Dermal fillers aren't as scary as you may think
‘For some, this can be mentally and emotionally transformative’
I love my dogs more than I do most people in my extended family. But in a moment of sheer excitement of seeing each other after months apart, I got a swipe across the face that has left me with what looks like two puncture marks on my cheek. It’s been a couple of years since but those marks only seemed to have solidified further. “Scars add character,” says my partner. I’ve always been a bit conscious of these. No primer, concealer or skin peeling solution has managed to fill or cover up this mark of love. During a visit to the dermatologist a year or two later, she looked at my face and said, “Have you considered getting a filler to fix the scar?” This was back when the concept of dermal fillers was still new to India outside of celebrity circles.
Cut to two weeks ago, I’m sitting across from another dermatologist, this time trying to figure out why the seven skincare products and supplements I’d already tried had a negligible effect on my dark circles. Then came the same suggestion for what she said are under-eye hollows giving the area a darker appearance. “What about injectable dermal fillers?”
It automatically hit the ‘this is plastic surgery’ red alert. A term that conjures up images of heavily botox-ed, wax-faced folks at your father’s golf club struggling to sip cocktails through a straw.
It’s not like people haven’t been getting dermal fillers for years. But the stigma made me shudder. “It’s not going under the knife. It’s a temporary lip filler. I keep saying that because I’m so worried about it being misinterpreted,” says beauty and lifestyle content creator Aanam C in a vlog where she documented her journey of getting lip fillers.
Aanam was one of the first Indian people with a platform that I saw talking about getting fillers so openly. The deeper I dug, I found more, like Anupa Sahu and Srishti S Bhatia who’ve transparently documented their experiences with fillers for their audience. Though it can be quite obvious, many dismiss and deny having opted for a cosmetic enhancement because of the stigma associated with it. You don’t owe anybody an explanation for your personal choices. It’s only when the results are falsely used to sell magical lip kits, under-eye creams and beauty tools that the ethical pool gets muddied.
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We’re not advocating for the normalisation of dermal fillers, botox and facelifts, per say, just conversation around them. Overuse has contributed to an unrealistic beauty standard, perpetuated by social media, that affects our body image and self-esteem.
When you’re equipped with the right kind of information, you also know what to look for in a specialist who won’t take advantage of your vulnerabilities for their own financial benefit.
“If a patient tells me about multiple things that they don’t like or lists most of their features, that is a major red flag for me,” says Dr Yash Mehta, principal surgeon and founder of Aesthetic & Cosmetic Surgery Clinic.
With more awareness and conversation comes a greater understanding of these potential benefits, physical and psychological risks. I started speaking to experts to know more about fillers before I made my own decision.
“Botox and fillers do minimise the signs of ageing, allowing you to look a certain way. But for some, this can be mentally and emotionally transformative. Boosting their self-confidence, and making them feel more at home in their skin. Whether that’s by changing the shape of their nose, filling out deep acne marks they’ve been self-conscious about or correcting a scar that they’ve been bullied over. The impact it can have is not always superficial,” says psychologist Palomi Tomar, Mind Care Clinic.
You need to find a professional who won’t take things too far, by identifying whether a patient’s request is reasonable or something rooted in body dysmorphia that requires intervention from a mental health professional.
Kaley Cuoco puts it well, saying, “I don’t think you should do it for a man or anyone else, but if it makes you feel confident, that’s amazing.”
What exactly is in dermal fillers?
Facial fillers go by various names. Juvéderm, Restylane, Radiesse, Bellafill and more. The difference is in the components. The most common one is hyaluronic acid, but there’s also calcium hydroxylapatite, Polymethylmethacrylate (PMMA), Poly-L-lactic acid and fat taken from our own body.
The type of filler used is determined by the doctor based on what you’re trying to achieve. For example, filling deep wrinkles will most likely be done using poly-L-lactic acid whereas hyaluronic acid may be used to add volume around the eyes and lips. Downtime varies, as does how long the effects will last.
What can fillers can help with?
As we get older, our skin loses collagen and hyaluronic acid which provide plumpness to the skin and maintains the elasticity of the skin.
Fillers primarily add volume to the targeted area. Dr Aanchal Panth, dermatologist and hair transplant surgeon, says they can be used to treat the hollows of the eyes, add plumpness to our lips, cheeks, nasolabial folds and can be used to augment areas of the face like the chin, jawline the nose (known as liquid rhinoplasty) and contour the cheekbones.
Fillers can also be used to correct indented scars as they plump up the area and reduce the indentation.
What happens during the procedure, and is it painful?
You may be advised to avoid certain medications, like blood thinners and the application of makeup prior to your appointment. Practitioners may add their own tweak to it, but the basic process is pretty standard. Dr Shilpi Bhadani, SB Aesthetics, explains that a numbing cream is first applied to the face to reduce any possible discomfort before the treatment is done.
It’s a quick process, taking anywhere from 15 to 30 minutes to complete, depending on the size of the area being targeted.
How much downtime is required?
Hailed by many as a ‘lunchtime procedure’, where you can be at the clinic and then head back to work/daily life right after, getting a dermal filler requires very little downtime as compared to other cosmetic procedures.
There may be slight soreness, bruising and swelling for some people, which usually subsides within 24-48 hours.
Can fillers ever really look ‘natural’?
With fillers, you can go for a full facial makeover or keep it as minimal as you’d like.
It’s all about putting the right volume of filler in the desired spots. For that, you need a seasoned professional. You can start with the lowest amount and have the doctor slowly build it up as you’d like. The result can be a change so subtle yet effective that others wouldn’t notice until it’s pointed out. Or you can go for the full Kylie Jenner pout.
Start your consultation by sharing with the doctor what you’d like to achieve. Ask to see photos of their previous procedures, and if you’re still uncertain, consult with more than one practitioner before making your decision.
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What if I don’t like how it looks?
Maybe you’ve changed your mind, or you feel your last maintenance appointment went a bit overboard and you don’t like the way it looks. The good thing with fillers is that they can be adjusted. The dermatologist can inject additional fillers in the area to balance out what’s not looking right to you or dissolve them completely. For hyaluronic acid fillers, the most common ones used and available in India, the enzyme hyaluronidase is injected into the area which breaks down the hyaluronic acid in the filler, explains Panth.
Will I have to do it forever once I start?
On one hand, if you want to maintain the look, then you will have to get fillers touched up. But it’s a common misconception that once you get fillers, you have to keep getting it done forever or your face will somehow start to melt like a wicked witch in water.
“The fact is fillers make you look younger. So, say you are 45 years old. You inject fillers, now you look 37 or 38. After two years, the fillers dissolve, then you look like you’re 47 years, but you are used to looking 38. That is why people feel it ages you but in reality, it has no negative impact on the progression of ageing. On the contrary, it has been shown that fillers can bring about bone remodelling and make you age slower,” says Panth.
Dermal fillers can last anywhere from six months to two years, depending on the kind that you get. The effects of fillers will fade away with time without any long-term side effects.