Nose Job

Dermal filler treatment has become one of the most popular cosmetic treatments ever since it was popularised by Hollywood celebrities and influencers such as Kylie Jenner and Kim Kardashian. Information about dermal fillers is widely available on the internet and social media. However, there are still a lot of misconceptions and confusion regarding filler treatment. For the purpose of this discussion, the fillers that I refer to in this article are the more commonly used fillers these days such as hyaluronic acid (HA) fillers. 

I am going to clear some of the misconceptions my patients have regarding dermal fillers treatment.


Misconception #1: I can use 1 syringe of filler to treat every part of my face

I often get patients who request to use only 1 filler to treat multiple areas, presumably due to budget concern or the fear of having too much fillers injected in the face. For example, a patient may ask for 1 filler for the chin, the under eye and the lips. 

There are 2 issues here. Firstly, different areas of the face have to be treated with different types of fillers. Secondly, 1 filler is often insufficient to treat so many different areas. 

There are many different types of fillers designed for specific areas of the face. For example, fillers for the chin (such as Restylane Lyft, Juvederm Volux and Belotero Intense) are what we commonly refer to as hard fillers. These fillers are designed to sculpt areas that require definition and absolutely cannot be injected in the under eye areas.

Therefore in this example case, this patient will require at least 3 fillers to treat the 3 areas mentioned – 1 hard filler for the chin, 1 hard filler for the temples and 1 soft filler (such as Belotero balance, Juvederm volbella or Teosyal Redensity II) for the under eye areas.

In other words, 1 filler is often not suitable or insufficient to treat multiple areas of the face.


Misconception #2: I will look worse if I stop doing fillers

A very common misconception is that once you start filler treatment, you will never be able to stop, because once you stop and the fillers wear off, you will look worse and older than before.

Some people also use this as an example of being “addicted” to injecting fillers.

Fillers are designed to restore volume loss and lift the skin to produce a more youthful look. With an adequate amount of fillers injected in the right place, I repeat – in the right place, it can help make your face look younger than your actual age. 

Once injected, fillers also stimulate your skin collagen production. Therefore after just one filler treatment, you will look better than when you started even after fillers have disappeared over a period of time. After repeated treatments, the results last longer and longer.

However, one day if you decided to stop doing fillers, it is absolutely fine. The fillers that have already been injected into your face would have done its job of delaying and interrupting the continuous ageing process of your facial skin. 

Don’t get me wrong. You will still continue to age. But you WILL NOT look worse than before you have had any filler treatment. In fact, you will look younger than your actual age.


Misconception #3 : Filler treatment makes my face look weird and unnatural (often quoting examples of Hollywood actress)

You may have seen pictures of celebrities who look more and more horrible over time, presumably from botched cosmetic treatment. Yes, filler treatment may be one of the culprits, but this is often due to poorly done or excessive cosmetic treatments they receive over the years – a combination of surgical and non-surgical cosmetic treatments.

As I mentioned before, an optimal amount of fillers injected in the right place with the right technique will never make your face look unnatural. In fact, a good filler treatment result is often “invisible”.

One of the biggest problems with filler treatment nowadays is excessive treatment or overfilling. This is often due to 2 reasons: patients keep asking for more fillers, and doctors fail to tell patients that more fillers will be too much for them. Excessive treatment will almost always result in a weird and unnatural looking face. Fillers, when administered by an experienced doctor, should produce beautiful and natural results. 


Misconception #4: Filler treatment is easy. I can get it done by anyone.

Filler treatment can only be performed by well trained and qualified doctors. Filler injection is an extremely complicated procedure. It requires an extensive understanding of human facial anatomy, a professional facial assessment skills and a well trained pair of hands to deliver the injection safely and effectively.  

Your doctor will need to understand your concerns and expectations, and explain to you how he or she can help you achieve a realistic result. Filler treatment is a complex procedure. Please do not get it done by just anyone.


Misconception #5: I am paying too much for the filler product. I would rather go to a cheaper place. 

Filler treatment prices vary in different places. A common scenario is when patients “shop” around for the cheapest price and make a decision on where to get filler treatment done based on which place offers the lowest pricing. 

Many people fail to realise that when it comes to cosmetic treatment such as filler injection, you are paying for the skills and professionalism, NOT the product. 

Let me give you an example. If you need a good haircut, you will pay a good hair stylist to cut your hair. You are paying for the hair stylist’s skills. You are not paying to have a pair of scissors and just let anyone cut your hair. Similarly, if you wish to have a good filler treatment, you will be paying for the doctor’s professional skills, not the filler product.

Having said that, the type of filler products being used do play a major role in the pricing of the filler treatment. As the saying goes, you get what you paid for. It is important to ask what fillers your doctor will be using on your face because safety is still the top priority when it comes to cosmetic treatment.


Misconception #6: The longer lasting the filler is, the more bang for the buck I get

There are many different brands of fillers out there. The common brands that are approved in Singapore are Juvederm, Belotero, Restylane and Teosyal fillers. Each brand has a whole range of different fillers that have different longevity, consistency, cohesivity and character.  Many patients tend to request to have the “longest lasting” filler because of the idea of making the money spent more worthwhile. Very long lasting filler may not necessarily be a good thing. In fact, it may potentially cause more problems in the future such as infection and formation of hard lumps (granuloma). 

We need to understand the ageing process well in order to understand why temporary (short term) fillers are the choice of fillers for most doctors these days. Skin ageing is a continuous process. Therefore, any cosmetic or anti-ageing treatment, including filler treatment, has to be intermittent and ongoing. A long term filler, once injected, stays with you for a long time. However, the filler does not automatically mold or change its shape and consistency according to how your face changes when you age. If it sticks around for too long, you may end up looking odd and unnatural. 

By using short term fillers, your doctor will be able to treat you at different stages of your ageing process effectively and safely. 


Misconception #7: If my friends did not notice that I have had fillers done, it is a waste of money – the doctor must have done a terrible job

As I mentioned earlier, a well done filler treatment is often “invisible” – no duck lips, pillow face or louhan fish forehead. In my practice, I often stress the importance of looking natural after filler treatment. If your filler can be specifically pointed out by a lay person, it usually means that it is not done well or there is too much filler being injected. When administered by an experienced doctor, the result should look natural and not dramatic. 

A skillfully done filler will have your friends commenting that you look more refreshed, younger or more attractive, but they will never be able to work out what treatment you have undergone. 

So the next time your friends did not ask you if you have had fillers done, do not worry. Your doctor has most likely done a very good job!        

I hope I have successfully clarified some of your misunderstanding regarding filler treatment. Please remember this the next time you wish to have fillers done : Safety is of the utmost importance. Choose your doctor carefully. Talk to your doctor, let your doctor assess your face thoroughly, address your concern and plan a good treatment based on your budget. Trust me, you will get the most out of your money this way.


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