Injectable Dermal Fillers

With 12 years experience, we’ve come to be very familiar with the various injectable dermal fillers available, their strengths and weaknesses, uses and misuses.

Doctors are disallowed by the Australian Therapeutic Goods Administration (“TGA”) to mention these dermal fillers by name in a website, nor are we allowed to mention their active ingredients. Please bear with us as we attempt to inform you without using these specific terms.

Non-permanent dermal fillers

The dermal fillers we obliquely refer to here as Agent R, Agent P, Agent S, Agent E and Agent J are all composed of the same substance. This substance occurs naturally in your body and is essentially a long complex sugar molecule, with around 100 grams of it residing in skin and in joints. The dermal filler manufacturers transform the substance slightly to ensure it lasts many months rather than a few hours.

Agent R is the best established dermal filler of this group, having been around for maybe 15 years or so. 20mg/ml concentration of “sugary goo” x 1.1ml in the syringe. These days Agent R comes with local anaesthetic pre-loaded in the syringe, making treatments easier and more comfortable.

Agent P is the same as Agent R, excepting that the particles are a little larger, creating a slightly firmer dermal filling effect that may last a little longer than Agent R. It is slightly more expensive.

Agent S is the same as Agent R and Agent P, excepting that the particles are bigger again, in fact 1mm in diameter. Agent S is good for building up cheeks, and lasts longer than agents R and P on account of the larger particle size taking longer to break down.

Agent E is made of the same sugary goo as the others, but is more liquid in consistency, without the particles. It is therefore the softest, but also the runniest, of this group of dermal fillers. It doesn’t have its own anaesthetic pre-loaded, so you need some anaesthetic prior to having Agent E injected. We like Agent E for soft lip enhancement, but find it too runny to place near eyes.

Agent J is liquid like Agent E, but not as runny. No particles. 24mg/ml concentration of sugary goo and 1.0ml in the syringe. Comes with anaesthetic preloaded in the syringe but at an extra price from the manufacturer, making Agent J the most expensive option of the sugary goo fillers. Still, it gives quite soft lips, and is firm enough to place near eyes. We like Agent J as well.

Permanent injectable dermal filler

There’s only one permanent injectable dermal filler available in Australia, which we will call Agent A. When a patient has had a non-permanent dermal filler on multiple occasions to the one place and can definitely say they want a permanent dermal filling effect, Agent A has a place.

When an older patient comes in looking for filling, Agent A is a good choice. However, we have found that Agent A carries a certain risk of side effects that we don’t see with the non-permanent fillers. The risk is very small but not entirely negligible.

Volume builder

Two products available in Australia work to build volume. Agent RR is composed of particles chemically similar to bone, mixed with a natural organic gel. When initially applied it fills like a regular filler, but because the bone-like particles stimulate your cells to make more collagen, we see a prolonged effect of 12-24 months depending on the site injected amongst other things. We also use it to build long-lasting volume in faces and facial lines.

Agent SS actually comes as a powder which we have to mix with local anaesthetic a full two days prior to injection. In the weeks and months after treatment, collagen,  volume and firmness builds in and under the skin. This effect can last three years.

So why isn’t there a queue out my door of patients lining up for agent SS?

Firstly, it takes a few weeks to a couple of months to work. Secondly, you generally want several treatments. Some patients are satisfied after one, but others need 4 or 5. All takes time and all costs money. Thirdly, the treatment has to be carefully but widely distributed under the skin so as to avoid lumpiness and ensure an even result. And finally, there’s a bruise risk. More so than with other fillers.

And fat?

The greatest way to achieve youthful filling of your face is with your own fat. Whereas the above-mentioned commercial fillers cost $600 – $1000 per ml to inject, we can easily harvest 50ml or 100ml or more fat for facial transfer. You can’t be allergic to your own fat and you won’t get a foreign body reaction to your own fat. We can always put in more fat. And fat transfer includes, of course, the stem cells residing in the fat. It’s early days yet in the stem cell story, but these cells may help further rejuvenate the appearance of your face.

Click the above links for more information on facial fillers, or book an appointment with us.

02 9368 0100