What are Injectable Dermal Fillers?

Dermal fillers are gel-like substances that are injected beneath the skin to restore lost volume, smooth lines and soften creases, or enhance facial contours. More than 1 million men and women annually choose this popular facial rejuvenation treatment, which can be a cost-effective way to look younger without surgery or downtime.

Instant results, quick treatment, and little to no downtime contribute to filler treatments’ popularity

Filler Myth #1: All dermal fillers are the same.
Filler Myth #2: Dermal fillers will make me look unnatural and a different person.
Filler Myth #3: Dermal fillers and botox are the same.

How is dermal filler done? 

Commonly via needle or a micro-cannula, which reduces pain and bruising.

Nose fillers, to enhance your nose bridge, tip and body. For the perkier, sharper you. Non surgically, with minimal pain, downtime and bruising. Results are instant. Nose fillers can be used to correct a flat nose bridge, a down pointing nose tip, and a dorsal hump, all common in Asians. It cannot be used to make a nose smaller. To do so visually, there are options. In the grand scheme of things, it is important for the nose to harmonise with the rest of your facial features. Keeping things natural, simple and beautiful.

Nose Threadlift:  

What are Possible Results To Expect?
The procedure is suitable for anyone who has not had surgical rhinoplasty or permanent fillers. 

What are Possible Results To Expect?

1. Smoothen the nose profile
2. Raise the nose bridge
3. Lift the nose tip

Results of the Nose Threadlift generally last 12 to 18 months. Number of threads vary and depend on your nasal profile and expectation.

Above is an example of nose fillers done to correct the sunken nose bridge, a common issue in Asians.

1.2 Chin Fillers

V shapeThe focus of V shaping, the secret to a slimmer, sharper face shape. Chin fillers can be used to correct a receding chin, a short chin, a chin that is sunken.

Asians have a short chin, and more often than not, lacking in projection. Chin fillers, if done in key positions, can simulate a chin implant.

Chin fillers do not change your bone structure. A series of chin fillers for the tapered, defined V look, with a sharper, more defined chin. Above, you see examples of chin filler and jaw botox done, to create the Korean Ultra V shape look.

How long do fillers last in laugh lines? How much does it cost to get laugh lines filled?
What are the best fillers for smile lines? What happens after fillers in laugh lines?

Laugh line fillers last on average 6-9 months, due to it being an area of dynamic movement, hence wearing out fillers faster. A syringe starts from $800 and one would at least need 2 for best results. The best fillers for laugh lines has to be those that are easily reversible, as its common to be lumpy over this area. Normally after laugh line fillers, one can expect temporary swelling, and in some cases, temporary bruising. Laugh lines occur due to sagginess and descent of the midface. The cheek fat gravitates downwards, and causes the sunken look. Hence the key is to lift, reposition and restore your midface volume FIRST. Overfilling of the laugh lines results in a stiff and un-natural look.

What’s the best filler for marionette lines?
How long does filler last in marionette lines?
Can fillers help with marionette lines?
How do you fill fillers with marionette lines?

Being an area with little soft tissue, its best to use a softer filler here. In my clinical experience, pure Hyaluronic acid fillers work best here. These fillers last an average of 6 to 12 months. Fillers done in the right place with the right amount helps soften marionette lines. They can be filled via a microcannula or directly with a sharp needle. Marionette lines or puppy lines form as a result of ageing and photodamage, causing collagen loss and subsequent saggy skin.

How much are fillers in the temple?
How do you fix a sunken temple?
Is it safe to inject filler in temples?

Temple fillers cost start from $800 per syringe. 2 syringes are needed for optimum change visually.  Sunken temples can be nicely filled with fillers, to reduce a bony appearance to your face. It is safe if done by experienced clinicians, but of course, no injection is 100 percent safe. Fillers Temple volume loss is common in women. Temple fillers help to frame your face, and tighten your contours. It is an often neglected area. 3 key take home messages.

Lip fillers serve 3 purposes, shape, volume and projection. Asians tend to lack full lips, so the Angelina Jolie and Shu Qi type lips are a rarity. Curvier lips, with good volume and projection can give the illusion of youth and vitality. Areas to focus on in Asians include the cupid’s bow, the lip projection and harmonising with the nose tip and chin.  Lip fillers do not change the shape of your lips, they enhance, project and define. 

Beautiful, well balanced, natural, Asian lips

What is an attractive pair of lips? What is the cost of lip fillers?

Cost starts from $900 per syringe. For an attractive lip, the upper lip should project around 2mm further than the lower lip.

Indication: 

1. Lip fillers can be used to add volume, definition and character to a face.
2. Asian lips and the concept of asian beauty differs with caucasians.
3. Every face is unique and will respond differently.

Dark eye circles are common in Asians. They manifest due to 3 key reasons.

1) Thin skin
2) Blood vessel congestion
3) Genetic and allergic
predisposition

Undereye fillers can help to fill the groove and brighten the undereyes, giving you an instant, fresher look. Undereye fillers cannot correct eye bags or excessively saggy skin. This is a job for blepharoplasty. Cost of undereye fillers start from $900 due to the complexity of this treatment. 

So what are dark eye circles?

It’s largely 2 issues, the discolouration and the puffiness.

Dark eye circles (discolouration) form as a result of vascular changes, shadowing, and pigments.

1. Vacular changes – which can be purple, blue, pink depending on the oxygenation in the blood
2. Shadowing – which is a direct result of ageing, where the skin develops fines lines and wrinkles and sags, and you lose volume in the cheeks
3. Pigments – which is the stimulation of your melanin cells, commonly as a result of sun exposure.

Are fillers good for forehead?
How much are fillers for forehead lines?
Is filler better than Botox for forehead?

Fillers help improve the contour of a flat and sloping forehead. Forehead fillers start from $900 a syringe due to the complexity of the procedure. Forehead fillers help to improve volume loss, while botox on forehead helps soften wrinkle lines. 

A high forehead is a sign of youth, vitality and prosperity. To create a harmonious forehead, it is essential to harmonise with your nose, cheeks and eyebrows. Generally, 2-4 syringes are needed, depending on your forehead contour and expected result. 

What is korean loveband treatment? 

The Aegyo sal or silkworm is a lovely cute roll just under the eye, not to be mistaken with eyebags which occupy a lower position and are lesss perky. This look, when carried off well, gives one a sweet, charming smile. Beauty is around the eyes of the beholder.And I really mean around.Our eyes, are the symbol of youth, vitality and charm.And just under the eye is this unique roll known as the charm-roll in Korea.The charm roll is a sign of beauty.

Many people have chubby cheeks and double chin. To some, it may be a fashion statement.  A symbol of power of and wisdom. To others, it is a curse. Hence some may go to Korea to undergo liposuction to achieve the perfect V shape look.

Today, I will share with you simple options available for reducing your double chin and chubby cheeks W/O liposuction. The medical term for chubby cheeks and double chin is excess Buccal Fat AND Submental Fat. Now all of us have it, however, in some cases, it is more visible due to a combination of reasons.

Where is buccal fat treatment done?

First is to understand where your buccal fat is located. Notice it is right in front of the jawline, hence contributing to a square jaw in Asians. Depending on the severity, the above options of non surgical vs surgical are available and will give a certain degree of efficacy.

For mild to moderate cases and a desire for non surgical intervention, combination treatment helps. This is my preferred approach. I call it the TIE approach.

• T: Threadlift and Microtoxin to provide skin firming and support
• I:  Injection – with collagen stimulators | Profhilo, Gouri
• E: Energy based devices – Skin tightening with Energy based devices RF, HIFU, Kiv Fat reduction via fat freezing

Double Chin can be fixed. It usually involves tightening your overlying skin, strengthening the underlying support and reducing the fat layer. Cost varies depending on the severity of your double chin and the combination of treatments to undergo. Surgical vs Non surgical treatments are the mainstay. Non surgical treatments last, on average a year or more, while surgical treatments last 5 years or more. 

How do we choose the right filler? What type of fillers are available?

Merz Boletero: An excellent product, their unique CPM technology provides pretty versatile fillers that blends seamlessly, hence I tend to like using them for sensitive areas like lips, undereye, forehead etc.

Juvederm : Their unique Vycross technology ensures long lasting effect (up to 2 years for Juvederm voluma) significant volume expansion compare to other fillers with the same amount, blend with surrounding tissues better and mixed with lidocaine inside, hence less painful during injection. It is very effective for your cheeks, laugh lines and submalar region. Often, good products come with slightly higher prices.

​Restylane : A time honoured and good product, and has a high G~ for a very effective lifting effect, hence brilliant for your chin, nose and jawline. Their NASHA technology enables this lifting while their new OBT technology ensures cohesive fillers.

Teoxane:  They have considered beauty in every dimension and have developed a best-in-class solution to preserve your natural self after dermal filler treatment with their most innovative development: Resilient Hyaluronic Acid (RHA). With Teoxane filler, results are quick and long lasting with minimal downtime.

Collagen stimulators: Radiesse and Sculptra and Asthefill

These are two of the longest lasting fillers on the market today. Sculptra ans Asthefill last longer, with results sustaining for up to 24 months. The results of Radiesse typically last for up to 1 year. The results of both fillers can be sustained by undergoing periodic maintenance treatments.

Sculptra needs anything from a few weeks to a month before desired final outcome may be obtained. Radiesse is a little bit different in that it delivers an instant volumizing effect (because of the highly viscous nature of the substance), in addition to the long-term advantage of longer collagen production. This makes Radiesse a unique product.

Skin rejuvenating agents | Anti ageing essentials: Profhilo, Gouri, Skinboosters, Volite, RD1

Gouri is effective for use and KFDA approved for forehead and periocular collagen stimulation. It has firming and skin rejuvenation properties. It is the newest product in the market. It is a PCL based product, similar to Ellanse but works on collagen stimulation like Sculptra.

Profhilo has good hydration and firming properties, being a pure grade hyaluronic acid product. It is a fair anti ageing agent. Its price is controlled at SGD 1k per syringe.

Skinboosters, Volite, Redensity 1 are all pure hyaluronic acid products that deliver much needed hydration to your skin. These are time tested, proven and traditional anti ageing rockstars.

Do note:

For patient’s comfort purposes, some hyaluronic acid gels have added Lidocaine. In any given case, the physician is expected to inform you on the choice of products and actions.

What are the Dos and Donts of dermal fillers?

Dermal Fillers Process

The length of procedure varies depending on the number of areas to be treated. Pain is very minimal, minority of patients may have swelling or bruising, and majority of patients can continue their daily activities, with satisfying results.

Number of injections

When possible, our patients are invited to come over once again after a couple of weeks so we can re-evaluate the treatment area and determine if any touch-ups are necessary.

Effects of filler injection

The effects of contouring immediately become apparent after the first procedure. Since little swelling around the injection area is to be expected considering the very high quality of fillers.

 ​Post-injection care

It is advisable for patients to avoid taking blood thinners, exercising and exposing the treated area to bright sun for 2 days following the intervention. 

How much do dermal fillers COST ? How much filler will I need?

A full consultation is necessary to achieve an accurate assessment and evaluation. As a general rule of thumb,

​

Under eyes and periorbital area   need 1-2 cc.

Nasolabial fold                                 need 1-2 cc.

Lips augmentation                          need 1-2 cc.

Temporal augmentation                need 1-2 cc.

Check augmentation                       need 1-2 cc.

Chin augmentation                         need 1-2 cc.

Jaw augmentation                          need 2-4 cc.

Hand volume restoration              need 2-3 cc.

Dr Daniel Chang

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