What you need to know about dermal injections before going under the needle.

Let’s face it: With age comes change. As we get older, the collagen in our face diminishes and our skin shifts from supple to saggy. For those seeking a solution that falls between using a superior anti-aging skin-care product and going under the knife, the nonsurgical filler route is a growing option. A filler is a minimally invasive injectable that uses a needle to plump skin and soften lines and wrinkles. Fillers are different from Botox injections, which use a needle to relax dynamic, or expression, wrinkles (where Botox smooths, fillers plump), and lasers (considered the “workhorse of skin quality,” they even out skin tone and texture, and repair the skin, helping to erase fine wrinkles and sun damage).

According to the American Society of Plastic Surgeons, women’s use of soft-tissue fillers surged 264 percent. Men are entering the market, but 96 percent of users are female, with the majority aged 40 to 54, for both surgical and noninvasive procedures. And a younger demographic, starting in their late 20s and early 30s, is taking a preventive approach by adding smaller doses earlier.

According to a report by FACEinstitude.ca of Canada, 81 percent of women surveyed believe noninvasive treatments are more mainstream than ever before. Today, booking a dermal-filler appointment is considered, by some, an extension of personal grooming, similar to highlighting your hair. Thankfully, the trend is moving away from an overdone Real Housewives look to a more natural appearance. 

Why chose fillers?

“Fillers are injectable volumizers,” says Dr. Cory Torgerson, a Toronto plastic surgeon, who likens fillers to using spackling paste to repair cracks and divots in a wall. As we get older, the fat compartments in our face shrink and our skin falls. Fillers can replace the volume loss and restore fullness to areas that appear deflated. “Today, 95 percent of the fillers on the market use natural products with hyaluronic acid, which include natural sugars found in the body,” says Dr. Torgerson. Hyaluronic acid has the ability to hold 1,000 times its weight in water.

Where are fillers injected?
“Concentrating solely on the nasal labial folds—smile or laugh lines—is being replaced with a more global approach [around the entire face],” says Dr. Torgerson. To fill the pockets where fat used to be, fillers are most commonly injected into the chin, cheeks, lips, jawline, eye circle, temple and forehead.

How long do fillers last?
Depending on what product is used and where it’s injected, the effect can last from three months to several years. “Due to mechanical movements around the jaw, mouth and lips, the injection can dissolve faster in those spots,” says Dr. Torgerson. “Around the eyes, where larger movements are less prevalent, it can last for years.”

The options
Dermal fillers fall into two categories: permanent, which can’t be removed; and the more often used semipermanent, which is temporary. In Canada, the materials used in dermal fillers can be collagen, hyaluronic acid or other biocompatible materials; unnatural products like silicone are banned. With a nonpermanent filler, if a patient isn’t satisfied, an enzyme can be injected that dissolves it within hours. For those who aren’t crazy about needles, lidocaine, a topical numbing agent, can be applied to ease the pain. Fillers can also be used in conjunction with Botox.

The top three semipermanent fillers used in Canada are:
Teosyal: This 100 percent hyaluronic-acid filler offers precise application with an ultra thin needle for a natural-looking outcome.
Restylane: This hyaluronic acid–based gel filler is over a decade old and the first approved by the U.S. Food and Drug Administration (FDA) for cosmetic injection.
Juvéderm: This injectable gel filler is the bestselling facial filler in North America.

How much do fillers cost?
The average price for an injectable is $600 to $800 per one cubic centimetre vial. On average a person may use anywhere from 2 to 4 vials in a visit, depending on which area of the face is receiving treatment. You should not attempt to reuse a vial that has been opened.

Postinjection: results and recovery
Expect instant results, with minimal to no swelling—no downtime required. For temporary swelling, apply ice. “It’s pretty painless, predictable, effective and quick,” says Dr. Torgerson. “You can go to lunch immediately following an appointment.”