Dr. Sibthorpe Answers Your Questions – Part 30 – All About Dermal Fillers

In this episode, Dr. Sibthorpe answers your most common questions about dermal fillers and facial rejuvenation. Learn about safety, risks, allergic reactions, and how to avoid lumps or migration. Discover how fillers can restore lost volume in temples, correct tear troughs, and enhance lips. Dr. Sibthorpe also explains why proper technique and careful assessment are critical for safe, effective results.

Q: Are dermal fillers safe, and what are the risks?

A: Dermal fillers are safe when administered by a qualified practitioner. The risks, if not, can be serious, including tissue necrosis and very rare cases of blindness. Common side effects include bruising or allergic reactions, though allergies are extremely rare. Fillers have been around a long time, and modern products rarely require patch testing, unlike collagen fillers used over 20 years ago.

Q: How do you know if you’re allergic to fillers?

A: Allergies can sometimes present later as delayed hypersensitivity reactions, so you might not know immediately. With current fillers, severe allergic reactions are very rare, and patch testing is no longer typically required.

Q: Can fillers migrate, cause lumps, or be removed if the results aren’t what I want?

A: Yes, fillers can cause lumps, bumps, and migration, but this is usually due to using large amounts, the wrong type of filler, or incorrect injection depth. Using small, strategic placements minimize these risks. If needed, most fillers can be dissolved safely.

Q: Can fillers be used for lost volume in the temples?

A: Yes, especially in older women who experience volume loss in this area. Deep placement is often the most effective technique, but it requires a highly skilled practitioner because improper injection can cause serious complications, including blindness.

Q: Can filler correct tear troughs and dark circles under the eyes?

A: Tear trough fillers can help with depressions and volume loss but won’t necessarily eliminate dark circles. This area is high-risk, and proper assessment is critical. Small amounts in a deep plane can be effective, but not everyone is suitable. Some patients, including myself in certain areas, may not be candidates due to poor drainage.

Q: What do you do if a patient insists on tear trough fillers but isn’t suitable?

A: I caution them and may turn them away if the treatment is inappropriate. Alternative treatments or different approaches may be better, depending on whether the issue is volume loss, mid-face changes, or superficial concerns. Newer options, like polynucleotides, can sometimes help.

Q: Are lip fillers permanent?

A: No, they shouldn’t be. Permanent fillers are not recommended in aesthetic medicine. Fillers lasting unusually long are usually the result of the wrong product or incorrect technique, often by inexperienced practitioners.