Filler is a treatment in which hyaluronic acid or a similar substance is injected to restore volume in hollowed areas; the product consistency and injection layer needed differ by area.
Filler at Atelier Plastic Surgery is not filler that looks only at the hollow; it looks at the balance of the whole face. Nasolabial folds often look deep not because of the crease itself but because the volume of the cheek has descended, and a chin can look short because the supporting structure of the jawline has weakened. Before filling a hollowed spot, we first establish why it looks hollow.
Filler is a treatment in which hyaluronic acid or a similar substance is injected to replace volume. Skin thickness and movement differ from area to area — nasolabial folds, chin, forehead, cheeks, front cheekbones, under-eyes, lips — so the firmness of the product and the injection layer differ too. In some areas a firm product is placed on the bone to build structure; in others a soft product is placed shallowly to smooth fine lines.
Dr. Juyoung Go has lectured at Korean and international conferences on the structural approach to the lower face, and co-authored the lower-face chapter of a textbook on minimally invasive injectable techniques. She sets the injection layer by the position of blood vessels and nerves, and decides the amount needed by looking at the bone structure, fat layers and ligaments of the face together.
For nasolabial folds, rather than filling the crease itself, we first consider supporting the descended cheek volume so the fold creases less. Reinforcing the deep layers of the front cheekbone and cheek may improve the nasolabial folds and the sagging look of the mid-face together. The crease itself is topped up shallowly, only as much as needed.
For the chin, a firm product is placed on the bone to refine its length and direction. Rather than lengthening the chin alone, the connection to the jawline and the area below the lip must be considered together for a natural profile. The amount needed is set by the proportions of the lower face.
The forehead needs a wide surface filled evenly, so a soft, well-spreading product is injected into a deep layer. If the temples are hollow, treating them at the same time lets the contour of the upper face connect in a rounded line. The injection layer is chosen to avoid the paths of blood vessels.
The skin under the eyes is thin, so a small amount must be placed in exactly the right layer. If under-eye hollowing is pronounced or there is protruding fat as well, under-eye fat repositioning may be a better fit than filler, and we explain the distinction at consultation.
For lips, we look at shape and the connection to the surrounding mouth area, not just thickness. Following the perspective presented in a conference lecture on lip and perioral aesthetics in Korean women, we refine volume without excess and the direction of the mouth corners.
These may vary depending on your condition; we will give you precise details at your consultation.
The face is layered: ligaments, fat compartments and skin over a bony framework. With age, bone resorbs, fat layers descend and ligaments loosen, so certain areas look hollow or folded. Filling the hollow as it is can make that area alone look puffy. We first find which structure has changed to create that appearance, then decide where support is needed.
Where structure is built on bone, we use a firm product that holds its shape; where the skin is thin and moves a lot, a soft product that spreads well. Even within the same area, results differ with injection depth, so we choose the layer that suits the purpose.
The serious complication of filler is filler entering a blood vessel and blocking blood flow. We set the injection layer and technique by the position and depth of the face's major vessels, and use cannulas and needles selectively depending on the area. Dr. Juyoung Go has lectured at conferences on the safety of lower-face filler treatment.
Rather than injecting a large amount at once, we recommend placing small amounts where needed and topping up any shortfall once the swelling has settled. Overcorrection is difficult to reverse and leaves an unnatural look.
There is swelling and redness at the injection sites, and the area may feel slightly firm to the touch. Cold compresses reduce swelling; do not press or rub the treated area hard.
Swelling and bruising are most noticeable during this period. Avoid alcohol, saunas and strenuous exercise. If the skin at the treated area turns white, or there is severe pain or any change in vision, contact the clinic immediately.
Most swelling has settled and the shape begins to take hold. Makeup can be worn from the next day, and bruising fades over 1–2 weeks.
The filler has settled into the tissue and is close to its final shape. At this stage we check for asymmetry or any shortfall and consider a touch-up injection if needed.
Volume gradually decreases depending on the area and product. Areas with little movement, such as the forehead and chin, last longer; areas with a lot of movement, such as the lips, decrease relatively quickly. We discuss the timing of a top-up as the volume begins to decline.
After filler treatment, swelling, bruising, redness and pain at the injection sites may occur and mostly improve within 1–2 weeks. If the amount or layer is not right, the area may feel lumpy, or asymmetry or overcorrection may result, and hyaluronic acid filler injected too shallowly can show through the skin with a bluish tint. Rarely, infection, delayed inflammatory reactions, nodules or migration of the filler may occur. The complication requiring the greatest caution is vascular occlusion. If filler enters or compresses a blood vessel, blood flow can be blocked and cause skin necrosis, and if it travels to the vessels around the eye it can lead to reduced vision or blindness. If the skin turns white or blotchy after treatment, or there is severe pain or any change in vision, you must contact the clinic immediately; hyaluronic acid filler can be dissolved with an enzyme (hyaluronidase). Treatment may be restricted if you are pregnant or breastfeeding, have an active infection or skin condition in the treatment area, or have an autoimmune disease or a tendency to keloids. Results and duration vary by individual.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
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