Over the last century, the life expectancy of the average UK citizen has increased by a massive 32 years. In 1901 women rarely made it past 49 and the average man died at 45. Access to sophisticated technology has enabled us to develop effective new drugs and treatments that prevent and cure a huge range of diseases that once would have killed us. Recent data suggests women now live until the age of 81 and men to 771.
Despite living longer, the visible signs of ageing still kick in not long after we stop growing. Even during our 20s, at the peak of adult skin health, the rate of skin cell renewal plummets by 28%, causing dead skin cells to settle on the surface. By our 30s, the damaging effects of pollution, smoking, drinking, bad diet and sunbathing start to take their toll on elastin and collagen production, causing skin to sag and lose its elasticity. By our 40s and 50s, sebum production (the oil that keeps skin glowing) plummets and fatty tissue depletes, causing skin to become thin, fragile and wrinkled. Now, because so many of us are living decades into old age, we want to maintain the glow of youth for a little longer. So much so, that we now have a whole anti-ageing industry worth around £25 billion2. People in the UK are so desperate to hold back the ravages of time that they spend £210 million on anti-ageing products every year2.
With new technologies come new treatments, and one of the newest anti-ageing procedures on the block is the dermal filler. This is a non-surgical 30 minute procedure involving the injection of a plumping solution into the dermis layer of the skin. When inserted directly into lines and wrinkles, the solution causes the sunken skin to rise to the level of the surrounding skin - temporarily making the wrinkle disappear.
What are dermal fillers?
Dermal fillers are non-surgical, temporary alternatives to cosmetic surgery. Unlike Botulinum toxin (Botox), which reduces the appearance and development of wrinkles by paralysing small facial muscles, dermal fillers simply plump out and fill in wrinkles, without affecting facial movement.
Not all dermal fillers comprise of the same chemical - different brands use different plumping solutions, (collagen, hyaluronic acid, calcium hydroxylapatites etc.) but they all serve the same principal functions:
- to reduce the signs of ageing
- to improve the look of scarring
- to alter facial structuring and contour (such as misbalanced features and defects).
Dermal fillers last for up to a year and are most commonly administered by dermatologists.
How dermal fillers work
Fillers are designed to instantly add volume to the dermis layer of the skin.
What is the dermis layer?
The dermis layer lies between the surface layer of the skin (epidermis) and the fatty layer beneath (hypodermis). It holds blood vessels, sweat glands, hair follicles and everything else the skin needs to function. All of this is held together by a tough connective tissue comprising of two proteins:
- elastin - for skin\'s elasticity
- collagen - for skin\'s firmness.
As we grow older, collagen and elastin production depletes significantly, causing skin to lose its firmness. Dermal fillers work by replacing these proteins and allowing dips and wrinkles to visibly rise with rejuvenated plumpness.
(To find out more about skin anatomy and the biological effects of ageing, please visit our Dermatology page.)
What are fillers made of?
Filler ingredients vary from brand to brand. There are many different filler brands available and each one involves the use of a slightly different plumping solution. Dermatologists select their fillers carefully, as some are more effective on certain kinds of lines and wrinkles than others. The two most common types of dermal fillers are:
1. Hyaluronic acid dermal fillers
This kind of filler is a gel made with hyaluronic acid particles. Hyaluronic acid works by promoting keratin production (the substance the surface layer of skin is predominantly made of), strengthening the collagen structure of the dermis and hydrating the skin. Young people have an abundance of hyaluronic acid, which keeps their skin looking healthy and hydrated.
This kind of dermal filler is recommended for moderate to severe wrinkles. The effects of hyaluronic acid last for up to a year.
Hyaluronic acid dermal fillers are usually recognised under the following brand names:
- Juvéderm® ULTRA
Hyaluronic acid fillers are the most popular of all the options in the UK, probably due to the fact that it\'s made with naturally occurring substances, meaning allergic reactions are rare. Also, the effects can be easily reversed simply by injecting a neutralising agent.
2. Collagen injections
In the 1970s, scientists testing anti-ageing treatments uncovered the astounding effects of cow collagen injected into human skin. Previously they\'d experimented by injecting substances such as paraffin and silicone into the skin - however, it turned out that the former was highly toxic and cancer-causing, and the latter was eventually banned for its high abuse potential. Collagen offered the safest, most effective option yet. Over the years, the collagen solution has been developed and improved to an increasingly high standard and, today, dermatologists more commonly use a synthetic version grown from human tissue in a lab.
Collagen injections last up to six months and are most effective on:
- frown lines
- crow\'s feet
- forehead lines
- lip border
- scar filling
- vertical lip lines.
Collagen injection brand names include:
Benefits of having dermal fillers
Of course, the main benefit of having dermal fillers is that they give skin the appearance of youth and vitality. Instead of tackling just lines and wrinkles, dermal fillers can improve the structure of the face and even hide surgical and acne scars. People most commonly choose dermal fillers for the following reasons:
- sunken cheeks
- weak chins
- thin lips
- deep lines between the nose and the lips
- smile lines/crows feet
- visible scars
- prominent veins
- aged hands
- frown lines.
Dermal fillers Vs Botox
Dynamic wrinkles (wrinkles that appear when we move our faces) can be prevented using Botox, which works by paralysing certain facial muscles. In a way, Botox is a preventative measure - if you can\'t form dynamic wrinkles then you\'re unlikely to form static wrinkles either (wrinkles that remain even when the face is in neutral position). Botox is a great option for deep wrinkles - especially those in the forehead, because they teach the client to stop using them (i.e. frowning). The effects become visible after about three or five days, and last for three to six months.
Dermal fillers are more effective for use on other areas of the face because they do not limit movement. Dermal fillers tend to be more expensive than Botox injections but they can often last for up to a year. They can also be a little more painful; however, an anaesthetic wipe will be used to reduce pain wherever possible.
Whereas Botox is used specifically to minimise wrinkles, dermal fillers can be used to plump up sunken cheeks, strengthen weakened chins and add definition wherever it\'s needed. You are advised to consult a dermatologist for further information about either of these treatments.
Dermal fillers Vs cosmetic surgery
The benefits of choosing dermal fillers over surgery are numerous:
- less invasive - no stress on the body
- no recovery time needed
- no risk from anaesthetic
- no painful recovery
- more natural looking
- temporary - if you don\'t like the effects you can have them reversed or just wait a few months.
Risks and side-effects of dermal fillers
No cosmetic procedure comes without its risks. However, compared to most dermatological and cosmetic treatments, dermal fillers are relatively safe. Any side-effects experienced only last a few days and are usually mild.
The two most common side-effects of dermal fillers are:
- bruising from impact of needle (lasts only few days)
- allergic reaction - far less common but can cause swelling or redness
- hardness and bumps in skin from product migration.
How much do dermal fillers cost?
The cost of your treatment will depend on a number of factors, including:
- location of the clinic you attend - higher rates in cities
- the amount of dermal filler used (contouring and sculpting requires more)
- the type of dermal filler used.
In general, the cost of your treatment could range between £150 and £750. However, treatments from high-end clinics in London have been known to charge over £1000. Always enquire about prices before you choose your dermatologist and know that it\'s ok to shop around a bit first - that\'s what we\'re here for. Always do your research, ask for testimonials and make sure you feel 100% comfortable before embarking on your smooth, wrinkle-free journey!
What training and qualifications should practitioners have?
Currently there is not statutory regulation of injectable treatments, meaning that anyone can essentially administer dermal fillers. However, to ensure optimum safety and best practice, many therapists choose to join a professional body.
To become a member of a professional body, therapists must meet a certain set of professionally monitored standards. This way, clients know they can expect the best in the way of safety and competency.
There are a number of professional bodies therapists can join to show they are sufficiently qualified to administer dermal fillers. The following list is not exhaustive but it does include some of the main bodies. To visit their websites and find out more, please follow the links below:
Treatments You Can Trust (TYCT) is a self regulatory body backed by cosmetic industry professionals and the UK government. Members of the TYCT are fully qualified, trained and insured. They must also meet a high standard of practice ensuring they deliver treatments in a safe, clean and reassuring environment.
The British Association of Aesthetic Plastic Surgeons (BAAPS) is a regulatory body concerned with advancing education and improving the practice of aesthetic plastic surgery in the UK.
Formed during WWI, the BAAPS aims to protect the public by:
A) Ensuring the public remains educated about the risks involved in plastic surgery.
B) Only registering members who have been scrutinised by the Council of BAAPS and then voted on during the Annual General Meeting.
C) Ensuring members work to a high standard while remaining fully knowledgeable of the latest technological and research developments in the industry.
1Public Health, \'Life Expectancy\', 2007
2Telegraph, \'Why Girls Love Steve\'
','Professional bodies section:-Noticed two different spellings of practice - I think it should be spelt with a \'c\' in both instances. -find is repeatedCOMMENTS-How often does this stat change? I am always wary about including \'now\' because nobody knows when \'now\' is and the stat could quite easily change. Change to say when the stats were collected. Alternatively you could put the date of the study in the reference list and rephrase the \'now\' e.g. recent estimates have predicted...1. Should its be their?2. Extra space3. Where is the link?4. L missing from Dermal in the page title5. L missing from Dermal in the URL. 1http://www.publichealth.bwdpct.nhs.uk/life-expectancy/.2http://www.telegraph.co.uk/news/uknews/1547982/Why-girls-love-Steve.html
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