.
- Poly-L-Lactic Acid (PLLA) This filler is a synthetic substance. It works by stimulating collagen production in the skin, making the skin look firmer and fuller. However, it takes time to work, with clear results within 2-3 months after injection, and the filler lasts no more than 24 months.
- Polymethylmethacrylate (PMMA) This filler is a synthetic substance made of tiny spherical particles, commonly mixed with collagen in a gel form. When injected into the skin, it reduces wrinkles through 2 mechanisms: it fills the skin in the short term with the gel-form collagen, and it stimulates long-term collagen production through this synthetic substance. This type of filler lasts as long as 5 years or more.
Filler Is Divided Into 3 Forms:
- Temporary Filler is a filling substance that breaks down on its own and can be dissolved with a dissolving agent. It leaves no residue in the body, and injection causes no dangerous side effects. It is approved by the Thai FDA for injection within a medical facility or clinic, for example, adding Hyaluronic Acid filler to replace areas lost with age, such as hollow temples, sagging cheeks, deep nasolabial folds, and a short chin. This is a temporary injection only, with results lasting 4-24 months, depending on the model and brand of filler.
- Semi-Permanent Filler is a filling substance that breaks down on its own but cannot break down completely, and there is currently no dissolving agent for it. Some types are approved for use, namely Biostimulator fillers such as Calcium Hydroxyapatite and PLLA.
- Permanent Filler is a filling substance that cannot break down on its own and has no dissolving agent. Once injected into the body, it may cause dangerous side effects. Removing it from the body requires specific methods only, such as scraping out the filler, aspirating the filler, or surgery. Fillers of this type are paraffin and liquid silicone, which are not approved by the Thai FDA for injection.
How Filler Works
When Hyaluronic Acid (HA) filler is injected into the skin, it binds with water molecules to plump the area, so that wrinkles and the deep folds of the skin in that area become smoother and firmer again. A key property of filler is its stability, which allows it to augment the nose and chin and to retain moisture deep into the inner layers of the skin, improving the skin's condition, making pores look smaller, and making the skin naturally more elastic and supple.
What Does Filler Help With?
As we age, the skin's natural collagen production declines, leading to wrinkles, sagging skin, and a loss of the elasticity and radiance it once had. ILLUM Clinic explains how filler can help address your skin concerns.
- Adds volume to the skin, as the water-retaining property of filler helps the skin stay hydrated, look smooth, radiant, and firmer, filling the face to make it look fuller.
- Helps reshape the face, as filler can refine the face to be more balanced and well-proportioned, by injecting areas such as the temples, forehead, or chin.
- Reduces wrinkles, as filler can fill in the deep folds and various wrinkles that come with age, and also helps slow the formation of future wrinkles.
- Makes the lips and cheeks look plump, helping fill the lips to look fuller, reducing fine lines around the lips, and reducing sagging or hollowing of the cheeks, as filler helps the lips and cheeks look fuller and plumper.
Which Areas Can Filler Be Injected?
Filler can be injected into many areas of the face, depending on the patient's wrinkles and deep folds, or wherever the patient wants to add volume. There are 10 areas on the face where filler produces a clearly visible change.
(graphic of injectable areas on the face)
- Forehead Improves the facial features and adds dimension to the face. For those with a sunken forehead, filler in this area helps the face look fuller and enhances the facial features, and also helps address forehead wrinkles.
Recommended filler amount: 3-5 cc (review image) - Temples Suitable for those with hollow or sunken temples. Filler helps the face look naturally fuller, more symmetrical, and better proportioned, and also gives the face a more youthful, softer look. Recommended filler amount: 1-3 cc (review image)
- Under-Eye Commonly injected to reduce dark circles and wrinkles, and also to address sagging under the eyes by filling the sunken areas beneath the eyes. When injected with the technique of an experienced doctor, it makes the under-eye area look naturally firmer and helps restore brighter, clearer skin under the eyes.
Recommended filler amount: 1-2 cc (review image) - Nasolabial Folds Suitable for those with deep nasolabial folds that make them look older and aged beyond their years.
Recommended filler amount: 1-2 cc (review image) - Nose Helps give the nose a more beautiful shape, corrects a crooked nose, and makes the nose more defined.
Recommended filler amount: 1-2 cc (review image) - Lips Helps make the lips look plumper. Suitable for those with thin lips who want to add dimension for a more attractive mouth. Recommended filler amount: 1-2 cc (review image)
- Chin Suitable for those who want to balance the proportions of the face, making the chin look naturally slimmer and longer.
Recommended filler amount: 1-3 cc (review image) - Cheeks Suitable for those with a flat face or who want to look younger.
Recommended filler amount: 1-3 cc (review image) - Hollow Cheeks Suitable for those who want a well-proportioned face with beautiful contours and a more youthful look.
Recommended filler amount: 2-4 cc (review image) - Jawline Suitable for those with an undefined jawline who want a sharper, more defined jawline.
Recommended filler amount: 2-4 cc (review image)
Is Filler Dangerous?
The only type of filler that is safest and certified is Hyaluronic Acid (HA Filler), certified by the US Food and Drug Administration (US FDA), which certifies that Hyaluronic Acid is a safe substance, widely used in aesthetic medicine. Once injected, it breaks down completely, 100%, with no residue, and can be re-injected continually without danger. Filler injection is not a dangerous or high-risk procedure, but you must choose a standardized clinic that uses genuine filler, with an experienced, expert doctor who uses the correct injection technique, for the patient's own safety.
Which Filler Brand Is Best, and How Long Does Each Model Last?
Choosing a filler brand depends on the area to be injected. The doctor assesses each patient's concerns case by case and selects the filler model suited to the injection area. Currently there are many brands of genuine filler to choose from, and each brand has sub-models with different properties, including the injection area, stability, and duration. Mainly, ILLUM Clinic carries popular fillers from 3 countries: fillers from the United States, from Sweden, and from Korea. ILLUM Clinic summarizes the duration of each filler model as follows:
Fillers From the United States: Juvederm
- Juvederm Voluma lasts 18 months
- Juvederm Volift lasts 12 months
- Juvederm Volux lasts 18 - 24 months
- Juvederm Ultra Plus lasts 8 months
- Skinvive lasts 8 - 12 months (developed from Juvederm Volite)
Fillers From Sweden: Restylane
- Restylane Vital Light lasts 6 - 12 months
- Restylane Perlane Lyft lasts 12 months
- Restylane Volyme lasts 18 months
- Restylane Vital lasts 12 months
- Restylane Kysse lasts 12 months
- Restylane Classic lasts 12 months
- Restylane DeFyne lasts 18 months
- Restylane Refyne lasts 12 months
Fillers From Korea: Atiere
- Atiere Classic lasts 6 - 12 months
- Atiere Intensive lasts 8 - 12 months
- Atiere Volume lasts 8 - 12 months
Promotion (graphic)
How to Identify Safe, Genuine Filler
For safety, those interested in filler injections should learn how to identify each brand of filler, what to look for, and whether it is legally imported by a company. You can check for the following:
- The FDA registration number on the box
- A Thai-language package insert
- A Lot number that can be verified by phone with the importing company
- The Lot number on the box, sachet, sticker, and syringe must match
These vary by brand.
How to Prepare Before Filler Injection
- Those interested can first study the necessary information, including choosing a standardized clinic, choosing a doctor, the technique used, and how to identify genuine filler of each brand, for safety and confidence in a good, worthwhile result.
- You should avoid certain medications and vitamins before filler injection, namely NSAIDs, aspirin, ginkgo biloba, primrose oil, St. John's Wort, garlic, Vitamin E, and ginseng, for at least 3-7 days before the injection.
- Avoid alcoholic beverages for at least 24 hours before filler injection.
- Avoid exfoliating products and plucking or shaving hair in the area to be injected.
- Always inform the doctor before the procedure if you have any underlying conditions or medications you take regularly.
- Avoid laser treatments and facial massage for at least 3 days before filler injection.
- In some cases, the doctor may consider prescribing a blood-clotting medication or an anti-swelling injection to reduce the risk of bruising, swelling, and inflammation or infection.
The Filler Injection Procedure
- Consult the doctor to assess the concerns you want to address. The doctor will recommend the filler brand and the amount of filler needed for the injection points, suited to each individual.
- An assistant cleanses the face thoroughly, either the whole face or only the injection points.
- Photos are taken before the procedure to compare results with afterward.
- Before injection, the doctor or assistant shows you the expiry date, or the QR code to scan and verify authenticity, and opens the filler box in front of you.
- The assistant applies an ice pack to the area to be injected to reduce the pain from the needle, and the filler itself already contains an anesthetic.
- After injecting one half of the face, the doctor lets you see the result first to discuss together whether you are satisfied, then continues injecting until finished. The assistant tends to everything afterward, cleaning the injected area and applying tape (Steri-Strip) over the needle holes to prevent infection.
- The doctor advises on self-care steps after filler injection for long-lasting results.
- Photos are taken after the procedure to compare results, record in your history, and send to you.
Self-Care Steps After Filler Injection
- Avoid touching, picking, scratching, and massaging the injection points, which may normally show swelling, redness, or bruising that gradually improves within 2-3 days.
- Stay in a cool environment and avoid all kinds of heat and activities that flush the face for at least 48 hours, such as intense exercise, sauna, and sun exposure.
- Avoid all heat-based lasers that reach deep skin layers for at least 1 month.
- Avoid facial massage and treatments in the first 2 weeks.
- Avoid certain foods that contribute to inflammation and swelling, such as:
- Avoid fermented and pickled foods for about 3-7 days
- Avoid alcohol for 1-2 days
- Avoid medications or vitamins that promote bleeding, such as aspirin, Vitamin E, and ginkgo leaf extract, for 1-2 weeks
What to Consider When Choosing a Clinic for Filler Injection
Today there are many clinics offering filler injections, but you should not get injected by just anyone, anywhere. Patients must consider credibility, a standardized and safe clinic, and good value. Here are our recommendations to consider:
- Choose a standardized clinic certified by the Ministry of Public Health.
- The doctor is experienced, credible, and a real physician.
- Only genuine filler is used, at a reasonable price.
- There are reviews from previous patients from credible sources.
- The clinic follows up on results after every injection.
- The location, travel, and parking are convenient, and appointments can be booked in advance.
Frequently Asked Questions About Filler
Beyond general questions such as what does filler help with? what is filler? and where can filler be injected? ILLUM Clinic has compiled the frequently asked questions below:
Is filler dangerous?
Filler injection is safe and not dangerous if the patient chooses a standardized clinic that uses genuine filler meeting Thai FDA standards, containing a skin-filling substance that mimics the natural substance in the skin, Hyaluronic Acid, which the body absorbs and breaks down naturally, making it very safe, and is injected by an experienced, expert doctor.
Does filler injection hurt?
For filler injection, the filler already contains an anesthetic, and the clinic applies a numbing cream and an ice pack during the injection, so most patients do not have problems with pain. However, after the injection some people may experience swelling, redness, itching, bruising, or a feeling of tightness. These symptoms improve within 2-3 days and usually resolve completely within 2 weeks.
Does filler break down completely on its own?
Genuine filler breaks down completely on its own, taking about 6-24 months depending on various factors, such as the brand and model of filler used, the injection site, the injection technique, self-care after injection, and each person's physical condition.
After the filler breaks down, will the face look older?
When filler breaks down, it does not break down all at once; the filler dissolves gradually, and over the long term it also helps stimulate collagen to replace part of it. So even after the filler has broken down, the face still looks better than before the filler injection.
What is filler dissolving injection, and when is it done?
Filler dissolving injection is the injection of the enzyme Hyaluronidase to break down the filler. It is done when results need to be corrected, for example, patients who have had so much filler that the face looks unnatural, filler that has clumped together, filler injected in the wrong location, or who dislike it and want it removed. Filler dissolving injection works only with genuine filler and cannot be used with counterfeit filler.
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