What is filler? Where can it be injected? How long does it last? Which brand should I choose?

If you feel that your face looks tired, has deep lines, flat skin, lacks dimension, or your face shape is not as proportionate as before… fillers may be the answer to help restore your freshness and confidence without surgery.

In this article, the doctor will help you understand everything about fillers, from working principles, injection sites, which brands are good, how long they last, to how to take care of yourself safely, so that you can make a confident decision and get the beautiful results you want.

What is filler?

Filler is a substance that dermatologists and aestheticians use to inject into the skin to help fill in areas that have sagging, deep lines, or lack volume, such as the cheeks, under the eyes, temples, or even to adjust the face to look softer and more youthful.

The most popular and safest filler today is Hyaluronic Acid (HA) , a substance naturally found in the body. It has good moisture retention properties and can be dissolved without leaving any residue.

How many types of fillers are there?

In medicine, fillers can be divided into several types, but the two main types used in cosmetic clinics are:

• HA (Hyaluronic Acid) filler: This is the most popular filler because it is safe, naturally dissolving, and if a problem occurs, the drug can be injected to dissolve it immediately (Hyaluronidase).
• Semi-permanent or permanent fillers: Such as Calcium Hydroxylapatite or Poly-L-lactic Acid, although they last longer, are not biodegradable, so they pose a higher risk for those who are inexperienced.

From the experience of the doctor who has treated many patients, HA filler is the most recommended option, especially for beginners or those who want natural and safe results.

How are fillers different from Botox?

Many people are still confused between “ fillers ” and “ botox ”, which actually have different functions.

• Filler = Fill (fill deep wrinkles, adjust the face shape to look voluminous)
• Botox = Reduces muscle activity (reduces wrinkles, slims the face by reducing the jaw muscles)

Therefore, if you have deep wrinkles, a sunken face, or dull-looking skin, the doctor will recommend a filler injection first.

Which areas are suitable for the filler injections?

In fact, “fillers” are considered a very flexible aid because they can be filled in many areas on the face and body. The main purpose is to fill in deep grooves, add volume, and adjust the face to be naturally proportional. The areas where fillers are popularly injected today include:

Under eye filler

Under-eye fillers help reduce deep wrinkles, dark circles, and tired-looking eyes, instantly making your face look brighter. They are ideal for people who don’t get enough sleep or have deep eye sockets due to genetics.

Cheek filler

Fills deep wrinkles due to age, helps the face look younger and reduces the appearance of fatigue. Suitable for both men and women.

Temple filler

People who have sunken or deep temples will have a hard and old look on their face. Filling the temples will help adjust the shape of the face to look softer and more balanced.

Forehead filler

Flat or sunken foreheads can be filled to make them look naturally prominent, adding dimension to the face and making the face clearly sweeter.

Chin filler

Used to adjust the face shape to be proportionate. For those with a short chin, a cut chin, or an unclear face shape, chin filler can help make the face look slimmer without surgery.

Lip filler

Add volume to the lips to make them fuller or adjust the shape of the lips to be balanced and natural, such as a Cupid's bow or Western-style lips.

Nose filler

Although it cannot replace surgery 100%, fillers can help adjust the shape of the nose to look sharper and more defined. It is suitable for those who do not want surgery.

Filler for nasolabial folds / crow's feet

Reduces the depth of wrinkles that show signs of aging, especially around the nasolabial folds, wrinkles at the corners of the mouth and around the eyes.

Back of hand filler

Fill in the back of the hand, where the skin is thin and the veins are clearly visible, to make it look fuller and more youthful. This is another point that many people start to pay attention to in their 40s.

Which brand of filler is good? Which area is it suitable for?

Choosing the right filler for each area on the face is not just about “price” or “brand”. It also requires considering the “ filler texture ” to see if it is suitable for the injection area and the doctor’s expertise in choosing the right one for each patient’s facial structure.

Juvederm® (USA)

• Features: The filler is soft and smooth, giving a smooth result, very moist, lasting for 12-18 months.
• Popular models:
  • Voluma: Slightly firm texture, suitable for cheekbones, temples, chin.
  • Volift: Medium texture, used for cheek grooves and lip edges.
  • Volbella: Extra soft texture, suitable for under eyes, lips, and small lines.
• Suitable for: Under the eyes, cheekbones, nasolabial folds, chin, temples, forehead, mouth

Restylane® (Sweden)

• Features: Fine filler texture, good stability, suitable for detailed molding.
  Popular models:
  • Lyft: Suitable for areas that require lifting, such as the cheekbones and chin.
  • Defyne/Refyne: Medium soft texture, suitable for the cheek grooves and nasolabial folds.
  • Vital: Restores skin, replenishes water, suitable for dry skin or shallow wrinkles.
•  Suitable for: Under the eyes, cheeks, marionette lines, mouth, cheeks, forehead.

Belotero® (German)

• Features: Very soft and fine texture, naturally fluffy, absorbs well into the skin.
• Popular models: Soft / Balance / Intense: separated by the density of the texture, suitable for areas with thin skin, such as under the eyes, small deep wrinkles
• Suitable for: Under the eyes, cheeks, lips, crow's feet

Neuramis® (Korea)

• Features: Good quality Korean filler, affordable price, suitable for beginners.
• Popular models: Deep / Volume: Suitable for chin, cheeks, temples, deep grooves.
• Suitable for: Cheeks, chin, cheek grooves, mouth (must be used with an experienced doctor to control the results accurately)

Revolax®, Dermalax®, EPTQ (other Korean fillers)

• Features: Economical price, popular among beginners, available in many models depending on the density of the meat.
• Suitable for: Light filling of cheeks, chin, and nasolabial folds (lasts for about 6-8 months)

How long do fillers last?

The duration of filler depends on many factors such as self-care, daily life, etc., which vary. The average duration for each brand is as follows:

This information is an average from clinical studies and the actual experience of doctors in the clinic.

Factors affecting the lifespan of fillers

1. Brand and model of filler Each filler model has a different molecular density, which directly affects its durability.
2. Injection sites Areas that “move a lot” such as the mouth, cheeks, filler will break down faster than still areas such as the temples, chin, under the eyes. Filler tends to last longer than other areas because it doesn’t move much.
3. Daily activities such as heavy exercise, heat treatments, or behaviors that cause a rapid metabolism will accelerate the breakdown of the filler.
4. Post-injection care: Avoid extreme heat, vigorous massage, or drinking alcohol for the first 48 hours to help extend the life of the filler.

Although the filler will dissolve on its own, some people may choose to refill it before the filler is 100% gone to maintain the beautiful and smooth results continuously. Refilling in small amounts and at the right time will help the face look more natural and you don't have to refill a lot at once.

How to choose a filler that suits your problem?

Choosing the right filler doesn't just depend on "where you want to inject it", but also requires consideration of:

• Individual problems
• Filler texture characteristics (soft-firm-elastic)
• Location to be injected
• What kind of results do you expect?

Because each area on the face has a different "skin structure", a filler that is suitable for under the eyes may not be suitable for the chin, or a filler that lasts long on the temples may make the mouth look stiff and unnatural.

Soft fillers: For thin skin, high-risk areas

• Suitable for: Under eyes, lips, forehead, crow's feet
• Features: Good dispersion, smooth, no lumps.
• Recommended fillers: Juvederm Volbella, Belotero Soft, Restylane Vital / Kysse

Medium filler: For general deep wrinkles

• Suitable for: nasolabial folds, marionette lines, corners of the mouth
• Features: Good shape retention, moves naturally with facial expressions.
• Recommended Filles: Juvederm Volift, Restylane Refyne/Defyne, Neuramis Deep

Firm filler: for facial contouring

• Suitable for: Chin, temples, cheekbones, jawline
• Features: Gives clear dimensions, lifts and tightens, lasts long.
• Recommended Filles: Juvederm Voluma, Restylane Lyft, Neuramis Volume

Specific problem cases

Do not choose fillers based on “promotions” or “one brand for the entire face” because each area requires the “right type” of filler to achieve good and safe results. The doctor will plan for you specifically for each area to achieve the “natural results that you really want”.

Who is suitable for filler injections?

In fact, filler injections are not just a matter of "age", but rather depend on the characteristics of the facial problems and the patient's expectations.

1. People who are starting to develop “wrinkles” or “deep lines” on their faces. If you start to notice small deep lines under your eyes, cheeks, or your face starts to lose moisture, it may be a good time to get fillers to slow down the skin’s sagging and keep your youthful look longer.
2. Some people who have had an imbalanced facial structure since birth do not have wrinkles but feel that their face looks unbalanced, such as a flat forehead, short chin, or sunken temples. Fillers can help adjust the face to be more balanced without having to rely on surgery.
3. For those who want to change their look naturally, fillers are ideal for those who want to “change their look” while still maintaining their own identity, such as adding fuller lips, adding a chin to make the face look slimmer, or adding cheekbones to make the face look sweeter, without looking fake or over the top.
4. People with a busy lifestyle who don’t want to rest. This procedure is suitable for people who don’t have time to rest, such as working people who have to meet clients all the time or mothers who have limited time because after the procedure, you can live your life normally and see the results immediately.
5. People who have to use their looks for work, careers that rely on their personality, such as presenters, actors, salespeople, coaches, or consultants, often choose to use fillers to boost their facial confidence without having to wear a lot of makeup or change their facial structure to look unnatural.
6. People who want to change the results of the original procedure. Some people have had filler injections before and feel that their face has changed or do not like the original results. Coming back to plan again with a specialist doctor will help "fix" and "adjust the shape of the face" to return to naturalness again.

What can fillers help with?

1. Restore volume lost from facial fat collapse. As we age, facial fat gradually collapses, especially around the cheeks, temples, and under the eyes, which makes the face look worn and aged. Fillers help restore fullness to the face, making it look younger and fresher immediately.
2. Fill in deep lines and wrinkles without surgery. Whether it's the cheeks, marionette lines, or wrinkles around the eyes, fillers can help fill in the skin in those areas to make it look shallower, making the face look smoother without surgery.
3. Adjust the facial dimensions to look more balanced and soft. Fillers help create balance in the face, such as filling in the chin to make the face look longer or filling in the forehead to make the face look sweeter, including adjusting small points such as the edge of the mouth or the frame of the face to look clearer and softer.
4. Solve the problem of shadows on the face that make you look tired. Some parts of the face when sunken down will create shadows that make the face look tired, such as shadows under the eyes, cheek grooves, or sunken temples. Filler helps fill in the light to spread on the face better, making the face look brighter even without makeup.
5. Boost confidence and attractiveness. Fillers help many patients feel more confident, whether it's socializing, working, or taking pictures, while still looking natural and still being themselves.
6. Reduced need for makeup. When the face looks naturally fuller, voluminous and balanced, many patients can wear less makeup or no longer need to use heavy shading/contouring techniques because their facial structure looks good from the ground up.

How should I prepare before getting filler injections?

Filler injection is a procedure that requires high precision and is directly related to the blood vessels on the face. Therefore, preparation before the procedure is very important. The doctor recommends the following practices that should be done in advance.

1. Study and select a hospital for filler injections that has standards, is reliable, and has a clear registration number.
2. Avoid taking NSAIDs and supplements that affect blood clotting. You should avoid them at least 3-7 days before the procedure , including aspirin, ibuprofen, vitamin E, fish oil, ginseng, garlic extract, and ginkgo biloba, because these substances will slow down blood clotting, increasing the risk of bruising or blood clots after the injection.
3. Avoid drinking alcohol 24 hours before the procedure. Alcohol dilates blood vessels and disrupts circulation, which can cause swelling, bruising, or an increased risk of bleeding under the skin .
4. Avoid harsh skin treatments before the procedure. Avoid laser, HIFU, RF, IPL, Chemical Peel or treatments that deeply disturb the facial skin for at least 3-5 days before the injection to make the skin strong and ready to receive the filler fully and reduce the risk of irritation.
5. Get enough rest. Your body must be ready. Patients who do not get enough sleep or are not feeling well may have low immunity, which makes them swell easily, recover slowly, or are more susceptible to infection than usual. Doctors recommend getting enough sleep at least 1 night before the injection.
6. Do not wear makeup or cream on the day of the appointment. For maximum cleanliness and safety, you should come with a clean face. Do not apply foundation, sunscreen, or thick moisturizer because it may contaminate the injection site and increase the chance of infection. If you wear cream or makeup, you should inform the doctor to cleanse your face before the injection.

What is the filler injection procedure like?

1. Assess your face thoroughly before the procedure. The doctor will assess your facial structure, the problems that need to be fixed, and your skin condition. Plan where to inject, how many cc's to use, which type of filler is suitable, and explain the expected results that are natural and not exaggerated. If you have a chronic disease, you should inform the doctor before the procedure.
2. Cleanse the face and apply anesthetic. The staff will wash the face and apply anesthetic to the entire area to be injected. This takes about 30–45 minutes. The anesthetic reduces pain and makes the patient feel comfortable during the procedure.
3. Filler injection : During the injection, you will feel only slight pressure. Generally, it takes 10-30 minutes per location, depending on the complexity.
4. Check the balance and spread the filler. After the injection, the doctor will make minor adjustments if necessary, such as checking the facial symmetry and gently massaging to help the filler spread smoothly.
5. Take Before-After photos and make a follow-up appointment. Most clinics will take comparative photos before and after the injection. In some cases, the doctor may make a follow-up appointment in 1-2 weeks to evaluate the results or add more if necessary.

After filler injection, how do you take care of yourself?

Although filler injections do not require recovery time, taking care of yourself during the first 24–72 hours is very important because this is the period when the filler is setting. If not taken care of properly, swelling, bruising, or undesired results may occur.

Things to do after filler injections

1. Apply a cold compress gently for the first 24 hours and drink gotu kola or pumpkin juice to help reduce swelling and minor inflammation after the procedure.
2. Drink plenty of water, especially if you have hyaluronic acid fillers, as this substance can absorb water and swell well. Drinking water will help your skin look fuller.
3. Sleeping with your head elevated on the first night will help reduce swelling and prevent unintentional compression of the filler.
4. Return to your doctor for scheduled appointments (if any) to assess the results and add more if necessary in certain areas.

Things to avoid after filler injections

1. Do not touch or massage the injection area hard as this may cause the filler to move or become misplaced.
2. Avoid laser / RF / HIFU / sauna / hot yoga for at least 7 days as the heat may cause the filler to deteriorate faster than normal.
3. Avoid strenuous exercise for the first 24–48 hours to prevent blood vessel dilation, which may increase bruising.
4. Avoid drinking alcohol and pickled foods for 2-3 days after filler injection.
5. Avoid massaging your face, sleeping face down, or putting your face against a pillow for at least 3–5 days to allow the filler to set completely.
6. Avoid using cosmetics or facial care products for 24 hours after filler injection.

Slight swelling, redness, or bruising in the first 1-3 days is normal. However, if there are any abnormal symptoms, such as severe pain, severe pain when pressed, or pale or purple skin, it is recommended to contact the clinic or see a doctor immediately, as these may be signs of complications that require specialized care.

How much does filler cost?

The price of fillers at cosmetic clinics varies depending on the brand, model, amount used, and injection location. Generally, it is calculated as “price per 1 cc (cc)”.

This price is an average price rate from standard clinics in Thailand, which may increase or decrease depending on promotions or techniques used.

Amount used per popular injection site (preliminary estimate)

• Under eyes: 1–2 cc
• Cheek groove: 1–2 cc
• Chin: 1–2 cc
• Temples: 2–3 cc
• Mouth: 1–1.5 cc
• Forehead: 2–4 cc

Some areas may require multiple cc's to achieve a balanced result, such as the temples or forehead.

Factors affecting the price of fillers

1. Brand and country of manufacture : European-American fillers are more expensive than Korean fillers, but have more research to support them.
2. Injection location : High-risk areas such as under the eyes or areas requiring high precision. The price will be higher depending on the technique.
3. Doctor's experience : Facial contouring specialists tend to charge higher fees than general practitioners.
4. Techniques and instruments used : Use of blunt needles, Face Design assessment, or Ultrasound guidance may increase costs.
5. Promotions/Packages in each clinic

Are fillers dangerous?

This question is very common, especially for those who have never had filler injections before. I understand that many people are concerned about “safety” or “will there be any side effects?”

In fact, fillers are considered a very safe procedure if performed by a specialist and using genuine fillers approved by the FDA. However, there are still some risks if not properly cared for.

What is the safety of fillers?

1. Filler brands must use only FDA-approved Hyaluronic Acid (HA) fillers, such as Juvederm, Restylane, Belotero. This group of fillers can naturally dissolve and has the “hyaluronidase enzyme” to help dissolve it if there is a problem.
2. Injection technique by the doctor If the doctor understands the facial structure and the location of the blood vessels, he/she will be able to avoid risk points and use techniques that reduce pain, swelling, and bruising accurately.
3. Clinic cleanliness and system The clinic must meet standards, use new needles every time, sterile equipment, and have a system for following up on results after injection.

What are the risks if done carelessly?

• Fake or substandard fillers : may cause inflammation, lumps, or be non-degradable.
• Injection by an inexperienced doctor or a quack doctor : risks injecting into the wrong layer of skin or into a vein, which may cause serious complications such as skin necrosis or, in severe cases, blindness.
• Lack of proper aftercare : such as repeat laser treatments or excessive pressure massage, may cause the filler to move or cause an irregular result.

How many side effects are there of fillers?

Side effects can be divided into two main categories: common (normal) symptoms and atypical (complications).

1. Common symptoms after filler injection (common and will go away on their own) These symptoms usually go away on their own within 2-7 days and are not considered dangerous, such as:
   • Redness and swelling at the injection site (usually most swollen in the first 24 hours)
   • Bruise or bruise from small needle marks
   • Slight pain or numbness, similar to pain when a point is pressed.
   • Rough skin / small lumps in the first 1–2 days, which usually smooth out on their own once the filler has set.
   • Post-injection care to help these symptoms improve quickly, such as applying cold compresses or avoiding vigorous massage.
2.  Abnormal symptoms (complications) If you experience these symptoms, you should see a doctor immediately because they may be a sign of incorrect injection or a problem with the blood vessels, including:
   • Severe, unusual, and persistent pain
   • Pale skin or a dark purple/black discoloration, which may indicate a blocked blood vessel.
   • Numbness in the injection area
   • Blurred vision, abnormal vision, or sudden eye pain (very rare, but an emergency)
   • There is pus or skin inflammation at the injection site that is red and hot.

If these symptoms are treated immediately, there is a good chance of recovery. However, if left untreated, they may cause long-term side effects, such as dead skin, damaged blood vessels, or permanent scars.

How to prevent or manage side effects

Preparation before the procedure, choosing an experienced doctor, and taking care of yourself after the injection all affect the chance of side effects. Therefore, the doctor summarizes the guidelines for both prevention before the procedure and solutions when symptoms occur.

How to prevent side effects before injection

1. Choose only authentic fillers that are FDA approved. They should be Hyaluronic Acid (HA) that can be dissolved and have clear documentation.
2. Injection by an experienced specialist. A doctor who understands the facial structure will be able to precisely avoid blood vessels and skin layers that are at risk of complications.
3. Avoid taking medications and supplements that make it difficult to stop bleeding, such as vitamin E, fish oil, and aspirin, before the procedure to prevent easy bruising.
4. Check the clinic to ensure it meets standards, uses new needles, sterile equipment, and has a support system in case of an emergency.

How to deal with minor side effects

• Swelling, bruising, redness, apply a cold compress gently for the first 24–48 hours and avoid pressing or touching the injection site. Most will resolve on their own in 3–7 days.
• If you feel a small lump or uneven skin, do not massage it yourself. You should have a doctor assess it first because some areas may need to be left for the filler to set on its own.

How to manage severe complications

If any abnormal symptoms occur, such as pale skin, severe pain, dark purple skin, or eye problems, you should see a doctor immediately. The initial treatment methods are as follows:

1. Uses Hyaluronidase as an enzyme to break down HA fillers, which can dissolve the fillers immediately.
2. Give vasodilators/anti-inflammatory drugs only in certain cases to prevent tissue death or blood clots.
3. Monitor symptoms closely and may schedule a follow-up appointment in 24–48 hours to assess whether they are safe.

When will filler results be seen? How often do I need to inject it?

Fillers are a procedure that can show results very quickly, especially if using a genuine filler, Hyaluronic Acid (HA), which is certified by the FDA, which is designed to fit into skin tissue and provide natural-looking results.

When will filler results be visible?

• The results are immediate after the injection. The face will look fuller and more defined at the injected area, but there may still be some swelling, which is normal.
• The real results will be apparent in 5-14 days after the swelling has gone down and the filler has started to settle into the skin better.
• In some cases, an evaluation and adjustment appointment may be made in the second week to ensure the most balanced results.

How often do I need to inject?

The frequency of filler injections depends on many factors, such as the brand used, the injection location, and each person's skin type.

If it is an area that moves frequently, such as the mouth or cheeks, the filler will break down faster than in still areas, such as the temples, chin, and under the eyes.

So when should I refill it?

It is recommended to come back for an evaluation before the filler has completely dissolved, so that the results remain consistently beautiful and there is no need to refill a large amount again, such as:

• Reapply partially every 8 – 12 months.
• If injecting to adjust the shape of the face, it is recommended to plan long-term with the doctor. You may divide some injections 1-2 times a year instead of injecting a large amount at once.

How to tell if filler is genuine?

“ Genuine filler ” does not necessarily have to be the most expensive, but it must have a clear source and be verifiable. A simple technique for checking genuine filler that everyone can do.

Check the filler box before injecting.

1. Must have a Thai label and be properly registered with the FDA. Look at the FDA registration number (starting with "W" or "FDA") and must have clear importer information and company name.
2. The serial number and lot number must match on both the box and the tube. The numbers should be clearly printed and not peel off.
3. There are QR Codes or anti-counterfeiting stickers. Some brands can be scanned to check the source immediately via website or application.
4. The box must be tightly sealed, not dented, and not opened beforehand. The clinic should unpack the box in front of the patient every time.

Observe the characteristics of the product

• The filler tube must be made of a clear material so that the gel inside can be seen.
• There is a label indicating the brand, model and serial number that matches the box.
• Vacuum packed (Sterile Packaging)

Questions to Ask Before Injection

• What brand of filler?
• Can I see the actual box before injecting?
• Is there a certificate or record of product lot information?
• Did you actually get the injection from a doctor?

However, don't forget to take a photo of the box + Serial Number every time you spray for long-term safety.

Summary

Fillers are substances that help fill deep wrinkles, adjust the shape of the face, and restore youthfulness to the face naturally and are highly safe. They can naturally dissolve and do not remain in the body. It is a popular procedure for beauty clinics. The results are seen immediately after the procedure without surgery. It is suitable for both those who are beginning to have wrinkles and those who want to adjust small points on the face to be more balanced.

Filler injections are a very popular procedure today. They can adjust the shape of many areas of the face, give a natural look, and are very safe. In this article, the doctor will introduce you to fillers. What are fillers?