What are fillers?

Dermal fillers (also called soft tissue fillers) are injectable treatments used to restore volume, smooth lines, and enhance facial contours. Most modern fillers are made from hyaluronic acid (a naturally occurring substance in the skin) which is gradually broken down by the body over time. Fillers may be used in areas such as the cheeks, lips, nasolabial folds (lines from the nose to mouth), marionette lines, jawline and under-eye hollows. Some fillers are specifically formulated for deeper lifting and structure, while others are designed for fine lines or delicate areas.

Why might I choose to have dermal filler?

You might choose dermal fillers to reduce the appearance of facial lines and wrinkles, restore lost facial volume, improve facial symmetry, or enhance features such as the lips or cheeks. Fillers can provide a relatively rapid, non-surgical option to restore or augment facial appearance. Realistic expectations are important: fillers improve appearance and may temporarily rejuvenate the skin, but they do not stop the natural ageing process.

What does the procedure involve?

Before treatment you will have a consultation to discuss your goals, medical history, allergies, and current medications. Photographs may be taken. The procedure is performed in clinic and usually takes 20–60 minutes depending on the areas treated. Topical anaesthetic or local anaesthetic injections may be used to increase comfort. The filler is injected using fine needles or cannulas into predetermined areas. After injection the practitioner may massage the area to achieve the desired contour. You may be observed briefly after treatment. Detailed aftercare instructions will be provided.

What are the benefits of the procedure?

Benefits include immediate visible improvement in volume and contour, smoothing of lines, and enhancement of facial features with minimal downtime. Results are often natural-looking when performed by an experienced clinician. When patients are not happy with the cosmetic outcome, it is possible to dissolve hyaluronic acid filler if required.

What are the risks and potential side effects?

Common temporary effects include redness, swelling, bruising, tenderness, itching, lumps or bumps at the injection site, and asymmetry. Most of these settle within days to weeks. Less common but important risks include infection, prolonged nodules or granuloma formation, allergic reaction (rare with modern hyaluronic acid fillers), and vascular complications (when filler is inadvertently injected into a blood vessel). Vascular occlusion can cause skin damage and, in severe cases, skin death or visual loss if the blood supply to the eye is affected. If you develop severe or increasing pain, significant change in skin colour (pale/white or dusky), sudden visual symptoms, or severe swelling seek urgent medical attention immediately. Your clinician will explain how risks are reduced, including technique, anatomy knowledge, and availability of hyaluronidase to reverse HA filler.

What alternatives are available?

Alternative options include no treatment, topical and energy-based skin treatments (e.g. laser, microneedling, radiofrequency), chemical peels, botulinum toxin for dynamic lines, or surgical procedures such as facelift or fat grafting for more dramatic or long-lasting changes. Your clinician can discuss suitable alternatives based on your goals.

What should I expect after the procedure?

Expect some redness, swelling and possibly bruising at the injection sites immediately after treatment. These effects typically improve over several days to weeks. You may notice mild firmness or lumps which usually settle. Avoid strenuous exercise, heavy alcohol, and heat exposure (such as hot baths, saunas, intense sun) for 24–48 hours, and follow specific aftercare given by your clinician. Results are visible immediately, with final settling over 1–2 weeks.

How many treatments will I need?

The number of treatments depends on the areas treated and the product used. Many people have a single treatment with maintenance sessions at intervals (commonly 6–18 months) as the filler gradually dissolves. Deep structural fillers may last longer. Your clinician will advise a personalised treatment plan.

Who should not have this procedure?

You should not have dermal fillers if you have an active infection in the treatment area, known allergy to a filler component, or uncontrolled medical conditions. Fillers are generally deferred in pregnancy and breastfeeding. Caution is required in patients with bleeding disorders or on anticoagulant medication (risk of bruising). A full medical history will be taken at consultation.

Who can perform this procedure?

Dermal fillers should be performed by appropriately trained, registered healthcare professionals with relevant qualifications and experience in facial anatomy and complications management. In the UK this typically means doctors, dentists, or registered nurses who have undergone specific training in cosmetic injectable treatments and work within an appropriate clinical governance framework. Choose a practitioner who is transparent about their training, complications protocol, and who offers follow-up and emergency contact.

Will I need a consultation?

Yes. A face-to-face consultation is essential to assess suitability, discuss expectations, review medical history, explain risks and aftercare, and obtain informed consent. Your practitioner will explain the likely outcome, alternatives, and what to expect in the event of complications. You should be given time to consider the information and ask questions, with a cooling off period if needed.

What to do in an emergency?

Very rarely, serious complications such as infection, vascular occlusion (blocked blood supply), or vision changes can occur after filler injections. If you develop severe or increasing pain, sudden whitening or dusky discolouration of the skin, rapid swelling, blisters, or any change in vision, you should seek urgent medical attention immediately. Contact your treating clinician or clinic without delay, and if they are not available, attend your nearest Emergency Department. Prompt treatment is essential to reduce the risk of long-term problems.

Where can I get more information?

You can find more information from:

• The British Cosmetic Dermatology Group (BCDG)
• The British Association of Dermatologists (www.bad.org.uk)
• The Joint Council for Cosmetic Practitioners (JCCP)
• NHS guidance on cosmetic procedures

This leaflet has been produced by the British Cosmetic Dermatology Group (BCDG).

Leaflet version: v1.0

Date of publication: September 2025

Planned review: September 2030