Most dermal fillers are made from hyaluronic acid, a substance naturally found in the body. Your own natural hyaluronic acid helps to maintain skin hydration and contributes to facial volume and structure. They are injectable treatments used to restore volume, support facial structure, improve the quality of skin and the appearance of lines and contours

For more see our blog post on this topic.

When administered by a medically qualified practitioner using a licensed product, dermal fillers have a well-established safety record. The most commonly used fillers are based on hyaluronic acid, a substance that occurs naturally in the body, and are both biocompatible and reversible. Serious complications are rare and almost always associated with unqualified practitioners or unlicensed products. Choosing the right practitioner is the single most important safety decision you will make.

Read Are Dermal Fillers Safe?

Unlike botulinum toxin, dermal fillers produce an immediate visible result. You will see the improvement as soon as the treatment is complete, though some initial swelling may slightly exaggerate the result in the first day or two. The final, settled result is typically visible at two weeks which is why a follow-up appointment at that point is standard practice.

ReadWhat Results Should You Expect from Dermal Fillers?

Some degree of swelling, redness, and tenderness at the injection sites is expected and normal following dermal filler treatment. Bruising is also common, particularly in the lips and around the eyes where the tissue is more vascular. These effects typically resolve within a few days to a week. We will provide specific aftercare guidance.

Most patients find the treatment very manageable. Modern filler products contain lidocaine, a local anaesthetic, within the formulation itself, which significantly reduces discomfort during injection. A topical anaesthetic cream can also be applied beforehand for more sensitive areas. The lips tend to be the most sensitive area; the cheeks and temples considerably less so.

Dermal fillers work immediately, the volumising effect is visible as soon as the product is placed. Unlike Botox, there is no waiting period for the result to develop. The final settled result, once any swelling has resolved, is typically visible at around two weeks.

Most patients return to normal activities immediately after treatment. We advise avoiding strenuous exercise, alcohol, and significant heat exposure, saunas, sunbeds or very hot showers for the rest of the treatment day, as these can increase swelling and bruising. Makeup can generally be applied after a few hours, avoiding direct pressure on treated areas.

A consultation is the most important part of the process. It allows us to assess your facial anatomy, understand your goals, take a full medical history, and determine whether treatment is appropriate and what approach will serve you best. It is also where we discuss realistic expectations, potential risks, and obtain your informed consent. No responsible practitioner should proceed without one.

Read whyyour consultation matters more than your treatment.

The most commonly treated areas are the cheeks, cheek bone, temples, nasolabial folds, lips, smokers lines, marionette lines, chin, and jawline. Under-eye hollows, the tear trough area, can also be treated, though this requires particular clinical expertise and careful patient selection. Fillers can also be used for hand rejuvenation.

Bruising, swelling, redness, and tenderness at injection sites are the most common side effects and typically resolve within a few days to a week. Temporary asymmetry in the immediate post-treatment period is also common as swelling settles unevenly. These are expected and manageable rather than serious concerns.

It is known that hyaluronic dermal filler injections can cause inflammatory reactions. Over the last 25 years Dr Forrester has used probably most of the available, most-reputable fillers. He used to believe that they all caused occasional lumps and nodules.

However, 8 years ago he changed to the Belotero brand of filler and since then he has seen not one single nodule or reaction. And that is after literally thousands of syringes of Belotero. This is a remarkable safety record.

Read Why I Now Use Belotero for All My Dermal Filler Treatments

Avoid massaging or applying significant pressure to treated areas for the first few days. Avoid strenuous exercise, alcohol, and significant heat exposure for 24 hours. Avoid dental treatment for two weeks following lip or perioral filler. Your practitioner will provide specific aftercare guidance.

Yes, we recommend a review appointment at four weeks following treatment. This allows us to assess the settled result, ensure you are happy, and make any minor adjustments if needed. It is also the appropriate time to add further product if the initial treatment was conservative and more is required. This follow-up is standard practice in responsible aesthetic medicine.

This varies considerably depending on the product used, the area treated, and individual factors such as metabolism.

Lip fillers typically last four to six months. Cheek and mid-face fillers generally last twelve to eighteen months. Deeper structural fillers can last longer. Individual variation is significant, some patients metabolise filler faster than others, and high-movement areas tend to break down more quickly.

Read How Long Do Dermal Fillers Last?

Well-placed, appropriate filler should not change your face, it should restore and enhance it. The goal is always to replace what time has taken away or refine what nature provided, in a way that looks entirely natural.

A patient leaving our clinic should look like themselves at their best, not like a different person. If treatment would significantly alter your appearance in a way that feels wrong, it is not the right treatment plan.

Read Will Dermal Fillers Change My Face?

Overdone filler results are almost always a consequence of too much product, placed without sufficient regard for the individual face's proportions and natural anatomy. There is also an important perception point: the results that attract attention are the ones that went wrong. The vast majority of well-delivered filler treatments go entirely unnoticed because looking natural is the whole point.

We write about this in more detail in our blog post The Problem with Only Noticing the Bad Ones

A medically qualified doctor with specific training and experience in aesthetic medicine, a thorough understanding of facial anatomy, including the vascular anatomy that makes certain areas high-risk, and the clinical background to manage complications if they arise.

At The Cosmetic Doctors Company, every filler treatment is performed by an experienced medical doctor. It is worth understanding what a ‘doctor-led’ clinic means, it not be what you think.

Read here to find out.

Hyaluronic acid fillers, the most widely used category, can be dissolved rapidly using an enzyme called hyaluronidase (Hyalase).

This makes them reversible if a result is unsatisfactory or, more importantly, if a vascular complication occurs and urgent dissolving is required. Not all fillers are reversible, Radiesse and Sculptra cannot be dissolved which makes appropriate patient selection and clinical expertise particularly important for these products

The most significant serious complication is vascular occlusion - accidental injection of filler into or compression of a blood vessel, blocking the blood supply to the tissue it supplies. In the most serious cases, involving the vessels that supply the eye, this can result in permanent vision loss. This risk is very rare but real, and it is one of the most important reasons to choose a medically qualified practitioner who carries hyaluronidase, understands the relevant anatomy, and can act immediately if a complication occurs.

We cover this in detail in our dedicated safety piece Are Dermal Fillers Safe Part II ?

Yes, at the Cosmetic Doctors Company all our treatments are delivered conservatively, with appropriate product selection, by a doctor who understands facial anatomy and prioritises natural results.

The standard we work to is that friends and colleagues notice that you look well, not that you have had something done. The best results are the ones nobody can point to.

See achieving natural, subtle results.

At The Cosmetic Doctors Company, serving patients across Surrey and South-West London from our clinic in Esher.

Every treatment is performed by an experienced, medically qualified doctor, using licensed products, following a thorough consultation and with hyaluronidase always available on site. We would be very happy to hear from you.

Because nothing else does what they do as immediately and as precisely. Biostimulatory treatments produce gradual improvement in skin quality and volume over months. Fillers restore specific, localised volume loss immediately, with a result visible the same day.

For patients with significant structural change, hollowing in the cheeks, temples, or tear troughs, no other non-surgical treatment provides the same precision of correction. They remain the most versatile and immediately effective tool in facial aesthetic medicine.

Yes, and in many cases a combination approach produces the most complete result. Botox addresses the muscular component of facial ageing; fillers address volume loss; biostimulatory treatments improve skin quality and collagen content. Each works on a different tissue layer and at a different depth. Used together in a thoughtful treatment plan, the results are more coherent and more natural-looking than any single treatment can achieve.

We have written about combination treatment in detail on our blog post on combination treatments.

We do not publish a fixed price list because treatment is never one-size-fits-all. The number of syringes required, the areas treated, and the complexity of the assessment all vary between patients. We are happy to provide a guide range when you get in touch, and all costs will be discussed clearly and in full before any treatment is agreed. No treatment will proceed without your fully informed consent.

This depends entirely on the individual assessment, the areas being treated, the degree of volume loss, and the goals of treatment. A single syringe may be appropriate for a subtle lip enhancement.

Significant structural restoration across multiple areas may require several. We will give you a clear indication at consultation, and we will never recommend more than is genuinely needed.

Low filler prices almost always reflect one of several compromises: a less experienced practitioner, a cheaper or potentially unlicensed product, minimal consultation, or inadequate aftercare. Bargain fillers may have a higher incidence of inflammatory reactions.

Since the cost of licensed filler product alone is significant, a price that seems too good to be true usually is. The financial margin at very low price points simply does not accommodate doing the treatment properly with a quality filler.

There is no absolute universal limit, but the principle of using the minimum amount necessary to achieve a natural and proportionate result is both clinically and aesthetically the right approach. Accumulation of filler over repeated treatments without proper assessment can produce unnatural results and in some cases tissue changes that are difficult to address. A practitioner who thinks carefully about cumulative volume, not just each individual treatment, is practising responsibly.

Pricing reflects the qualifications and experience of the practitioner, the quality and provenance of the product, the clinical environment, and the standard of consultation and aftercare provided.The wholesale price of fillers varies greatly; at the Cosmetic Doctors Company we use what we regard as the finest dermal fillers available.

Very low prices frequently indicate compromises in one or more of these areas i.e. cheaper product, less experienced practitioner, or minimal consultation. When something is being injected into your face, the cheapest option is rarely the best value.

With consistent, well-considered treatment over time, the goal is a face that ages more gracefully rather than one that changes character.

Maintaining appropriate volume as it naturally depletes, rather than waiting for significant change and then correcting it dramatically, tends to produce the most coherent and natural-looking long-term results. A practitioner who thinks about your face over years rather than appointments will guide this process appropriately.

Hyaluronic acid, the most widely used filler ingredient, attracts and binds water within the surrounding tissue, improving hydration at a level topical skincare cannot reach. Well-placed filler therefore tends to improve not just contour but the overall quality and condition of the skin in the treated area. It is one of the reasons that a good filler result often makes the skin look better, not just fuller.

The tear trough is the hollow that develops beneath the eye, producing the appearance of tiredness or dark circles. Filler placed carefully in this area can significantly improve the appearance of under-eye hollowing.

However, it is one of the most technically demanding filler treatments, with a higher risk profile than most facial areas, and it is not suitable for everyone. Patients with significant skin laxity, prominent eye bags, or very thin skin in this area may not be good candidates. A thorough clinical assessment is essential before proceeding.

Several causes are possible. Too much product in the wrong area can create an unnatural heaviness or distort proportions. Filler placed in an area that was not the primary driver of the concern can create an imbalance. Poor product selection for the tissue plane can produce an unnatural appearance. And filler placed without assessment of the whole face can correct one area while making another look worse by comparison.

This is one of the reasons that treating the face as a whole, rather than responding to individual concerns in isolation, produces better outcomes.

Read The Whole Face, Not Just the Lines

You do not; your practitioner does, after discussion with you and a thorough clinical assessment. The appropriate amount is determined by the degree of volume loss, the area being treated, the product being used, and the goals of treatment. A conservative starting point with a review at two weeks is always preferable to over-treatment that cannot be easily undone. If you feel you are being encouraged to have more than feels right, trust that instinct.

A good approach may be to start with a conservative amount, allow that to settle, then return for a follow-up a few weeks later, reassess and consider a little more.

The goal of good filler treatment is neither. It is to make you look well, rested and like yourself at your best. Restoring volume that has been gradually lost, refining contours that have shifted with age, and improving the structural support of the face produces a result that reads as vitality rather than treatment.

We have written about the distinction between looking younger and looking well in detail elsewhere on this blog and it is a distinction worth understanding before any treatment decision.

Read the difference between looking younger and looking well

A consultation is a dedicated clinical assessment with no obligation to proceed. It is where we take your medical history, assess your facial anatomy, understand your goals, discuss realistic expectations and risks, and give you an honest clinical recommendation.

A treatment appointment follows only if you choose to proceed, and only after your informed consent has been properly obtained. The two should never be compressed into a single rushed encounter.

Looking refreshed means looking like yourself, rested, well, and at ease in your face. It is what good aesthetic treatment aims for and what patients consistently describe as their goal. Looking overdone means a result that draws attention to itself, features that look exaggerated, proportions that look altered, or a face that reads as treated rather than natural.

The difference is almost always a matter of volume and placement, too much product, or product in the wrong place, crosses the line from restoration to alteration.

Botulinum toxin relaxes muscles, it addresses the dynamic component of facial ageing, softening the lines produced by repeated expression. Dermal fillers add volume. They address the structural component, restoring the fullness that depletes with age.

They work on different tissues and at different depths, and they complement each other in a comprehensive treatment plan rather than competing. A patient who needs both will get better results from both than from either alone.

Yes, significantly. Different brands vary in their hyaluronic acid concentration, degree of crosslinking, particle size, and rheological properties (the way they behave mechanically in the tissue). These differences determine how a product performs in different tissue planes and for different indications. Some products are designed for fine surface lines; others for deep structural support.

An experienced practitioner selects the most appropriate product for each specific indication rather than using a single product for everything. See why Dr Forrester now only uses the Belotero range of hyaluronic acid filler.

Dermal fillers add volume immediately by introducing a substance that physically occupies space in the tissue. Biostimulatory treatments work by stimulating the body's own collagen and elastin production over weeks and months. They produce a gradual improvement in skin quality and structure rather than immediate volumetric correction.

The two approaches address different aspects of facial ageing and are complementary rather than interchangeable. We examine this in detail in our biostimulators post on our blog.

Hyaluronic acid fillers are the most widely used biocompatible, immediately effective, and reversible with hyaluronidase. Radiesse is calcium hydroxyapatite which provides immediate structural correction while also stimulating collagen production but cannot be dissolved if problems arise. Sculptra is poly-L-lactic acid and works purely as a biostimulator, producing gradual collagen stimulation over months with no immediate volumetric effect.

Each has specific indications and a different risk profile, and the choice between them should be guided by clinical assessment rather than patient preference alone.

In the UK, the regulatory position is more complicated than most patients realise. Dermal fillers are not prescription medicines, unlike Botox, which means that until recently there was no legal requirement even for a prescriber to be involved. This is slowly changing, but the person actually administering the treatment is still not legally required to have medical training or even any training at all.

This is a significant patient safety concern that responsible practitioners and organisations such as Save Face have been campaigning to address.

A medically qualified doctor with specific training in aesthetic medicine, thorough knowledge of facial anatomy. This must include the danger zones where incorrect placement can cause vascular occlusion. As well as the clinical background to manage complications immediately and effectively.

Hyaluronidase must be on site. Professional indemnity insurance must be in place. These are not optional extras. They are the minimum standards that protect you.

Blood-thinning medications and supplements, including aspirin, ibuprofen, warfarin, fish oil, vitamin E, and certain herbal products, increase the risk of bruising at injection sites. Where clinically safe to do so, we advise pausing these for a week before treatment. Prescription anticoagulants should only be paused under medical guidance. Always disclose your full medication list at consultation.

Several questions matter:

• What are your medical qualifications and are you GMC registered?

• Do you carry professional indemnity insurance?

• What product will you use and is it a licensed filler?

• Do you have hyaluronidase on site?

• What would you do if I developed a vascular complication?

These are not difficult questions for a qualified, well-prepared practitioner and the confidence and clarity of the answers will tell you a great deal about the person you are considering trusting with your face.

Vascular occlusion occurs when filler is inadvertently injected into or compresses a blood vessel, blocking blood supply to the tissue it serves. The consequences range from localised skin damage to, in the most serious cases involving the vessels supplying the eye, permanent vision loss.

It is the most serious complication associated with dermal filler treatment. It is rare but its management requires immediate recognition, hyaluronidase on site, and the clinical knowledge to act without delay. This is why the choice of practitioner matters so profoundly. We have written a dedicated piece on vascular occlusion safety in our post Vascular Occlusion and Why the Practitioner Makes All the Difference.

They should have a clearly defined complication management protocol including immediate access to hyaluronidase for hyaluronic acid filler complications, knowledge of the clinical signs of vascular compromise, and an emergency pathway for escalation if required.

Vascular occlusion is a time-critical emergency; the window for effective intervention can be measured in minutes in the most serious cases. A practitioner who cannot describe their complication protocol clearly is not adequately prepared.

Licensed dermal filler products should be sourced through regulated pharmaceutical supply chains and stored under appropriate conditions.

At our clinic, we use only licensed products sourced through legitimate medical supply channels. If you are ever uncertain about the provenance of a product being used in your treatment that uncertainty is itself a reason to reconsider the provider.

No. Dermal filler treatment is contraindicated during pregnancy and breastfeeding. While systemic absorption of hyaluronic acid filler is minimal, the absence of safety data in these populations means that treatment should not proceed. Any patient who is pregnant, trying to conceive, or breastfeeding should postpone treatment until this is no longer the case.

Yes. Active autoimmune conditions, certain inflammatory skin conditions, a history of severe allergic reactions or anaphylaxis, and active infection or inflammation at the intended treatment site are among the contraindications.

Certain medications also require careful consideration. This is one of the reasons a thorough medical history is an essential component of every consultation not a bureaucratic formality.

Certain areas of the face namely, between the brows (the glabella). the nose, and the immediate area around the eye socket (periorbital) are the highest-risk anatomical zones due to their proximity to vessels that supply the eye. Treatment in these areas requires particular expertise and extreme caution. Other high-risk areas include the nasolabial folds near the angular artery.

A practitioner who treats these areas without full understanding of the relevant vascular anatomy is operating recklessly.

Yes, in certain contexts. The backs of the hands are a well-established non-facial indication, addressing the volume loss and prominence of tendons and veins that accumulates with age. Certain diluted filler preparations are increasingly used for skin quality improvement in the neck, décolletage, and body. These applications require the same standard of clinical assessment and the same awareness of anatomical risk as facial treatment.

A medical provider has the training to take a full medical history, identify contraindications, understand the vascular anatomy of the face, carry hyaluronidase, and manage complications clinically. They are registered with a professional regulatory body and carry mandatory indemnity insurance.

A non-medical provider lacks this framework and in a treatment that carries the risk of vascular occlusion, that difference is not a minor one. It is the difference between a complication that is managed immediately and one that is not managed at all.

Read How to Choose a Safe Aesthetic Practitioner.

Absolutely not. Dermal filler treatment requires individual clinical assessment, a proper medical history, informed consent, appropriate facilities, and a practitioner who can manage complications immediately.

A social setting, a pop-up clinic, or a party provides none of these things. The casual normalisation of what is a medical procedure with genuine risks is one of the aesthetic industry's most concerning developments.

The media coverage of dermal fillers tends to focus on the results that attract attention — the dramatically overfilled lips, the pillow cheeks, the faces that announce their treatment rather than concealing it. This creates a significantly distorted picture of what filler treatment actually looks like in everyday practice.

The vast majority of well-delivered filler treatments go entirely unnoticed, by friends, colleagues, and cameras, because looking natural is precisely the point. The results that succeed are invisible by design; the results that fail are visible by definition. It is an unavoidable selection bias, and it means that almost everything the public sees of dermal fillers represents the outer limits of the approach rather than its everyday reality.

Add to this the genuine and well-documented problems caused by unqualified practitioners and unlicensed products, which do deserve media attention and the picture that emerges bears little resemblance to what a carefully assessed, conservatively delivered filler treatment by a qualified doctor actually produces.

Read more here

Ask directly, a qualified practitioner will answer without hesitation. Check their registration on the GMC, NMC, or GDC register.

Look for membership of professional bodies such as the BCAM or JCCP. A practitioner who is reluctant to provide this information is providing important information of a different kind.

Well-placed, appropriate filler used conservatively over time does not cause long-term damage. However, the accumulation of excessive filler without proper assessment can be a concern in patients who have received repeated high-volume treatments over years.

This can produce tissue changes including chronic oedema, displacement of natural fat compartments, and an unnatural heaviness that becomes progressively harder to address. This is one of the strongest arguments for conservative treatment and consistent clinical oversight over time.

Hyaluronic acid filler is gradually broken down by the body's own hyaluronidase enzymes over months. The process is gradual rather than abrupt, the result fades progressively rather than disappearing suddenly.

The face returns towards its pre-treatment appearance rather than looking worse than before. With consistent maintenance treatment, the improvements can be sustained over time with progressively smaller amounts of product as the tissue adapts.

In experienced hands, with conservative doses and proper clinical assessment, repeated treatment over time is safe and produces good long-term results. Problems arise when repeated treatments accumulate excessive volumes without adequate assessment, when product is placed in tissue that has already been over-treated, or when there is no consideration of the cumulative picture across treatments.

A practitioner who treats each session in isolation, without reference to what has gone before, is not practising with the long-term interest of the patient's face in mind.