Refresh and restore your look
Improve the signs of ageing with dermal fillers treatment. Natural looking results.
What are dermal fillers?
Dermal fillers treatment are injectable gel-like substances that can be used for many cosmetic enhancements. The approach to the aging face takes into account the various changes, and also the different treatment strategies to target the multiple components of the aging face.
Dr. Ng employs dermal fillers as part of many facial sculpting treatment plans and to address signs of aging and concerns. Dermal fillers can be used to add volume, reduce lines, wrinkles, and folds on your skin.
HOW DR.NG uses fillers
With more than decade of experience, Dr. Ng believes in customising the right blend of complementary treatments for each patient. He often uses multiple types of fillers, pairs fillers with neuromodulators, and enhances results with lasers or other skin treatments.
what can fillers treat?
- Age related volume loss e.g. temples, cheeks, chin, jawline.
- Age related skin textural changes e.g. fine lines, wrinkles, folds.
- Cosmetic enhacement e.g lip, cheek, chin augmentation
- Atrophic Scarring e.g. acne scarring
- Congenital atrophy or volume deficiency
- HIV lipoatrophy or lipodystrophy
Which fillers treatment type is best for me?
Fat was the first filler substance used. In the late 19th century, Dr. Neuber, a German surgeon transplanted fat from the arm of a man to fill a facial defect. Today fat grafting is a common procedure to volumize the face and many body areas, but the average fat survival rate is only about 25% to 30%, and the procedure is associated with surgical risks. Collagen fillers entered the market in the early 1980s, but were associated with allergic reactions, did not last very long (3-4 months on average), and were derived from animals thereby raising concerns of cross infection.
Today, with the advancement of biocompatible fillers and a greater understanding of age related changes, there is an ever increasing number of fillers treatment entering the market. It can be indeed be overwhelming for a consumer to decide which works best for you.
classification of fillers
- Collagen: human, bovine, porcine
- Hyaluronic acid (HA)
- Poly-L-lactic acid (PLLA)
- Calcium hydroxylapatite (CaHa)
- Polymethyl methacrylate (PMMA)
- Short lasting or biodegradable (< 6 months): soft hyaluronic acid fillers, collagen.
- Long lasting (up to 24 months): HA fillers, PLLA, CaHa.
- Permanent (more than 24 months): PMMA
What is the Ideal Filler Treatment?
To understand which fillers treatment to go for, you need to know the individual properties of the fillers. A consultation with your doctor to discuss the benefits, suitability and level of expected improvement is needed before any filler procedure. Individuals vary, and so does the treatment response.
Although there is no ‘ideal’ filler at present, there are some characteristics that are important in terms of safety and efficacy:
- Provides reproducible and consistent results
- Non-allergenic and non-inflammatory
- Long lasting with natural looking results with ageing
common filler types in singapore
Hyaluronic Acid Fillers
(Restylane, Juvederm, Belotero, Profhilo)
Hyaluronic acid (HA) fillers are gel based injectable fillers. Hyaluronic acid forms an integral part of human tissue; it provides a supporting framework for collagen and elastin to bind. It hydrates the skin due to its water binding ability, volumizing the treatment areas and reducing lines, wrinkles and folds.
Although abundant in youth, the passage of time and environmental factors such as UV exposure depletes the presence of hyaluronic acid within the skin. The arrival of Hyaluronic Acid (HA) fillers in the USA in the 2003 disrupted the way we look at fillers and has since become the dominant filler type used today.
Modern day synthetic HA fillers treatment are non-animal sourced derived, have low allergic potential, lasts much longer (thanks to cross-linking technology), and has a greater element of safety. HA fillers are reversible with the enzyme, Hyaluronidase.
Calcium Hydroxylapatite Fillers
Radiesse is a calcium hydroxyapatite (CaHA) filler. The CaHA particles act as a scaffold for new tissue formation and collagen deposition. These CaHA microspheres slowly degrade over time by the body’s metabolic pathway.
- Non-animal source, non-immunogenic
- Stimulates collagen production over time
- Lasts up to 24 months
- Cheeks, Nasolabial folds, Prejowl sulcus and marionette lines
- Cannot be reversed
- Case reports of nodules, granulomas and filler migration
- Not suitable for lips and periorbital area
Poly-L-lactic acid Fillers
Sculptra consists of micro particles of poly-L-lactic acid (PLLA). Following injection of PLLA into the skin, an inflammatory response leads to collagen formation and subsequently volumization.
- Biocompatible and biodegradable
- Lasts up to 24 months
- Multiple treatments needed
- Delayed nodule and granuloma formation
- Not suitable active areas such as the forehead, periorbital, nose, mouth, neck and hands.
Ellanse consists of polycaprolactone smooth microspheres suspended in an aqueous carboxymethylcellulose gel vehicle.
It works by not only filling up your lines and wrinkles, but also by stimulating your body’s own collagen for longer lasting natural results.
- Immediate volumisation followed by sustained collagen formation
- Lasts 18-24 months
- Cheeks, chin, nasolabial folds, marionette lines, hands
- Lower risk of nodules and granuloma formation
- Not suitable for use in eyelids, lips
Fillers treatment FAQs
A consultation and aesthetic assessment is necessary to understand your concerns, expectations and suitability for filler treatments. During consultation, your doctor may ask details of your medical history, medication/surgical/dermatological history, scarring potential e.g. keloids, current pregnancy/breastfeeding status, allergies, reactions and timing of previous aesthetic procedures.
- Breastfeeding or Pregnancy
- Active skin infection or inflammation
- Autoimmune diseases
- Multiple severe allergies and hypersensitivities
- Recent plastic surgery e.g. rhinoplasty
- On blood thinners or pre-existing blood clotting disorder
Facial ageing approach takes into account the different layers of the skin, fat, muscle, ligaments and bones. With a patient tailored approach, Dr. Ng uses a combination of aesthetic treatments that are unique to your skin type and condition; botulinum toxin injections to relax the muscles, Pico lasers for pigmentation and skin resurfacing, vascular laser for facial redness and veins, RF microneedling for skin tightening and skin rejuvenation, Threads for lifting.
The most common side effects are temporary injection side swelling, discomfort and bruising, which typically fade in 7 days.
Some individuals may develop lumps under the site of injection. This is more common under the lower eyelids where the skin is thinner and on the lips.
Quite uncommonly, fillers may lead to skin infections and may trigger an allergic reaction in susceptible individuals.
A serious but fortunately rare complication of fillers treatment is the accidental injection of filler into the blood vessel. This can cause the skin that is being supplied to the blood vessel to die if steps are not taken to salvage it on time. There have been cases of individuals going blind/stroke following filler injection, especially to the nose, glabella and forehead filler injections, as the blood vessels supplying these areas share the same path to the eyes.
Depending on the filler type, location injected and volume used, you may see an immediate result. However, there may be associated swelling with the filler treatment over the next few days which eventually subsides. For some of the longer lasting fillers e.g. PLLA, CaHa, PCL, improvements are more appreciable over time due to continued collagen formation and remodelling.
schedule an appointment for fillers treatment in singapore
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- Pavlovic M, Adamic M, Schuller Petrovic S. The actual role of hyaluronic acid-based and calcium hydroxylapatite soft tissue fillers: a guide for a practicing dermatologist. G Ital Dermatol Venereol. 2012 Jun. 147(3):295-314.
- Ballin AC, Brandt FS, Cazzaniga A. Dermal fillers: an update. American journal of clinical dermatology. 2015 Aug;16:271-83.
- Cheng LY, Sun XM, Tang MY, Jin R, Cui WG, Zhang YG. An update review on recent skin fillers. Plast Aesthet Res. 2016 Mar 23;3:92-9.