Dermal fillers, how they work and what to ask first

What dermal fillers are

Dermal fillers are injectable gels placed under the skin to add volume, lift or contour. As we age, the face loses fat, bone and collagen, and areas that once looked full can look hollow or tired. Filler replaces some of that lost support.

The main types

• Hyaluronic acid fillers. The most common type. The gel holds water, gives an immediate result and can usually be dissolved by a provider if needed.
• Calcium hydroxylapatite fillers. A thicker gel often used for deeper support, such as along the jawline. Over time it also encourages the body to make collagen.
• Poly-L-lactic acid. A collagen stimulator that builds volume gradually over a series of visits rather than all at once.
• Polymethylmethacrylate fillers. A longer-lasting option used in specific situations, chosen with extra care because it cannot be dissolved.

Common areas

• Cheeks and midface
• Under-eye hollows, often called tear troughs
• Smile lines between the nose and mouth
• Chin and jawline
• Lips, see lip filler
• Temples and the backs of the hands

Fillers add volume, while neuromodulators such as Botox relax the muscles behind expression lines. Many plans use both. Read botox vs filler and the botox guide.

How the appointment usually goes

The visit starts with a consultation. The provider asks about your health history, medications and any previous filler, then assesses your face from several angles, at rest and in motion. Expect a conversation about proportion and balance rather than a single spot, since adding volume in one area often changes how another looks.

The skin is cleaned and often numbed. Many fillers contain a local anesthetic. The provider injects with a fine needle or a blunt cannula, shaping as they go and checking the result in a mirror with you. You may feel pressure and some stinging, and there is often a small amount of massage at the end.

Session length and how many sessions

Most appointments take 30 to 60 minutes. Hyaluronic acid fillers usually give a visible result in one session, with a check-in about two weeks later. Collagen stimulators such as poly-L-lactic acid usually take a series of sessions spaced weeks apart, because the result builds gradually. Maintenance visits keep the effect over time.

Recovery and aftercare in general terms

Swelling, tenderness and bruising at the injection points are common and usually settle within a few days to a week for many people. Swelling under the eyes can take longer to fully settle. Small lumps may be felt early and often soften as the filler integrates.

Providers often advise avoiding heavy exercise, alcohol, very hot environments and pressing on the area for a short time. Follow the instructions your own provider gives. Contact the clinic promptly if you notice severe pain, skin that turns pale or dusky, or any change in vision, since these need urgent attention.

How long results usually last

It depends on the product and the area. For many people, hyaluronic acid fillers last from about 6 months to well over a year, with filler in quieter areas such as the chin or cheeks lasting longer than in the lips. Collagen stimulators can last longer once the result has built. Metabolism and lifestyle also play a part. It varies, and no provider can promise an exact timeline. Read how long do dermal fillers last for a closer look.

Reasons a provider may say no or ask you to wait

A careful provider screens before treating and may decline or suggest waiting in cases such as:

• Pregnancy or breastfeeding
• An active skin infection, rash or cold sore in the area
• Certain medications, including blood thinners
• Certain autoimmune conditions or a history of severe allergic reactions
• A known allergy to any ingredient in the product, including lidocaine
• Recent dental work or an infection elsewhere in the body
• Previous permanent filler in the same area

Ask a licensed provider.

What it costs

Price varies by clinic, ask for a quote. Fillers are usually priced by the amount of product, and the type of filler matters as much as the quantity.

What moves the price

• The type and brand of filler
• How much product your plan needs
• The number of areas treated
• The provider's training and experience with facial anatomy
• Your city
• How often you return for maintenance

The American Society of Plastic Surgeons publishes national average fees each year in its procedural statistics report, and those averages exclude facility costs. Your local quote is the number that counts. For lips specifically, see lip filler cost.

Questions to ask at the consultation

• Who will inject me, and what is their license and training?
• Which type of filler do you recommend for this area, and why?
• Can this filler be dissolved if needed?
• How much product do you expect my plan to need?
• What does a natural result look like for my face?
• How do you handle complications, and is there a doctor on call?
• When should I come back for a check-in?

Find a clinic that offers dermal fillers

Search the directory for dermal fillers to see med spas and medical practices near you that list them, then request an appointment in a few steps. You can also browse every med spa near me by city.

Dermal filler questions