Dermal Fillers

What are dermal fillers?

Dermal fillers are sterile gels used to correct fine lines and plump out wrinkles and folds in the face. Fillers are also used to sculpt lips and for restoring facial contours by adding volume. They provide a subtle, but natural enhancement and long lasting results – typically 9 – 18 months depending which area is treated and the type of filler used.

Dermal Fillers are made from Hyaluronic Acid (HA). This is a substance made naturally by the body that gives your skin it’s volume and fullness. The levels of HA decrease in the skin as we age making the skin less full and firm allowing wrinkles to appear. HA injections fill the space between the collagen and elastin fibres restoring skin to it’s youthful plump appearance.

There are several different HA materials available – Dr Hayward uses the brand Belotero which delivers a natural look and feel. It contains a local anaesthetic agent for added comfort and provides long lasting results.

Where and how are fillers used?

The most common areas to treat are the nasolabial lines (the lines running from the nose to the mouth). Other areas commonly treated include the lips, cheeks, the corners of the mouth and the perioral lines (smokers lines). They can also be used in the chin and jaw line area and also to soften frown lines – especially any residual frown lines after anti-wrinkle (‘Botox’) treatment.

The Belotero range treats everything from fine lines around the lips to deep folds and wrinkles and can also be used to add more volume and restore facial contours (there is a natural loss of volume from the cheeks as we age). Different thickness of fillers are used in different locations on the face e.g. a thicker filler product called Volume is used for cheek filler, whereas a thinner product (Balance) is used to correct much finer lines around the lips.

We also perform tear trough treatments to smooth out eye bags, dark circles and shadows making you look naturally revitalised and rejuvenated.

What does the treatment consist of?

Firstly the doctor will assess you and discuss the best treatment options. A local anaesthetic cream e.g. Emla is applied to the area to be treated. This cream takes at least 15 minutes to work so will be left on the skin for some time to ensure the skin is numbed and treatment will be comfortable for you. After this time the cream is removed and the area is thoroughly cleaned. Fillers are then injected directly into the desired area on the face using a fine needle. All the fillers used contain local anaesthetic to further ease any discomfort. The procedure is very well tolerated from a pain point of view – at most, clients just describe a mild stinging sensation when the filler is injected.

After injection, the filler is gently manipulated into the exact position (if needed).


The results are instant. Lines and wrinkles are smoothed out and the skin appears plumper, fuller and
restored to its younger appearance. The effect continues to improve over the first few weeks and will maintain the improved appearance for 6 or more months depending where it was treated and the type of filler used.

There is no down time required and if desired you can apply breathable make-up over the treated area immediately – although we do advise to try and avoid make up for 12 hours.

It is extremely important to have realistic expectations with the results of fillers. Most patients are extremely happy with fillers. However, fillers do not “get rid of” all your wrinkles. Patients should expect “significant improvement,” not complete wrinkle removal. If a patient doesn’t get the result they want, often the answer is have more filler on a later date.

Are there any side effects?

Overall dermal fillers are a safe and well tolerated treatment. It produces excellent cosmetic results and any side effects are mild and temporary. However, as with all medical and injectable procedures, there are some potential risks which you need to be aware of listed below.

Potential injection related side effects include:

  • Temporary discomfort with the injection – brief – reduced with Emla cream
  • Redness at the site (typically 20 – 40 minutes post procedure)
  • Bruising (usually small and fades within 1 week – maximum of 2 weeks)
  • Swelling (up to 48 hours after treatment) – especially with lip treatments
  • Haematoma – a bruise which causes a small lump (can take 2 weeks to resolve)
  • Infection (very rare, approximately 1 in 100,000 patients), but can cause scarring
  • Fainting (needle related pain or anxiety)

Potential side effects related to Belotero dermal filler include:

  • Tenderness at the injection site – up to 48 hours afterwards
  • Lumps – it is normal to be able to feel the filler under the skin initially. If raised bumps appear, firm massage will help to even them out
  • Uneven appearance. Some areas may be more affected by fillers or swell more than other areas. This can be corrected by more filler treatment at a later date
  • Incomplete removal of deep lines – these require additional filler treatment
  • Allergic reaction (rare, 1 in 10,000) – swelling and firmness – days or weeks after treatment. There are rare cases of lump (granuloma) formation (1 in 15,000)
  • Skin necrosis – very rare – occurs if filler is injected into an arterial blood vessel
  • Fillers are temporary and typically last 6 – 12 months. Touch up and follow on treatments will help to maintain the desired correction

Please bear in mind that the more serious side effects are extremely rare, but do need to be mentioned prior to treatment.

After Care

  • Post treatment, there may be some redness, tenderness or swelling at the treatment site. This is a normal treatment response that will resolve itself within a few days
  • It is not unusual to experience bruising or swelling around the treatment site. This is short term and will also subside within a few days
  • Bruising can be avoided or minimized by avoiding aspirin and alcohol for 24 hours pre and post treatment
  • If you are prone to bruising, frequent icing in the first 24 – 48 hours after treatment can help reduce bruising. Ice as much as you can for the first 48 hours. 20 minutes on and 20 minutes off at least five times a day
  • Avoid wearing make-up post treatment for 12 hours
  • There is no need to massage the product area unless you feel lumps or unevenness
  • Do not expose the treated areas to intense heat (e.g. solarium, sauna) for at least 48 hours after treatment
  • Lip treatments generally take a little longer to settle and may feel tender and appear uneven. This will gradually resolve itself within the first week and will not affect the final result
  • If you have suffered from cold sores, the treatment may result in a fresh eruption of the virus. If this occurs you may use Zovirax cream
  • Rarely, there may be slight visibility of the dermal filler below the surface of the skin
  • Allergic responses to dermal filler treatments are rare, as is infection of the treated area. However, if you experience any unusual symptoms, please contact the clinic as soon as possible
  • On very rare occasions (less than 1 in 15,000 treatments) prolonged firmness, abscess formation or grayish discoloration at the implant site has occurred. These reactions can develop weeks to months later following the injections and may persist for several months, but normally resolve with time

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