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Face Treatment

Dermal Fillers (Facial Fillers)

HISTORY OF DERMAL FILLERS (FACIAL FILLERS)

Dermal fillers (facial fillers) are nothing new. In fact, doctors started using mineral oil and paraffin a long time ago as soft tissue fillers, but there were many permanent side effects. In the 1980s, collagen fillers were invented, but they weren't popular due to the risks of allergies and short lifespan. In the 90s came Hyaluronic acid-based (HA) dermal fillers, which are still used today.

WHAT ARE DERMAL FILLERS (FACIAL FILLERS) USED FOR?

Lips Enhancement

Define and enhance lips

Skin quality

Improve skin quality

Scar Improvement

Improve the appearance of acne and facial scars

Iron out wrinkles

Smooth out fine lines on the forehead

Smoothen Lines

Smooth out your nasolabial folds and marionette lines

Facial Definition

Remodel the cheeks and chin for better facial definition

Skin Hydration

Increase hydration to the face, neck, hands and chest

Revolumisation

Replace volume loss on the face due to the ageing process

TYPES OF DERMAL FILLERS AVAILABLE IN SINGAPORE

Dermal fillers may be classified as temporary, semi-permanent, or permanent based on their chemical makeup.

Permanent fillers, which are not approved in Singapore, should not be used on the face. Only registered, qualified, and trained medical doctors with knowledge of facial anatomy can administer dermal fillers (facial fillers) in Singapore.

There are many types of dermal fillers (facial fillers) available in Singapore.

Type: Calcium Hydroxylapatite

  • A synthetic compound similar to the hard tissues of the body
  • Cheek enhancement and improve facial volume in areas where needed
  • Correct moderate to severe creases such as nasolabial folds, frown lines, and marionette lines
  • Example of FDA-approved Calcium Hydroxylapatite fillers available in Singapore: Radiesse®

Type: Hyaluronic Acid

  • Most widely used type of dermal filler (facial filler)
  • Acne scars, cheek depressions (due to facial scarring or injury)
  • Crow's feet, nasolabial folds, frown lines, marionette lines
  • Forehead lines
  • Redefining lip border
  • Smoker's lines (vertical lines on the mouth)
  • Improve skin's contour
  • Examples of Hyaluronic acid-based dermal fillers available in Singapore: Juvéderm, Restylane, Belotero and Definisse

Type: Polyalkylimide

  • Semi-permanent dermal filler (facial filler)
  • Lip enhancement
  • Treats deep nasolabial folds & depressed scars
  • Cheek and jawline enhancement
  • Cheek and jawline enhancement
  • Examples of Polyalkylimide fillers available in Singapore: Aquamid®

Type: Polylactic Acid

  • Treats laughing lines
  • Plump thin lips
  • Treats deep nasolabial folds
  • Examples of FDA-approved Poly-L-Lactic acid  fillers available in Singapore: Sculptra®

Disclaimer: The images provided are for illustrative purposes only. The dermal fillers listing is intended solely for educational purposes along with their recommended indications supported by clinical research listed in the References section. The listing is not intended to endorse the use of any specific products. It's important to note that dermal fillers are classified as medical devices under HSA regulation. The proper use of dermal fillers necessitates a clinical evaluation of the patient's condition and informed discussions between healthcare professionals and the patient.

HOW DO DERMAL FILLERS (FACIAL FILLERS) WORK?

Hyaluronic-based (HA) dermal fillers are much preferred due to safety considerations. Once injected, HA dermal filler acts as a cushion, supporting facial structures and tissues that may have lost volume and elasticity.

In your body, hyaluronic acid fills the spaces between cells, protecting them by retaining water and serving as a sponge. Considered a "natural moisturiser", hyaluronic acid performs different bodily tasks.

For instance, it helps maintain healthy joint cushioning and hydrates the connective tissue. Hyaluronic acid can hold up to 1,000 times its weight in water, keeping our skin's smoothness (moisturising effect) and plumpness (volumising effect).

During the ageing process, the production of hyaluronic acid naturally decreases. The skin becomes drier, and its ability to retain moisture and maintain elasticity depletes. Today, the signs and symptoms of the skin's natural ageing process can be reduced by replacing the lost hyaluronic acid.

I heard there are many dermal fillers available. Which one does Amaris B. Clinic use?

There are many dermal fillers that medical practitioners offer in Singapore, such as Belotero [1, 2, 3], Juvederm [4, 6, 7, 8, 9], Restylane [5, 10, 11, 12], Voluma [13, 14, 15]. Each of these has its own characteristics and indicated purposes. For example, Belotero and Restylane Silk correct shallow and fine facial lines, while Voluma is recommended for cheek enhancement.

Does Amaris B. Clinic use FDA and HSA-approved HA dermal fillers?

As responsible healthcare providers, we prioritise the safety and well-being of our patients. We believe in using dermal fillers that have received approval from reputable regulatory bodies like the FDA and HSA. Our approach is guided by a commitment to quality, which includes products with proven efficacy and safety, backed by clinical studies.

WHAT SHOULD I EXPECT BEFORE THE DERMAL FILLERS (FACIAL FILLERS) TREATMENT?

Dr Ivan Puah will assess your clinical condition and ensure that your expectations are understood during the consultation and assessment. He will explain how to administer your treatment and address your concerns.

During the treatment, he will inject selected dermal fillers[16] into areas of your face where required through careful and strategic injection points for an even and natural facial enhancement and rejuvenation result.

When can I see the results?

The treatment may take 30 minutes. You will most likely be able to continue your daily activities as soon as your appointment is over.

Results and improvements will be noticeable immediately, but allow 7 to 14 days for minor side effects such as bruising or swelling (if any) to dissipate.

Will I look natural?

Your results is closely tied to the skill and artistic judgment of your doctor. Achieving the best cosmetic outcomes demands a keen aesthetic sense, a skill not all medical practitioners possess. When others can readily identify that your facial features seem disproportionate, stiff, or unnaturally altered, it may be a sign of a poorly executed procedure.

Amaris B. Clinic takes pride in our commitment to delivering aesthetically pleasing dermal filler (facial filler) results. Our approach focuses on the doctor's ability to create a subtle, balanced, and authentically enhanced appearance for each patient.

WHY IS LIP FILLER SO POPULAR?

The skin of the lips is very thin as it is made up of lesser cellular layers than the rest of our face. For most women, the thinness of lips regarding appearance leads to the desire for fuller-looking ones.

Lip fillers have long been used to restore volume to thin lips and smooth vertical lip lines. However, the emergence of the "duck lips" trend gave lip fillers a bad reputation. Did you know those exaggerated, pillowy lips are telltale signs of poorly done filler treatments?

A skilled and well-executed lip filler procedure should be virtually undetectable. Your lips will appear naturally volumised, enhancing your unique features. You should look like the best version of yourself, not a completely different person.

Fortunately, the era of overfilled lips is coming to an end.

Embrace the return of natural lip looks, where the beauty lies in the subtlety of enhancement. Say goodbye to "sausage lips" forever!

Why are full lips considered attractive?

Scientists at Manchester University conducted a study that demonstrated the attraction of full lips. Thinner lips are thought to reduce their feminine appearance, while those with full lips are considered more attractive and appear more youthful.

In the study, men who were shown different images of women spent an average of seven seconds gazing at the lips of women who wore lipstick and spent significantly less time looking at their other features.

What can I do about thin lips?

An effective treatment is available if thin lips are denting your confidence or you’ve always wanted fuller-looking lips.

Dermal Filler adds volume to the your lips, creating a fuller look.

WHO CAN PERFORM DERMAL FILLERS (FACIAL FILLERS) IN SINGAPORE?

Dermal Filler (Facial filler) is marked as a medical device In Singapore under HSA regulation. Treatments such as dermal filler, injectable neurotoxins, and BioRemodelling HA+ Injection can only be prescribed and carried out by registered and trained doctors in Singapore.

Dr Ivan Puah

Dr Ivan Puah, the Medical Director of Amaris B. Clinic, holds a Graduate Diploma in Family Dermatology from NUS and boasts over 17 years of clinical experience in addressing various dermatological concerns. His proficiency encompasses the treatment of skin laxity, wrinkles, fine lines, hyperpigmentation, acne scarring, and more.

Dr Puah's knowledge and skill are further acknowledged through his appointment as a trainer-to-doctor by Merz Singapore and Allergan Singapore.

Dr Ivan Puah Dermal filler and botulinum toxin injections

Our Awards

DERMAL FILLERS FAQS

Can I do dermal fillers while I'm pregnant or breastfeeding?

No, dermal fillers (facial fillers) are not approved for use during pregnancy or breastfeeding.

Do dermal fillers (facial fillers) hurt?

Nearly all our hyaluronic acid fillers are available with lidocaine to maximise your treatment comfort. The discomfort level is minimal.

Will facial cream achieve the same result as dermal fillers (facial fillers)?

No. Although cosmetic and skin care companies have developed innovative skin care products purported to replace volume or increase skin hydration, it is impossible to achieve that.

Increasing volume can only be achieved via injectables such as dermal fillers (facial fillers) or through a minimally-invasive procedure known as ADR-C Facial Enhancement (Facial Fat Grafting).

To increase hydration internally, you will require moisturising dermal fillers.

Can I remove dermal fillers?

It is possible to remove hyaluronic acid-based (HA) dermal fillers with an enzyme known as hyaluronidase if needed.

Hyaluronidase will break down the filler in a short space of time. However, it will not be possible to remove dermal fillers that are not HA-based.

Are dermal fillers (facial fillers) suitable for men?

Certainly! At Amaris B. Clinic, we treat many male patients who opt for dermal fillers (facial fillers) to improve skin texture, enhance their cheeks, and reduce facial lines.

Do dermal fillers (facial fillers) stretch the skin?

There is a possibility that the face is overfilled. This should never occur in the hands of skilled and experienced doctors who understand facial anatomy and harmony.

Pillow face (overfilling of cheeks and under eyes), Avatar nose (overfill on the nose bridge), bulging forehead, witch's chin (overly pointed chin), and overly protruding cheekbones are commonly seen in cases of over-treatment. In such cases, loose skin can sometimes be seen if the dermal fillers are dissolved in the areas where they are over-treated.

Do lips get thinner with age?

As we age, the production of collagen decreases. Collagen is responsible for the skin’s youthful appearance, including our lips, and its loss leads to an aged and thin appearance.

Another cause of thin lips is the sun’s ultraviolet rays. This exposure can also lead to lip discolouration, causing them to darken.

How do I prevent lip discolouration?

Being mindful and refraining from using too much lipstick can help prevent lip discolouration, as does wearing a lip balm with sunscreen, which can also reduce the sun’s ultraviolet rays thinning and ageing effects on the lips.

Reference

[1] Prasetyo Ad, Prager W, Rubin Mg, Moretti Ea, Nikolis A. Hyaluronic Acid Fillers With Cohesive Polydensified Matrix For Soft-Tissue Augmentation And Rejuvenation: A Literature Review. Clin Cosmet Investig Dermatol. 2016 Sep 8;9:257-80. DOI: 10.2147/CCID.S106551. PMID: 27660479; PMCID: PMC5021061.

[2] Lorenc, Z. Paul M.D.; Fagien, Steven M.D.; Flynn, Timothy C. M.D.; Waldorf, Heidi A. M.D.. Clinical Application And Assessment Of Belotero: A Roundtable Discussion. Plastic And Reconstructive Surgery 132(4s-2):P 69s-76s, October 2013. | DOI: 10.1097/PRS.0b013e31829a0bfc

[3] Sundaram, Hema M.D.; Cassuto, Daniel M.D.. Biophysical Characteristics Of Hyaluronic Acid Soft-Tissue Fillers And Their Relevance To Aesthetic Applications. Plastic And Reconstructive Surgery 132(4s-2):P 5s-21s, October 2013. | DOI: 10.1097/PRS.0b013e31829d1d40

[4] [5] Flynn, Timothy Corcoran M.D.; Thompson, David H. Ph.D.; Hyun, Seok-Hee Ph.D.. Molecular Weight Analyses And Enzymatic Degradation Profiles Of The Soft-Tissue Fillers Belotero Balance, Restylane, And Juvéderm Ultra. Plastic And Reconstructive Surgery 132(4s-2):P 22s-32s, October 2013. | DOI: 10.1097/PRS.0b013e31829e88a3

[6] Lupo, Mary P. M.D.; Smith, Stacy R. M.D.; Thomas, Jane A. A.A.S, C.C.R.A.; Murphy, Diane K. M.B.A.; Beddingfield, Frederick C. Iii, M.D., Ph.D.. Effectiveness Of Juvéderm Ultra Plus Dermal Filler In The Treatment Of Severe Nasolabial Folds. Plastic And Reconstructive Surgery 121(1):P 289-297, January 2008. | DOI: 10.1097/01.prs.0000294968.76862.83

[7] Bogdan Allemann I, Baumann L. Hyaluronic Acid Gel (Juvéderm) Preparations In The Treatment Of Facial Wrinkles And Folds. Clin Interv Aging. 2008;3(4):629-34. DOI: 10.2147/cia.s3118. PMID: 19281055; PMCID: PMC2682392.

[8] Wolfgang G. Philipp-Dormston, David Eccleston, Koenraad De Boulle, Said Hilton, Helga Van Den Elzen & Myooran Nathan (2014) A Prospective, Observational Study Of The Volumising Effect Of Open-Label Aesthetic Use Of Juvéderm® Voluma® With Lidocaine In Mid-Face Area, Journal Of Cosmetic And Laser Therapy, 16:4, 171-179, DOI: 10.3109/14764172.2014.910079

[9] Li D, Xie Y, Li Q, Sun J, Jiang P, Jia Y, Murphy Dk, Li Q. Safety And Effectiveness Of Juvéderm Ultra Plus Injectable Gel In Correcting Severe Nasolabial Folds In Chinese Subjects. Plast Reconstr Surg Glob Open. 2017 Jan 16;5(1):E1133. DOI: 10.1097/GOX.0000000000001133. PMID: 28203492; PMCID: PMC5293290.

[10] Yan, Xiaoqing M.D.; Xu, Jun M.D.; Lu, Changsheng M.D.; Ma, Yongguang M.D.; Li, Wei M.D.. A Multicenter Study Of The Efficacy And Safety Of Restylane In The Treatment Of Nasolabial Folds In China. Plastic And Reconstructive Surgery 124(5):P 256e-257e, November 2009. | DOI: 10.1097/PRS.0b013e3181b98cbb

[11] Percec I, Bertucci V, Solish N, Wagner T, Nogueira A, Mashburn J. An Objective, Quantitative, Dynamic Assessment Of Hyaluronic Acid Fillers That Adapt To Facial Movement. Plast Reconstr Surg. 2020 Feb;145(2):295e-305e. DOI: 10.1097/PRS.0000000000006461. PMID: 31985621; PMCID: PMC7004449.

[12] Wu, Y., Sun, N., Xu, Y. Et Al. Clinical Comparison Between Two Hyaluronic Acid-Derived Fillers In The Treatment Of Nasolabial Folds In Chinese Subjects: Biohyalux Versus Restylane. Arch Dermatol Res 308, 145–151 (2016). https://doi.org/10.1007/s00403-016-1630-2

[13] Ho D, Jagdeo J. Voluma: A Systematic Review Of Clinical Experience. Journal Of Drugs In Dermatology : Jdd. 2015 Sep;14(9):934-940. PMID: 26355610.

[14] Li D, Wang X, Wu Y, Sun J, Li Q, Guo S, Jia Y, Murphy Dk. A Randomized, Controlled, Multicenter Study Of Juvéderm Voluma For Enhancement Of Malar Volume In Chinese Subjects. Plast Reconstr Surg. 2017 Jun;139(6):1250e-1259e. DOI: 10.1097/PRS.0000000000003355. PMID: 28538556; PMCID: PMC5444429.

[15] Callan P, Goodman Gj, Carlisle I, Liew S, Muzikants P, Scamp T, Halstead Mb, Rogers Jd. Efficacy And Safety Of A Hyaluronic Acid Filler In Subjects Treated For Correction Of Midface Volume Deficiency: A 24 Month Study. Clin Cosmet Investig Dermatol. 2013 Mar 20;6:81-9. DOI: 10.2147/CCID.S40581. PMID: 23687448; PMCID: PMC3610404.

[16] Gold Mh. Use Of Hyaluronic Acid Fillers For The Treatment Of The Aging Face. Clin Interv Aging. 2007;2(3):369-76. DOI: 10.2147/Cia.S1244. PMID: 18044187; PMCID: PMC2685277.

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