Dermal Fillers in Brighton & Hove

01 Understanding dermal filler

Hyaluronic acid — but not all the same

This page discusses cross-linked hyaluronic-acid gel fillers. Hyaluronic acid is a molecule naturally present in the body, where it helps bind water and support tissue. The material used as filler is manufactured, purified and modified so that it persists much longer than the hyaluronic acid your body continually produces and breaks down.^[8][9][44]

That distinction matters. “Acid” is part of its chemical name; it does not mean that the injected gel is corrosive like an acid in everyday use. The core molecule is familiar to the body, but the finished gel is still an implanted medical material. “Natural” does not mean risk-free, and the name on a box is not a diagnosis or a treatment plan.

02 Why different fillers behave differently

The material has to match the tissue and the objective

Hyaluronic-acid gels differ in softness, support and how they behave with movement. The material is selected for the tissue, depth and intended change — not because one product is fashionable or assumed to be universally “better”.^[8][41]

Technical material properties can help a clinician make that decision, but they are not a shopping list for patients and do not create a rule that one gel is always better or always lasts longer.

03 How and why it works

Cross-linked hyaluronic-acid filler occupies space, provides mechanical support and attracts water. In the right tissue plane, that may improve contour, projection or the transition between facial structures. Over time, the material integrates with surrounding tissue and is gradually metabolised.^[9][44]

Filler is sometimes promoted as a collagen treatment. That is not a reliable benefit to promise. If collagen or skin quality is the real objective, a treatment designed for that purpose is usually a more honest conversation.

Natural origin does not make incorrect placement, excessive volume or vascular injection harmless.

04 Why filler became popular

Filler can create a visible, targeted change without surgery or general anaesthesia. It can be planned in small amounts and, with hyaluronic-acid material, there may be a clinical option to reduce the product if correction is required.^[1]

Those are genuine advantages. Each has a counterpart: the early appearance is affected by swelling, precision depends on diagnosis and placement, a non-surgical treatment cannot reproduce surgery, and “reversible” does not mean simple, complete or risk-free.

05 Advantages and limitations

Potential advantages

• —A visible change can be created in a selected structural concern.
• —Support, volume, contour or proportion can be addressed without surgery.
• —The plan can be conservative and staged when there is a clear reason.
• —Different gel properties allow the material to be matched to the tissue and objective.
• —Filler can address structural concerns that surface-focused skin treatments cannot.

Limitations

• —Swelling and bruising can temporarily distort the result.
• —The outcome depends heavily on correct diagnosis, material choice and placement.
• —Adding volume cannot correct every layer of facial ageing.
• —Previous product may remain after the visible effect has faded.
• —Repeated, automatic top-ups can accumulate and alter proportion.
• —Results and longevity vary; there is no personal guarantee.
• —Rare but serious vascular, visual and neurological complications are possible.

06 Structural ageing

Ageing is not simply “loss of collagen”

A face changes across several layers. Bone remodels; fat compartments change; ligaments, muscle activity and skin all contribute; weight, hormones, sun exposure and previous treatments may alter the picture further.^[3][26]

Replacing volume cannot undo every change in bone, ligament or skin. Filler has a role only when support or volume is genuinely part of the concern and the proposed correction remains proportionate.

Age does not prescribe the treatment. Anatomy and the reason for treating do.

07 After weight change

Weight change can reveal hollows, reduce facial support or make laxity more apparent. The same face may contain areas that have lost volume and others where adding volume would make heaviness worse.^[4]

The objective is not to chase every hollow. I look at what has changed, what is still changing and whether structure, skin, time or no treatment offers the more sensible answer.

08 Assessing the whole face

The face is seen in movement, profile, light and shadow

A feature cannot be planned well in isolation. I look at the relationship between the upper, middle and lower face; front and side views; natural asymmetry; movement; skin quality; and any previous treatment.

Classical proportions can help describe balance, but they are not measurements to impose. Sex, ethnicity, culture and personal preference influence what looks harmonious. The aim is to work with your identity rather than move every face towards one template.^[3]

Where structure contributes to a resting appearance that reads as tired or downturned, that may sometimes be modified. This is a discussion about anatomy and facial cues, not a promise to remove an emotion.

09 Deciding by the goal

Filler is considered for a limited set of structural goals: restoring selected support or volume, refining projection or contour, improving proportion, or softening a shadow whose cause is genuinely structural.

It does not treat pigmentation, pores, surface texture, muscle movement, excess skin or excess fat. It does not replace surgery. It should not be used to treat every sign of ageing by adding more.

Filler may improve selected structural support. It does not replace treatment directed at skin quality.

Sometimes the correct plan is another treatment. Sometimes it is to leave previous filler alone. Sometimes it is no treatment.

10 Area-by-area decisions

An area is not a treatment plan

The same concern can have different causes in different faces. A shadow may come from volume loss, bone structure, skin quality, fluid, fat, movement or laxity. Naming the location does not establish that filler belongs there.

Every proposed area is judged against five questions:

1. What is actually creating the concern?
2. Would added support or volume address that cause?
3. What change is realistic in movement and from more than one angle?
4. Would treatment improve overall proportion or make another area heavier?
5. Does the likely benefit justify the anatomical and clinical risk?

Not every area where filler can technically be placed is one I will offer or recommend. Naming an area does not establish a treatment.

11 Amount and staged planning

A syringe is a unit of product, not a treatment objective.

The amount depends on anatomy, previous filler, the intended change and whether a staged plan is justified. A small amount in the wrong place can look wrong; a larger plan is not automatically better or more valuable.

Staging can allow early swelling to settle and the effect on proportion to be judged before any further decision. It should have a defined objective. It is not an open-ended commitment to keep adding.

The material is selected for the tissue, depth, movement and goal. A fashionable product or technical term is not a reason to treat.

12 The consultation, treatment decision and recovery

The consultation starts with what you see and what you want to change. I then review relevant medical history, previous treatment and any product that may still be present, before assessing the face at rest, in movement and in profile.

If filler is appropriate, the plan should make the intended change, alternatives, material, amount, risks and likely recovery clear before treatment. Whether consultation and treatment occur on the same visit depends on how the appointment was booked, the assessment and whether it is clinically appropriate.

An initial change may be visible early, but swelling, redness, tenderness, bruising or temporary unevenness can alter what you see. The result should not be judged until those early effects have settled. The appropriate appointment length, anaesthetic approach, review point and aftercare depend on the agreed treatment rather than one universal filler pathway.

13 How long filler lasts

Duration — three different questions

“How long does it last?” can mean three different things:

• —Visible correction: whether a clinician can still measure an improvement.
• —Patient satisfaction: whether the person remains happy with the result.
• —Detectable material: whether filler can still be seen on imaging.

These are not interchangeable. A visible result can soften while material remains; a person can remain satisfied after the measured correction has reduced.

Studies report different results because products, areas, volumes, techniques and endpoints differ. For example, one product-specific 60-person lip study reported measurable fullness responses falling from 93.2% at three months to 48.3% at twelve months, while more than 80% remained satisfied at twelve months.^[34] A product-specific controlled study in 148 Chinese adults reported 76% responders at six months and 51% at twelve months, with high satisfaction in that selected group.^[35] Those figures describe those studies, not every filler or every face.

Imaging adds a different warning. In a small review of 33 patients, hyaluronic-acid material remained detectable in the midface years after injection.^[5] That does not mean the visible result lasted for years. It means residual product must be considered before any top-up.

There is no good basis for promising that exercise or a self-described “fast metabolism” independently makes facial filler disappear faster. Material properties and movement are plausible influences, but a single personal duration still cannot be predicted from them.

How long filler appears to last also depends on the product and its cross-linking, the treated area, movement, amount and placement, local tissue, previous filler and individual breakdown. These factors affect each other, so they cannot be converted into one personal number before treatment.

14 The “done” look, honestly

Nobody sets out to look overfilled. It usually develops one reasonable-sounding decision at a time: automatic top-ups, residual product being ignored, isolated features treated without the whole face, swelling mistaken for the final result, too much material, or a product and tissue plane that do not fit the objective.

At some point, more product stops improving structure and starts reducing proportion. It may erase natural transitions, flatten light and shadow, distort movement or make one feature dominate.

Not everyone wants an undetectable result. Wanting a stronger or more visibly enhanced feature is a legitimate preference. The necessary conversation is how visible you want it to be, how it may look in motion and from different angles, what the limits are and where my own clinical boundary lies.

I do not accept every request simply because it is technically possible. If the result would be disproportionate, unsafe or unlikely to serve the stated goal, I will decline.

15 When filler works well

Used for the right problem, hyaluronic-acid filler can create a meaningful and satisfying change. The better evidence supports improvement in selected structural indications, but no study can decide whether filler is right for an individual face.^[7][11][12]

Four things need to align:

• —Diagnosis: the concern really is structural or volume-related.
• —Material: the gel’s behaviour matches the tissue and objective.
• —Placement: the plane, amount and distribution support the plan.
• —Expectation: the desired change is realistic, proportionate and understood.

A strong result is not simply one that can be seen. It is one that answers the right problem without creating a new one.

16 Why filler may disappoint

Disappointment often begins before the syringe: the wrong cause is identified, skin or laxity is treated as missing volume, previous filler is overlooked, natural asymmetry is underestimated, or the expectation really requires surgery.

If a result is not right, the first response should not automatically be more product. The tissue may need time to settle. Previous records, photographs and the material used need to be understood. The correct next step may be observation, further assessment, a separate correction pathway or no further treatment.

17 Reversibility — what that word really means

Hyaluronic-acid filler can sometimes be reduced for a clear clinical reason, but it is not a simple reset. The response may be incomplete, more than one intervention may be needed and correction carries its own risks.^{[21][22][23][24]} Treating a blood-supply problem is a different, urgent pathway.

18 Safety and suitability

Common early effects

Swelling, redness, tenderness, pain, bruising and short-lived unevenness or asymmetry can occur after treatment. They are usually temporary, but “usually” is not a guarantee.^[13]

Less common problems

These include infection, prolonged swelling, visible or palpable lumps, migration, superficial placement that creates a bluish appearance, and delayed inflammatory reactions or nodules. The true frequency of some of these problems is uncertain because studies use different products and definitions, and referral studies count complications rather than all treatments.^{[18][19][20][45]}

Rare but serious complications

Unintended injection into a blood vessel can compromise the skin’s blood supply and may lead to tissue injury or scarring. Rare visual or neurological events, including visual loss and stroke, are documented.^[14][16]

Vascular occlusion was reported infrequently in large retrospective studies, but it can cause serious harm. Estimates vary because studies count syringes or sites, mix materials and devices, and may rely on clinician reporting. Individual risk is not known, and prompt action matters.

I have not caused a vascular occlusion in my own practice. I have, however, assessed patients who came to me for emergency care after filler treatment elsewhere and, where clinically appropriate, carried out dissolution treatment. That experience is one reason I believe every patient has the right to recognise concerning changes and know what to do and where to seek help.

Skin blood supply — contact the treating clinic now

Contact the clinic immediately if an area remains unusually pale or white after gentle pressure; the colour returns noticeably more slowly than on the matching side; or the skin becomes dusky, mottled, grey, unusually cold or blistered. Severe or increasing pain is also a warning sign, although pain is not always present. Do not wait to see whether it settles.

Capillary refill is a warning aid, not a self-clearance test. A quick return of colour does not rule out a problem when other concerning changes are present.

No website replaces the individual emergency and aftercare instructions that must be confirmed before treatment.

19 When treatment may need to wait

Cosmetic filler in England is limited to people aged 18 or over.^[2]

Pregnancy or breastfeeding, active infection or broken skin, a previous serious reaction, significant allergy history, relevant autoimmune or inflammatory disease, immunosuppression, medicines or supplements that affect bleeding, recent or planned dental work, recurrent cold sores and previous filler or implants can all change the decision.

This is not a checklist for self-clearance. It is why the medical history and previous treatment record matter. The outcome may be to proceed, change the plan, wait, seek another opinion or not treat.

20 Choosing a practitioner

Filler is placed into a three-dimensional, moving face containing vessels, nerves, muscles, fat compartments, ligaments and often material from previous treatments.^[26] Technical confidence is not the same as anatomical judgement.

Useful questions include:

• —Are you a registered healthcare professional?
• —What is your training in facial anatomy and filler assessment?
• —Who decides whether I should be treated at all?
• —What material would be used and why is it appropriate here?
• —How are product identity and batch details recorded?
• —What risks are specific to the proposed area and plan?
• —Who remains accountable after treatment, and how are concerns reviewed?

Before treatment, ask who is responsible if a complication occurs, how you can contact them urgently, and what immediate treatment and referral arrangements are in place. If the practitioner cannot explain the emergency pathway clearly, do not proceed.

At odNOVA, the assessment and treatment decision are made personally by Piotr Wojtowicz, a GPhC-registered Pharmacist Independent Prescriber with an MSc in Cosmetic & Aesthetic Medicine and a PGDip in Dermatology in Clinical Practice.

His training also includes cadaveric dissection, giving him direct, three-dimensional experience of the anatomy and tissue planes relevant to facial treatment.

Proper consent is a conversation: the objective, realistic outcome, alternatives, material, risks, costs and what happens if the result needs review. A signature cannot replace that discussion.

21 Maintenance and review

Maintenance is reassessment, not an automatic calendar. A visible effect may fade while material remains, so the current face and any residual product need to be judged before more is added.^[5]

The first correction of an area often requires more product because the plan is building the initial structural change. Later maintenance may require less if some correction or material remains. This is not a guaranteed pattern or an automatic top-up. Each visit reassesses the current face, and the appropriate amount may be smaller, similar — or zero.

Routine top-ups can quietly turn a balanced result into accumulated volume. Sometimes the correct maintenance plan is to wait. Sometimes it is to do nothing.

22 Alternatives

Match the method to the problem

• —Movement-led lines: assess facial movement rather than add volume.
• —Poor skin quality, fine surface lines or dehydration: consider a skin-quality pathway.
• —Pigmentation: investigate the pigment and use a pigment-focused plan.
• —Texture or acne scarring: consider resurfacing, microneedling, peels or another scar-specific pathway where appropriate.
• —Generalised laxity or descended tissue: filler may not reproduce a surgical result; a surgical opinion may be more honest.
• —Under-eye bags, excess skin, fluid or festoons: adding volume can make the problem worse; specialist assessment may be more appropriate.
• —Existing or uncertain filler: wait, obtain records or consider further assessment rather than add blindly.
• —A small concern with uncertain benefit: observation or no treatment is a valid outcome.

23 What the evidence supports

The evidence for dermal filler is useful but uneven. Findings for one material, area, volume, technique or follow-up period cannot be transferred automatically to another.

The strongest evidence on the current page concerns selected midface volume restoration.^[7] Evidence for lips and chin is also useful but variable.^[11][12] Duration studies use different endpoints and do not provide one honest “lasts X months” figure. Imaging shows that material can persist beyond the visible effect.^[5] The true frequency of the rarest complications remains difficult to measure. Published visual-loss and vascular-complication evidence is largely case-based,^[16][43] while the large retrospective clinician survey in reference 42 relied on clinicians reporting their own cases rather than complications being recorded prospectively.^[42]

Industry involvement is common in filler research. That does not make every result invalid, but it means the product, study design, conflicts and exact endpoint should be shown rather than hidden behind a headline.

Dermal filler is most valuable when it restores something that is genuinely missing. It becomes problematic when it is used to treat every sign of ageing by adding more.

24 Fees and the plan

Filler should not be sold as a per-area shopping list. The agreed plan and total cost need to be clear before treatment, including whether treatment is staged and what is included in the fee.

Before treatment, you should know the total cost of the agreed plan, what the fee includes and whether any proposed treatment is staged.

View current fees

25 Questions, answered

26 References

How to read the sources

Inline reference numbers support specific statements, not the page as a whole. The appendix also retains supplementary evidence from the source record, so not every listed source is cited in the body. Evidence for one material, treatment area, technique, endpoint or follow-up period does not automatically predict another. Industry involvement, small samples and study design limitations are shown where relevant.

This page is general patient information. It cannot determine whether dermal filler is suitable for you and does not replace an individual medical assessment, consent discussion or treatment-specific aftercare.