Dermal fillers are one of the most popular aesthetic treatments worldwide. Yet despite their widespread use, they remain surrounded by alarming images, misinformation, and conflicting information online, leading to understandable patient concerns.
It’s sad to say, but we have become used to seeing overfilled lips and faces, and most of us would agree that they don’t look good. The aesthetic sector is still largely unregulated, meaning that anyone can set up a business offering dermal fillers. These individuals are not governed by a professional regulatory body, which essentially means they can do whatever they like.
Data from Save Face, a UK-based national register of accredited practitioners, indicates that the vast majority of complaints regarding non-surgical cosmetic treatments — between 80% and 90% — involve procedures carried out by non-medics.
As a medical doctor specialising in aesthetic medicine, Dr James’ approach has always been guided by prioritising safety and natural results. Well-placed filler should never be obvious. In fact, the best aesthetic work is the kind where people feel you look refreshed but can’t say why.
What Are Dermal Fillers?
Dermal fillers are injectable treatments used to restore volume, enhance facial balance, correct asymmetry, and soften signs of ageing.
The fillers we use are made from hyaluronic acid, a naturally occurring substance found in the skin that helps maintain hydration and structure.
Over time, we gradually lose collagen, fat, and structural support within the face. This can lead to subtle changes such as:
- Hollowing under the eyes
- Flattening of the cheeks
- Softening of the jawline
- Loss of definition around the lips and mouth
- Sunken temples
When used carefully, fillers simply restore what has been lost, rather than dramatically altering the face.
The biggest client concern – will Fillers Make me Look different or fake?
This is by far the most common fear, and it is completely understandable. Social media often highlights extreme cases where excessive filler has been used, which can create the impression that filler inevitably leads to an unnatural appearance.
In reality, overfilling is not the result of filler itself — it is the result of poor technique or poor judgement.
Often, very small amounts of filler placed strategically can create significant improvement while remaining completely undetectable. People should notice that you look well, not that you have had treatment.
Another misconception is that fillers are permanent
Another common misconception is that fillers are permanent. Hyaluronic acid fillers gradually break down over time, typically lasting between 9 and 18 months, depending on the product used and the area treated.
If you decide not to continue treatment, your face simply returns to its natural baseline. There is no sudden collapse or damage caused by stopping treatment.
Can you dissolve dermal filler?
It is possible to have hyaluronic acid fillers dissolved. This may be recommended if filler has migrated; for example from the lips to the lip border, if you are unhappy with your results, or if you have had multiple treatments over time and would prefer to start again.
The process is very similar to a filler treatment. A product called hyaluronidase is injected directly into the unwanted filler. This enzyme breaks down the hyaluronic acid into smaller molecules that the body can naturally remove. The filler is then gradually metabolised and eliminated by the body over the following days.
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