A Personalized Touch of Health and Beauty in Filler Treatments
At Rejenacell, our approach to dermal filler treatments goes beyond aesthetics; fillers also play a role in restoring facial harmony and supporting overall skin health. We apply fillers through personalized protocols tailored to each individual’s needs and unique facial structure. Our goal is to provide patients with not only natural volume restoration and rejuvenation but also a balanced, refreshed appearance. In this way, we deliver safe and effective results that enhance both confidence and quality of life.
Mechanical volume effect
Hyaluronic acid fillers, in particular, provide physical volume in the area where they are injected. Sunken areas are lifted as they fill, and wrinkles are smoothed out.
Hydration Effect
Hyaluronic acid is a molecule with a very high water-binding capacity. Following filler application, it not only increases volume but also improves skin hydration and elasticity.
Biostimulation
Biostimulatory fillers such as CaHA, PLLA, and PCL stimulate fibroblasts. This leads to an increase in type I and type III collagen production, improving skin thickness and quality over the long term. The effect usually begins a few weeks after injection and can last for years.
Combined Effect
In modern clinical practice, both mechanical volume and biostimulation effects are often used together. For example, HA filler may be preferred for lips or nasolabial folds, while CaHA or PLLA is chosen for midface lifting.
Key Advantages of Filler Application
An Overview of the Role of Fillers in Health and Aesthetics
Dermal filler treatments are minimally invasive procedures that help restore lost volume, support facial contours, and give the skin a more balanced, youthful appearance. Beyond their cosmetic benefits, fillers are also used in medical contexts such as traumatic contour deformities and congenital anomalies. At Rejenacell, fillers are applied through personalized protocols tailored to each individual’s needs and facial structure. Our goal is to achieve safe, balanced, and effective results while preserving natural features—enhancing both aesthetic appearance and overall quality of life.
What is Filler?
How is Filler Applied?
Introduction
Dermal filler applications have become one of the most important minimally invasive methods in modern aesthetic medicine. Among the most noticeable signs of facial aging are volume loss, deepening of lines, contour irregularities, decreased skin elasticity, and the loss or displacement of subcutaneous fat tissue. This process often gives a person a tired, unhappy, or older appearance than they actually are. With precise injections of dermal fillers into the appropriate areas, these signs of aging can be corrected quickly and without the need for surgery.
Today, fillers are used not only for aesthetic purposes but also for reconstructive and functional indications. For example, conditions such as volume loss in the face due to HIV treatment–related lipodystrophy, congenital anomalies (such as cleft lip sequelae), traumatic contour deformities, and hemifacial atrophy can benefit from filler treatments.
History of Dermal Fillers
1890s: The first attempts were made with paraffin injections but were soon abandoned due to complications.
1950s: Liquid silicone injections became popular; however, risks of granuloma and migration raised safety concerns.
1980s: The first FDA-approved collagen fillers entered clinical use. Since they were bovine-derived, allergy testing was required.
1990s: The development of hyaluronic acid fillers marked the beginning of the “gold standard” era, which continues today.
After 2000: Biostimulatory fillers such as CaHA, PLLA, and PCL gained attention not only for providing volume but also for stimulating collagen and improving skin quality.
Today, we have both short-term fillers that provide immediate volume and long-term biostimulatory fillers that rejuvenate the skin.
Mechanism of Action of Fillers
The primary goal of fillers is to restore lost volume, support facial contours, and enhance skin quality. The mechanism of action differs depending on the type of product used.
Mechanical Volume Effect
Hyaluronic acid fillers, in particular, provide physical volume in the area where they are injected. Sunken areas are lifted as they fill, and wrinkles are smoothed out.
Hydration Effect
Hyaluronic acid is a molecule with a very high water-binding capacity. After filler application, it not only provides volume but also improves skin hydration and elasticity.
Biostimulation
Biostimulatory fillers such as CaHA, PLLA, and PCL stimulate fibroblasts. This increases the production of type I and type III collagen, improving skin thickness and quality in the long term. The effect usually begins a few weeks after injection and can last for years.
Combined Effect
In modern clinical practice, both mechanical volume and biostimulation effects are often used together. For example, HA fillers may be preferred for lips or nasolabial folds, while CaHA or PLLA is chosen for midface lifting.
Aesthetic Applications of Fillers
Fillers are most commonly applied to the facial area. The most frequently treated areas include:
Nasolabial folds: Softening of deep lines extending from the sides of the nose to the corners of the mouth.
Marionette lines: Lines running from the corners of the mouth down to the chin that create a sad appearance; can be improved with fillers.
Lips: Adding volume, enhancing contour, and increasing hydration. Also effective for vertical “barcode lines” caused by smoking.
Tear troughs (under-eye area): Reduces hollowness and tired appearance. Low-density HA fillers are preferred.
Cheeks and cheekbones: Restoring midface volume and providing a lifting effect for a younger, more dynamic look.
Chin and jawline: Reshaping the lower face to achieve more defined and sharper contours.
Nose (non-surgical rhinoplasty): Correcting minor imperfections, elevating the nasal bridge, or balancing slight asymmetries.
Temples: Reducing hollowness for a fuller and more balanced facial appearance.
Neck and décolleté: Softening fine lines and improving skin quality.
Hands: Reducing the prominence of veins and tendons to achieve a more youthful appearance.
Medical Applications of Fillers
Although fillers are mostly known for aesthetic purposes, they also have reconstructive and functional uses, such as:
HIV-related lipodystrophy: Patients on antiretroviral therapy often develop sunken cheeks and loss of facial contours. HA or PLLA fillers are FDA-approved for restoring these areas.
Traumatic contour deformities: Used to restore facial symmetry following accidents or surgeries.
Congenital anomalies: Supportive treatment in cases such as cleft lip-palate sequelae or hemifacial atrophy.
Laryngeal applications: Certain filler agents can be used for vocal cord medialization in vocal cord paralysis.
Hand and body deformities: Fillers can reduce the visibility of veins and tendons on the back of the hands and may also be used for contour corrections in other body areas.
How Are Fillers Applied?
Assessment and Planning
Reviewing patient history and checking for contraindications.
Taking facial photographs (frontal, lateral, and 45° angles).
Selecting the appropriate product for the targeted area (e.g., soft HA for lips, dense HA or CaHA for jawline).
Clearly explaining expectations to the patient.
Marking
Identifying and marking the treatment areas.
Paying special attention to vascular anatomical risk zones (glabella, nasal dorsum, nasolabial artery line).
Anesthesia
Most HA fillers contain lidocaine.
For sensitive areas such as the lips, topical anesthetic cream or dental block may be applied.
Injection Techniques
Needle: Provides precision in small areas but carries a higher risk of complications.
Cannula: Safer for larger areas with a lower risk of bruising.
Techniques: Linear retrograde, bolus, fanning, cross-hatching.
Duration
On average 15–30 minutes.
Patients can usually resume daily activities immediately after the procedure.
Everything You Want to Know
About Filler
Expected Effects After Filler Treatment
Immediate volume effect: HA and CaHA fillers show results instantly upon application.
Delayed effect: Biostimulatory fillers such as PLLA and PCL begin to take effect 1–2 months after treatment.
Swelling and bruising: May occur within the first 24–48 hours and are temporary.
Final results: The filler typically settles within 7–10 days.
Duration of effect:
HA: 6–12 months
CaHA: 12–18 months
PLLA: 18–24 months
PCL: 24–36 months
Side Effects and Complications
Common
Redness
Mild swelling
Bruising
Tenderness
Moderate
Asymmetry
Nodules or lump formation
Temporary hypoesthesia
Severe
Vascular occlusion: Accidental injection into a blood vessel can cause tissue necrosis.
Signs: Sudden pain, blanching of the skin → followed by bruising.
Emergency management: Hyaluronidase, massage, warm compress, aspirin, hyperbaric oxygen.
Vision loss: Can occur due to ophthalmic artery involvement; rare but the most serious complication.
Infection: Preventable with sterile technique.
Granuloma: Rarely occurs as a foreign body reaction.
Contraindications
Absolute
Pregnancy and breastfeeding
Active infection at the injection site
Active phase of autoimmune diseases
Known allergy to filler material
Relative
Anticoagulant therapy (higher risk of bruising)
History of severe complications from previous filler treatments
Psychiatric conditions (e.g., body dysmorphic disorder)
Post-Filler Care
Post-treatment care is essential not only for the success of filler applications but also for preventing complications. Similar to Botox, fillers also require attention to specific timelines after the procedure.
First Hours
Head position: Remaining upright is recommended. For the first few hours, avoid lying down for long periods or bending the head forward.
Touching the area: Do not touch, rub, or massage the treated areas unless advised by your physician.
Makeup: Avoid makeup for at least six hours. If applied, it should be done gently.
Facial movements: Normal expressions are fine, but avoid exaggerated movements, especially after lip fillers.
First Day
Heat and environment: Avoid saunas, steam baths, tanning beds, and hot yoga.
Exercise: Refrain from high-intensity workouts such as running, weightlifting, or HIIT. Light walking is acceptable.
Diet:
Avoid very hot or cold foods, particularly after lip fillers.
Do not consume alcohol, as it may increase swelling and bruising.
Limit very salty or spicy foods.
Medications:
NSAIDs such as aspirin or ibuprofen can increase the risk of bruising and should be avoided.
Herbal supplements like omega-3, ginkgo, garlic extract, and vitamin E should also be discontinued temporarily.
Within Two to Three Days
Swelling and bruising: Cold compresses may be applied, but avoid direct ice-to-skin contact.
Sleeping position: Sleeping on the back with the head slightly elevated is recommended the first night.
Massage: Only if specifically recommended by the physician.
Within One to Two Weeks
Professional treatments: Procedures such as microdermabrasion, chemical peels, or laser should be postponed for at least one to two weeks.
Sun exposure: Use wide-brimmed hats and mineral sunscreen for protection.
Follow-up: A control visit is usually scheduled around day 10–14, when the filler has fully settled and can be evaluated most accurately.
Retouch and Follow-Up Strategy
Timing of follow-up: A control visit is recommended on days 10–14. Earlier evaluations may be misleading since swelling may still be present and the filler may not have fully settled.
Indications for retouch:
Noticeable asymmetry
Insufficient volume
Localized depressions
Situations where retouch should be avoided:
Within the first week (filler has not yet settled)
Areas where excessive volume has already been applied (additional filler increases the risk of complications)
If there is suspicion of infection or active inflammation
Antigen risk: Frequent “micro-retouches” within the same cycle are not recommended, as this may increase the risk of immune response, particularly with biostimulatory fillers.
Current Literature and Clinical Experience
Profiloplasty approach: Rather than focusing on a single wrinkle, the aim is to harmonize the entire facial structure (e.g., balance between nose, chin, forehead, and cheeks).
Skinbooster fillers: Application of diluted HA fillers into the skin improves hydration and radiance.
Functional uses: Filler treatments provide both aesthetic and psychosocial benefits in cases such as HIV-related lipodystrophy, congenital anomalies, and post-traumatic deformities.
Combination protocols: Combining fillers with Botox, PRP, or laser yields longer-lasting and more natural results compared to fillers alone.
Evidence-based outcomes:
The safety and effectiveness of HA fillers have been demonstrated in dozens of randomized clinical trials.
PLLA fillers have been shown in histological studies to increase skin thickness through long-term collagen stimulation.
CaHA fillers have been reported to provide lasting lifting effects for 12–18 months even after a single application.
Advantages of Fillers
Non-surgical procedure
Short treatment time (15–30 minutes)
Minimal downtime
Immediate results (HA, CaHA)
Reversible (HA → with hyaluronidase)
Long-term collagen stimulation (PLLA, PCL)
Customized treatment planning
Can be combined with other protocols
Conclusion
Dermal fillers are an indispensable part of modern aesthetic medicine. With the right product selection, proper technique based on anatomical knowledge, and patient compliance, safe and effective outcomes can be achieved.
For patients: A younger, more balanced, and natural appearance
For physicians: A minimally invasive treatment option with high patient satisfaction
From a scientific perspective: Randomized clinical trials confirm the effectiveness of fillers in both the short and long term
Fillers are not only a method of “wrinkle correction” but are also considered a preventive anti-aging treatment, a tool for balancing the three-dimensional anatomy of the face, and an approach that enhances psychosocial quality of life.
Dermal Fillers: Frequently Asked Questions and Answers
What is the difference between fillers and Botox?
Fillers: Provide volume by filling sunken areas.
Botox: Relaxes muscle activity to reduce wrinkles.
In general, the two methods complement each other.
When are the effects of fillers visible?
Hyaluronic acid and CaHA fillers: Results are visible immediately.
Biostimulatory fillers (PLLA, PCL): Effects appear within a few weeks and improve over time.
How long do fillers last?
Hyaluronic acid: 6–12 months
CaHA: 12–18 months
PLLA: 18–24 months
PCL: 24–36 months
Fat grafting: Partially permanent, varies from person to person
Are fillers painful?
Most dermal fillers contain lidocaine. Additionally, a numbing cream is applied before the procedure. For this reason, only mild discomfort is usually felt, not significant pain.
Is swelling or bruising common after fillers?
Yes, especially in vascular areas such as the lips, short-term swelling or bruising may occur. These typically resolve within 2–3 days.
Do fillers look natural?
When the right product, proper dosage, and anatomical knowledge are used, fillers appear natural. Overfilling or poor technique may cause an “artificial” look.
Are fillers harmful?
When performed by a qualified physician under sterile conditions with the right products, fillers are safe. The most common side effects are temporary swelling, redness, and bruising. Serious complications are rare but should be known.
Is there an age limit for fillers?
Generally, fillers are applied to individuals over the age of 18. In younger patients, they are performed only for medical reasons (e.g., congenital anomalies).
Can fillers be used for facial reshaping?
Yes. Fillers can be used to shape the lips, chin, cheeks, jawline, and nose. This is why they are also called “non-surgical aesthetics.”
What should I avoid after fillers?
First 24 hours: No intense exercise, sauna, steam bath, or alcohol.
First 6 hours: No makeup.
First night: Sleep on your back with your head slightly elevated.
After lip fillers: Avoid straws and very hot or cold foods.
When is the follow-up appointment scheduled?
A control visit is usually scheduled 10–14 days after treatment. By this time, the filler has fully settled.
When can touch-ups be done?
Not in the early period. If necessary, a touch-up can be performed on days 10–14.
Can fillers be dissolved?
Yes, especially hyaluronic acid fillers can be dissolved with the enzyme hyaluronidase. This is one of the most important safety advantages.
Will my face sag after fillers?
No. Fillers support facial tissues. When the filler dissolves, the skin returns to its original state, without additional sagging.
Can fillers and Botox be done together?
Yes. Combined treatments provide both volume and muscle relaxation, resulting in more natural and effective outcomes.
Can pregnant or breastfeeding women get fillers?
No. Since there are no safety studies for this period, fillers are not recommended during pregnancy or breastfeeding.
Should I massage the area after fillers?
Generally, no. Massage should only be performed if recommended by the physician (e.g., in case of lump formation).
What results do patients enjoy most after fillers?
A more dynamic and youthful facial expression
Enhanced lip volume and contour
Reduction of tired appearance
Small non-surgical corrections to the nose
Our Personalized
Filler Treatment
Restored Volume
Fillers restore lost facial volume, softening folds and enhancing contours naturally.
Scientific and Safe
Performed by specialists, following precise protocols and using FDA-approved materials.
Natural Results
Designed to refresh and balance facial features without looking artificial.
Quick and Comfortable
A minimally invasive procedure with little downtime, allowing a fast return to daily activities.