7 Visible Signs of Ageing in Asians
Did you know that your neck, hands and eyes are delicate areas to pay particular attention to, in your attempt to cover up the piling age?
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.

Define and enhance lips

Improve skin quality

Improve the appearance of acne and facial scars

Smooth out fine lines on the forehead

Smooth out your nasolabial folds and marionette lines

Remodel the cheeks and chin for better facial definition

Increase hydration to the face, neck, hands and chest

Replace volume loss on the face due to the ageing process

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 doctors trained in facial injectables can administer fillers in Singapore.

A synthetic compound similar to the hard tissues of the body.
Usually addresses:

Most widely used type of dermal filler (facial filler)[1].
Usually addresses:

Most widely used type of dermal filler (facial filler)[1].
Usually addresses:

Semi-permanent dermal filler (facial filler).
Usually addresses:
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.
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.
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.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.
Dr Ivan Puah will assess your clinical condition and ensure that your expectations are understood during the consultation and assessment. He will explain how best 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.
7 days before your treatment, discontinue taking blood thinners, NSAIDs, vitamin E, fish oil and other herbal supplements.
Avoid consuming alcohol and excessive caffeine for at least 24 hours before your appointment.
Avoid using makeup, skincare products, including waxing or bleaching, on the treatment area for at least three days before your treatment.
24 hours before, limit strenuous exercise and avoid going for saunas or using the hot tubs.
Results and improvements will be noticeable immediately.
Minor side effects such as bruising or swelling (if any) to dissipate.
Your skin will take some time to integrate with the surrounding tissues, and results, in general, will last up to 6 - 12 months.
Your results are very much dependent on the skills and aesthetic sense of your doctor.
Not every medical practitioner has the aesthetic sensibility to provide patients with the optimal cosmetic outcome. If someone looks at you and can tell that you look different (but not great), such as your nose or cheeks are totally out of proportion to your face or that your face looks "stiff" and pillowy, this is an indication of a poorly executed job.
A successful and good dermal filler (facial filler) results lie in the doctor's ability to create a subtle, balanced, and natural appearance for the patient, which is what we do at Amaris B. Clinic.
A skilled and well-executed lip filler procedure should be virtually undetectable. Your lips will appear naturally volumised, enhancing your unique features.










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 medical doctors in Singapore.
Dr Ivan Puah, medical director of Amaris B. Clinic, obtained a Graduate Diploma in Family Dermatology from NUS.
He has over 20 years of clinical experience treating patients with skin laxity, wrinkles, fine lines, hyperpigmentation, acne scarring issues, and many others.
Dr Puah is also the appointed trainer-to-doctor by Merz Singapore and Allergan Singapore.

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.
I heard there are many HA dermal fillers brands available. Which one do you use?
There are many HA dermal fillers that medical practitioners offer in Singapore, such as:
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.
As ethical healthcare professionals, it is important that medical practitioners only provide FDA and HSA-approved HA dermal fillers to their patients.
We believe that only quality products that have undergone stringent assessment, with proven track records and multiple clinical studies, will benefit the patients.
Why is lip filler so popular?
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.
How to avoid getting sausage lips?
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?
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.

Dr Ivan Puah's novel 360° Glandular Tissue Dissection (360°GTD®) technique minimises surgical invasiveness while achieving cosmetic results.

Dr Ivan Puah's novel 360° Glandular Tissue Dissection (360°GTD®) technique minimises surgical invasiveness while achieving cosmetic results.

Dr Ivan Puah's novel 360° Glandular Tissue Dissection (360°GTD®) technique minimises surgical invasiveness while achieving cosmetic results.