What to Expect: Dermal Fillers —
Planned First, Placed In Small Amounts

Your first visit is a consultation with Dr Sin Yong. Its job is to decide what your face needs, which may be less filler than you expected, or none. How filler is chosen by depth and region is on the dermal filler page.

He asks about your concern and how it has changed, your health and medicines, and every injectable you have had before: product, areas and dates, as far as you know them. He examines your whole face at rest and in movement. If the main problem is descent rather than lost volume, lifting may be suggested first.

Tell him about blood-thinning medicines or supplements, any past reaction to filler or anaesthetic, cold sores if your lips are to be treated, recent or planned dental work, and pregnancy or breastfeeding, when treatment is deferred. An active cold sore postpones lip treatment until it has healed. Never stop a prescribed medicine without asking the doctor who prescribed it. Photographs are taken, with your consent, for your medical record only and are never published. You leave with a written plan naming the areas, product and depth, and no decision is expected on the day.

1. Confirming the plan. Dr SY goes through the agreed plan with you. Nothing is added in the chair that was not agreed.
2. Cleaning and marking. The skin is cleaned, and the entry points and zones are marked.
3. Numbing. Numbing cream goes on first; on the lips it is left for 20 to 30 minutes. Local anaesthetic may be added at the entry points, and many fillers also contain it.
4. Placement. Product goes in area by area at the planned depth: deep on bone where structure is needed, as in the cheeks, chin and jawline, and more superficially for softer work. A fine needle or a blunt cannula is chosen by layer; under the eyes, a blunt cannula is the default.
5. Checking as it goes. Small amounts at a time, with the two sides compared before more is added. Your skin colour is watched throughout, because a colour change is the earliest sign of pressure on a vessel.
6. Before you leave. The treated areas are looked at with you and the skin is checked again. A cool compress may be held on lightly, and you go home with written aftercare naming the product, areas and depth.

Hyaluronidase, the enzyme that dissolves hyaluronic acid, is kept on site.

Most people describe pressure, a brief sting at each entry point and a sense of fullness as the product goes in. The lips and the under-eye area are more sensitive than the cheeks or chin. On the lips, numbing cream and the local anaesthetic most lip fillers contain usually keep treatment manageable.

Say so at once if anything feels sharper than expected. Dr SY stops at the first blanching of the skin or pain out of proportion to the injection.

What to do on the first day and over the next fortnight, and which signs need a call, is in dermal filler aftercare.

How you are likely to look, and when the result is judged at your two-week check, is in dermal filler downtime.