Dermal fillers.
A gel made from hyaluronic acid is placed under the skin to replace volume that has been lost, or to give structure where there was never much. It works on the shape of the face rather than on the surface of the skin.
It replaces volume, it does not relax anything.
Hyaluronic acid is a sugar molecule your body already makes and already holds in the skin. It binds water, which is why it fills. For injection it is cross linked into a gel, and how tightly it is cross linked decides what it can do. A firm gel placed deep against bone gives structure to a cheek or a jawline. A soft gel placed shallow gives a lip its shape without looking solid.
That distinction matters more than the amount used. Using a firm structural gel in a lip is what produces the stiff overfilled look people are afraid of, and using a soft gel to rebuild a cheekbone produces nothing at all.
The body breaks it down gradually with an enzyme it already produces, which is why it fades rather than stopping suddenly, and why it can be dissolved on purpose if there is ever a reason to.
What it treats, and what it does not.
Commonly treated
- Lip volume, shape and definition of the border
- Flattening of the cheek, and the shadow under it
- Chin projection and jawline definition
- The folds running from nose to mouth corner
- The lines running down from the mouth corner
- Hollowing at the temple
- Tear trough hollowing, which is the most technical area on this list
- Volume loss on the backs of the hands
Not what this does
- It does not soften a line made purely by movement. That is muscle, and it needs wrinkle relaxing injections.
- It does not improve skin quality, texture, pores or scarring.
- It does not lift loose skin. Past a certain point the honest answer is a surgical opinion, not more product.
- It does not treat pigmentation or the brown discolouration under the eyes, which is often skin rather than shadow.
- It does not make a face look like someone else's. Anatomy sets the ceiling.
What actually happens.
Assessment
Medical history, medication and previous treatment first, including any filler you have had before and roughly when. Then the face is looked at in motion and at rest, because the area you point to is often not the area causing what you see.
Numbing
Topical anaesthetic for most areas, and longer for lips, which are the most sensitive place on this list. Most modern fillers also carry a local anaesthetic inside the gel itself.
Marking
Entry points marked, and the plan described before anything is injected. This is the moment to say if you want less than what is being proposed.
Injection
Either a fine needle or a blunt cannula depending on the area. A cannula moves through tissue rather than piercing straight down, which reduces bruising and lowers the risk in areas with vessels running through them.
Moulding and check
The gel is shaped by hand, and you are given a mirror while you are sitting upright. Symmetry is judged with the face at rest, not while you are smiling at your own reflection.
Review
Around two weeks later, once swelling has fully gone. Filler can always be added. Judging the result on day two, when lips in particular are at their most swollen, is judging the swelling.
Recovery, described honestly.
This has more visible downtime than most people expect, and lips have the most of all.
- Swelling starts within hours and peaks around day two. Lips can look substantially bigger than the result you agreed to, and that is normal.
- Most swelling has gone by day seven. The final result is at about two weeks.
- Bruising is common, more so with a needle than a cannula, and more so on blood thinners or fish oil. It covers with makeup after a day.
- Sleep with your head raised for the first two nights, and use a cold compress rather than heat.
- No heavy exercise, sauna or hot yoga for forty eight hours.
- Avoid dental work for two weeks either side, since the pressure and the bacteria both matter.
- Small lumps in the first fortnight usually settle. Ones that are still there after two weeks get looked at rather than waited out.
Vascular occlusion, and why it is discussed openly.
This is rare, and it is the reason filler is a medical procedure rather than a beauty treatment. Any clinic that will not discuss it is the wrong clinic.
What it is
Filler placed into or pressed against an artery can block the blood supply to the skin it feeds. Left unrecognised it damages that skin, and in the areas around the nose and eyes it carries a small risk to vision.
What makes it manageable
- Hyaluronic acid filler can be dissolved. An enzyme called hyaluronidase breaks it down within hours, and any clinic injecting it should hold it on site.
- The warning signs are recognisable and worth knowing: pain out of proportion to the procedure, skin that goes white and stays white, or a dusky mottled discolouration appearing over the following hours.
- Speed is what changes the outcome. Any of those signs is a same day phone call, not a wait and see.
- Cannulas, conservative volumes and slow injection all reduce the chance of it happening at all.
Reasons this is declined or postponed.
Standard across any clinic. Raised here so it is known before an appointment rather than at one.
- Pregnancy and breastfeeding
- Active infection, inflamed skin or a cold sore anywhere near the injection site
- A previous allergic or inflammatory reaction to hyaluronic acid filler
- Autoimmune conditions in an active flare, which is a discussion rather than an automatic no
- Blood thinning medication, which does not rule it out but changes the bruising conversation
- Permanent or semi permanent filler already in the area from elsewhere, since it cannot be dissolved and it changes what is safe to add
- Anyone under eighteen seeking it for cosmetic reasons
- Expectations that no amount of filler will meet, where the honest answer is a different treatment or none
When something else is the better answer.
Filler is the most requested treatment on this site and frequently the wrong one.
| Option | Where it genuinely wins | Where it does not |
|---|---|---|
| Dermal filler | Volume that has gone, structure that was never there, and folds present whether you move or not. | Lines made by movement, skin quality, and skin that has become loose. |
| Wrinkle relaxing injections | Frown lines, forehead lines and crow's feet, which are made by muscle. | Anything to do with lost volume or facial structure. |
| Skin treatments | Texture, dullness, fine crepey lines and scarring, over a course. | Shape. No skin treatment rebuilds a cheekbone. |
| A surgical opinion | Skin that has descended rather than deflated. Filling a face that needs lifting makes it heavier, not younger. | Cost, downtime and reversibility all move against it. |
| Doing nothing | Entirely reasonable. Filler is elective, it is repeated, and stopping simply returns you to where you were. | Volume loss continues either way. |
Often asked about together.
About this treatment specifically.
Will it look obvious?
Obvious filler is almost always too much of it, placed too superficially, or placed in an area that needed something else. The result you are picturing when you worry about this is usually several millilitres over several years without anyone stepping back. Starting with less, and reviewing at two weeks before adding, is what prevents it.
Can it be removed if I hate it?
Yes, and this is the single biggest advantage of hyaluronic acid over every other material. An enzyme called hyaluronidase dissolves it, usually within a day or two. It is not free and it is not instant perfection, since it also dissolves some of your own hyaluronic acid, but it means no decision here is permanent.
How long does it actually last?
Six to eighteen months, depending on the area and the firmness of the gel. Lips are at the short end, because they move constantly and have a rich blood supply. A deep structural placement on the cheek or jaw is at the long end. Metabolism and exercise both shorten it.
Does it hurt?
Lips are genuinely uncomfortable and everywhere else is mild. Topical numbing is used, and most fillers contain a local anaesthetic that takes effect within the first few seconds of injection. The pressure is more noticeable than the needle.
What is filler migration?
Gel that has moved beyond where it was placed, most visibly as a shelf above the lip border. It is associated with repeated treatment before the previous filler has gone, with too much volume for the tissue, and with placement that is too superficial. It is one of the reasons a review appointment and a gap between treatments matter.
Can I have it before a wedding or an event?
Allow four weeks. Two weeks covers the swelling, and the extra fortnight leaves room for a review and any adjustment. Filler three days before an event is a decision made with no way back.
Is it safe under the eyes?
It is the most technical area on the face, and it is the one most often treated when it should not have been. It suits a true hollow with good skin quality. It does not suit puffiness, fluid retention or brown pigmentation, and treating those with filler makes them look worse. Expect this area to be declined more often than it is treated.
Call and describe what you notice.
416 475 324871 Albert Street, Oshawa, Ontario L1H 4R1.
Simok Aesthetics is a medical aesthetics clinic at 71 Albert Street in Oshawa, Ontario, offering injectables, skin treatments, PRP, vein treatment and IV nutrition therapy to patients across Durham Region.