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Dermal fillers are a type of substance injected into the issues under the skin to remedy a variety of structural changes on the face.

Some examples include restoring loss of facial volume, plumping lips for fullness and hydration, reshaping the jaw for a more prominent look, and filling in dark undereye circles for a more refreshed look.

While dermal fillers can improve your natural contour and enhance your looks, they are associated with certain risks. We will be discussing more about dermal fillers and their potential complications today.

1 | Different Types of Dermal Fillers

Dermal fillers on the market today can be composed of the following:

  • Hyaluronic acid
  • Calcium hydroxylapatite
  • Poly-L-lactic acid
  • Polymethyl-methacrylate microspheres
  • Autogenous fat

Hyaluronic acid

Hyaluronic acid (HA) is the most common type of filler used for many applications.

It is present in many different parts of the human body. Nowadays, it is made through a process of bio-fermentation and therefore it is free of animal-based ingredients, 100% biocompatible and biodegradable.

Some of these well-known brands include Stylage, Restylane, Teosyal, Juvederm, Belotero, Princess, Rejeunesse, etc. HA can range from a softer more runny texture as a skin booster to a more viscous texture depending on the area it will be injected into. Think of filler as injectable implants that are meant to ‘mimic’ the same internal structure of the area of injection.

For example, lip filler will be more soft and cushiony for the lips to look realistic and plump, whereas jaw filler will be more solid to support the bone structure. These fillers tend to last around 6 months on average or more, and can be ‘reversed’ by dissolving using hyaluronidase.

If you don’t want your HA filler anymore, or simply want a different look, you can dissolve it!

Calcium hydroxylapatite

Calcium hydroxylapatite (CaHA) is naturally present in the human bones.

The filler consists of small calcium-rich microspheres mixed with Carboxymethylcellulose (a safe substance derived from cellulose backbone). It is manufactured through a biosynthetic process and does not have an animal origin. It is a longer lasting dermal filler due to its structure and calcium content (such as Radiesse).

This type of filler is especially effective for jawline contouring and chin enhancement because it can hold the shape very well. The main purpose is collagen stimulation. Calcium fillers are not permanent, but they cannot be dissolved. On average, they last for 12-18 months.

Poly-L-lactic acid

Poly-L-lactic acid (PLLA) fillers are synthetic and made into special microspheres.

The human organism recognizes these tiny particles as foreign bodies and they trick the skin into producing more collagen. Therefore, the main effect is more stimulating than filling. A popular brand is Sculptra.

This product is known to assist the skin to naturally rejuvenate itself over time. Depending on your own rate of metabolism, it can last up to 2 years. However, it takes at least 3 separate sessions before you start to notice a difference.

Polymethyl-Methacrylate Microspheres

Polymethyl-Methacrylate Microspheres (PMMA), like Bellafill, consists only 20% of the injectable material with the rest being collagen. The filler is semi-permanent.

In comparison with the PLLA fillers, they have the advantage of providing the volume and collagen boosting properties and longer duration of up to 5 years.

The response may differ from one patient to another and the result is best seen after 3 months. Some people may experience an allergic reaction to this filler, but it cannot be dissolved. The only way to remove PMMA is through surgery.

Autogenous fat

Autogenous fat transplant is moving part of your body fat into another area of your body. There is no allergic reaction to this procedure. It can even last for many years.

On the other hand, roughly up to 50-60% of the initial volume injected may be lost and a touch-up procedure may be required. As a result, there is a possibility of minor asymmetry if the volume loss on both sides of the face is not exactly equal.

2 | What to Expect During Your Appointment

Dermal fillers are considered to be minimally invasive as they involve injecting the substance under your skin. Due to this reason, different analgesic options are available, with numbing cream being the most common approach.

The injector may map out the area of injection, and apply the numbing to your face before the actual injection. Any discomfort should not be intolerable. In some cases, a nerve block is applied to minimize the pain. After injecting the patient, the injector may mold the filler into the desired shape.

Filler appointments are generally quick with minimal downtime.

3 | What are the Risks of Dermal Fillers

Bruising and Swelling

As with any cosmetic procedure, dermal fillers can carry certain risks, with the most common being bruising and swelling after injection.

Bruising may occur when veins have been disturbed during the procedure, and can happen more noticeably for lip filler procedures due to the fact that the lips are very vascular.

Swelling should be expected after injection as it is a normal bodily reaction to being poked with a needle. HA also draws in water. However, excessive bruising and swelling may indicate a more serious issue and should be followed up with the injector to rule out any adverse reactions.

Vascular occlusion

Vascular occlusion is a serious risk that can occur when filler is incorrectly injected into a blood vessel and cuts off the supply of oxygen and blood to that area. When this occurs, the patient may experience blanching or lightening of the skin with increasing pain. The affected area can progress to necrosis or tissue death if not treated promptly with care.


Besides the occlusion, embolism may occur. The filler may migrate through the blood vessel to the brain causing a stroke or to the retinal artery causing irreversible blindness. Avoiding high risk areas like the glabellar region and the nose help to lower the risk but will never completely eliminate the potential harm.

Filler migration

Filler migration happens when the filler shifts from the injection site. This usually occurs in the first few days after the injection when the filler is still bonding with the tissues. The best way to avoid this is to refrain from strenuous exercise, sleep on your back, and not to press too hard on the filler.

3 | How to minimize the Risks of Dermal Fillers

Different injection techniques are used to reduce serious complications, such as the use of a cannula instead of a needle. Cannulas are flexible thin tubes with a blunted end that look like needles, and are usually made of a larger gauge and greater length. They have the advantage of being much less likely to puncture a blood vessel, and can allow the injector to fill a larger area with less entry points.

The speed of the injection, the depth of the injection, and the amount injected can make all the difference to the level of safety and outcome. An experienced injector understands that different fillers are targeted for different depths of the tissue. The right amount is important as over-injection can lead to complications and undesirable results. Sometimes, it may take a few treatments to achieve your desired goal, but remember safety is priority.

Our most important piece of advice is this:
An injector needs to be professional, reliable, knowledgeable and experienced.

He/she has to pay close attention to analyze the overall anatomy of your face. Having dermal filler injection is like painting a canvas. No one’s face is the same and every stroke on a painting is different. Having an injector who is careful with his/her work can make a huge difference to the outcome of your face!

Get Dermal Fillers Without Worrying!

At Ovo Medi Spa, our injectors are highly trained and fully licensed physicians with the utmost professionalism and precision for cosmetic procedures. We offer all new clients a free 30 minute consultation to discuss your cosmetic and skin goals, and answer any questions you may have.

Choose Ovo Medi Spa for your Vancouver filler injections. Call us at +1(604) 568-8800 to schedule a free consultation.

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