What is a filler application and for what purpose is it used?

Filler application is the process of injecting substances that are suitable for use, for the treatment of volume loss, depressions, and for medium and deep wrinkles.

What are the materials used for filling?

Filler applications can be made with 2 different substances. The first of these is hyaluronic acid. Hyaluronic acid is a polymer that is also found in the human body, has water-retaining properties, and plays a very important role in collagen repair and skin elasticity. Different molecular forms of hyaluronic acid that do not cause allergies and reactions in the human body are used for filling purposes. Another filling method is fat injection, which is also known as lipofilling. In this method, the injection substance is the patient’s own fat. This adipose tissue is taken from the desired area of ​​the patient, subjected to some procedures, and injected into the target areas. Hyaluronic acid and fat injection have some advantages and disadvantages of their own. For example, while hyaluronic acid fillers can be done in office conditions, fat injections are made under operating room conditions, but the effect is permanent in lipofilling (See Fat Injection (Lipofilling) Section). In this section, filling applications with hyaluronic acid will be discussed.


Which areas are fillers applied to?

Fillers are mostly used in the lip area, nasolabial area (folds extending from both sides of the nose to the corners of the mouth, smile lines) and in the under-eye area.


Should you prefer filler or Botox (Botulinum toxin)?

Fillers and Botox are completely different applications when their principles of action are considered. Botox reduces nerve impulses to the muscles. Thanks to this effect, Botox is used in the treatment of superficial / medium wrinkles, for eyebrow lifting, in cases where there is excessive sweating in areas such as armpits / hands / feet (hyperhidrosis), excessive teeth clenching and masseter hypertrophy, in cases where the gums appear more than normal when talking or laughing (gummy smile) and in the case of chronic migraine (See Botox (Botulinum Toxin) Applications). The filling and volume effect provided by the filler is not expected in Botox application. There is no nerve block or muscle blockage in the effect mechanism of the filler.


What is the permanence of hyaluronic acid fillers?

The permanence of hyaluronic acid fillers varies according to the product used, the area treated and the individual factors. Age, smoking, sun protection status, nutrition and individual reasons are some of these variable factors. Although the permanence varies according to the region, it is approximately 6 months-2 years. It is thought that filler application at regular intervals increases the permanence and reduces the amount of filler that will be needed in the next session.


Wouldn’t it be worse than before when the effect of filler passes?

The answer is “no”. The applied hyaluronic acid filler will be absorbed in 6 months-2 years. Therefore, the applied area returns to its former state without causing any deformity.


Are filler applications safe?

Medical aesthetic procedures such as fillers are safe applications when applied by doctors who have both theoretical and practical knowledge and experience in skin and subcutaneous anatomy, have in-depth knowledge of the subject, can manage complications and are experts in their field.


What is under-eye (light) filler and for what purpose is it preferred?

External factors such as individual causes, acquired factors or sleep disorders may make the under-eye area look darker and more purple than it should be. This causes the individual to look tired and older. Thanks to the filler injection to this area, the sunken appearance in the inner (medial) part of the lower eyelid (tear trough deformity) is corrected, and a little (23-30%) lightening is provided in the color of this area, thanks to the content of the filler. In this way, a more lively, more dynamic and a younger look is aimed.


How is under-eye filler applied?

There is no need for operating room conditions for this procedure. It is one of the safe applications that can be done easily in office conditions where sterility principles are taken into account. The process takes an average of 10 minutes. By entering with the help of a needle or a cannula (I prefer needle more in this area), the desired volume of filler is injected onto the bone.


Is under-eye filler application painful, is anesthesia performed before the application?

The answer to this question depends on the preference of the patient and the doctor. Pain is not expected in this area. Superficial anesthesia can be provided before the procedure with topical (applied) creams. In addition to the thinness of the cannulas and needles used, the pain is minimal due to the presence of anesthetic substance in the filler. For patients who do not want any pain, local anesthesia injection can be made through the mouth before filler application.


What should be considered after under-eye filler application?

After the application, you can return to your normal routine and daily life. Minimal edema is expected. This edema becomes maximum after 48-72 hours and then decreases rapidly. Ice and strip usage on the day of application reduces edema.


Is bruising expected after under-eye filler application?

After the application of under-eye filler, bruises may rarely occur and these bruises are expected to disappear within 3 days. If bruises occur, the use of foundation in this process will easily mask the bruises.


Is control required after under-eye filler application?

Edema may occur due to needle/cannula entry and exit, filler injection itself and finger manipulations. 10-14 days after the application, with the decrease of edema, I prefer to evaluate the situation again and touch up if necessary.


What is the permanency of under-eye filler?

The permanence of the under-eye filler varies depending on the product used and the individual factors. Since it is an inactive area, unlike lip zone, its permanence is thought to be somewhat higher than in other areas. Permanence in this region is on average 1.5 years. It is thought that filler application at regular intervals increases the permanence and reduces the amount of filler that will be needed in the next session.


Does under-eye filler application provide solutions to all problems in the lower eyelid (for example under-eye bags, excess skin)?

The answer is “no”. I would like to draw attention to this point. The purpose of the under-eye filler is to eliminate the collapse (depression) that is especially evident in the inner (medial) part of the lower eyelid and to lighten the dark color a little. In very minimal under-eye bagging and minimal skin excess, the filler fills the inner (medial) hollowness and beautifies the transition. However, it is not a treatment option for moderate and advanced lower eyelid skin excess and under-eye bags. In this case, lower eyelid aesthetics should be considered (See Blepharoplasty and Periocular Rejuvenation Section). In this case, the application of under-eye filler instead of lower eyelid aesthetics will worsen the existing deformity instead of correcting it.


What is the alternative of hyaluronic acid for filling purposes?

It is fat injection, that is, lipofilling. Hyaluronic acid and lipofilling have some advantages and disadvantages of their own. Hyaluronic acid fillers can be made in office conditions, and the volume and appearance can be evaluated immediately after the application. However, its effects are not permanent (permanence is 6 months-2 years) and the cost per cc used is high since the injection material is imported.


Fat injection is not an office application like fillers and botulinum toxin applications. The fat must be taken under sterile conditions, prepared with a sterile and appropriate method, and injected again sterile. It can be performed under local anesthesia, sedation or general anesthesia according to the preference of the patient and the doctor. Since some of the injected fat (approximately 20%) will be absorbed in the future and more volume will be given during the procedure for this purpose (over-correction), this situation does not give a clear idea about the permanent shape immediately after the procedure. If the advantages of the fat injection application are evaluated, the filling material used is the individual’s own fat, so there is no possibility of an allergic reaction. Although some of the injected part will be resorbed after the fat injection, the remaining part (about 80%) is permanent. In addition, since the source is the individual’s own body, it is abundant. Therefore, it can be taken in high amounts and injected into different areas in larger amounts, and the cost per cc is relatively low. Fat injection can be combined with stem cell (SVF) treatments and can also be used for skin rejuvenation (See Fat Injection (Lipofilling) Section) (See Stem Cell (SVF) Therapy Section).


Under-eye (light) filler application can be done easily in office conditions. It is reliable and the result is immediately visible at the end of the application. Deformities (medial depression and dark circles) make the individual look more tired and older. These deformities are corrected with the application of under-eye light filler. A more lively, more dynamic and a younger look is obtained by correcting the sunken appearance in the inner (medial) part of the lower eyelid and lightening the color of this area a little. I would like to remind you again that the under-eye filler is effective in correcting the depression of the medial part of the lower eyelid (tear trough deformity), not the bags and excess skin. In case of bagging and excess skin, lower eyelid aesthetics should be considered (See Blepharoplasty and Periocular Rejuvenation Section). I would like to remind you that there are several different options for filling purposes. Hyaluronic acid fillers are always good choices if filler application will not be made to more than one area and if a daily office procedure is desired instead of operating room conditions. However, if permanent results are desired, if larger amount of filler application is planned in more than one area in a single session, and if a combination with stem cell (SVF) treatment is considered, I would like to remind you that fat injection are one of the recommended and preferred applications (See Fat Injection (Lipofilling) Section) (See Stem Cell (SVF) Therapy Section). You can find related articles in the References section. Best regards.