Dermal Fillers

Dermal fillers are commonly used to:

• Enhance and restore volume to cheeks and temples
• Plump and enhance the lips
• Reduce the appearance of fine lines and wrinkles on the face
• Improve facial symmetry
• Enhance skin quality

Hyaluronic acid, calcium hydroxyapatite, and poly-L-lactic acid (PLLA) are currently approved for use in New Zealand.
Permanent fillers such as polymethylmethacrylate (PMMA) are not recommended by NZSCM.
Autologous fat injections (facial fat grafting) are typically performed by plastic surgeons in New Zealand 

• Hyaluronic acid (HA) is a naturally occurring substance that is already found in your skin, which helps keep it firm and hydrated.
  HA fillers generally last 6-12 months or longer, while the body gradually and naturally breaks down the filler.
• Calcium hydroxylapatite (CaHA) is also a naturally occurring substance found in teeth and bones.  It is used as a filler, with particles suspended in a gel. CaHA adds volume and also stimulates natural collagen production.
• Poly-L-lactic acid (PLLA) is a biodegradable synthetic substance which is used as a filler to stimulate collagen production.

Dermal fillers are regulated by Medsafe, which is the NZ Medicines and Medical Devices Safety Authority.  Medsafe generally approves fillers that are FDA (USA), TGA (Australia) and EMA (European authority) approved. Dermal fillers are Class II medical devices, which means there is a medium risk to the human body associated with their use.
Importantly, dermal fillers are not prescription medicines in New Zealand. This means:

• They do not require a prescription to be supplied
• They can be purchased and used more freely than prescription-only injectables (such as botulinum toxin)
• There is no legal requirement for a medical consultation before administration

Because of this, it is especially important to choose a provider who:

• Uses only Medsafe-approved fillers
• Has specific training in dermal fillers
• Works within a regulated clinical environment
• Follows evidence-based safety protocols, including having Hyalase (a prescription-only medicine used to dissolve hyaluronic acid fillers) available in case of complications

Biostimulators are dermal fillers which are aiming to stimulate the body's natural collagen production. Over time, the body responds to the injected substances by producing more collagen which can restore volume, improve skin texture and elasticity, and reduce wrinkles.

Dermal filler potential side effects and adverse events include:

• Swelling, tenderness, redness and bruising are all possible - and are expected to resolve in a few days.
• More rarely, lumps or unevenness can occur which may need further treatment.
• Infection can occur which may require antibiotic treatment or dissolving of the filler.
• Very rarely, hard lumps of scar tissue can form which may require treatment with steroids.
• There is a very rare chance of blockage to blood vessels (vascular occlusion), which can cause damage to the surrounding skin or in extremely rare cases, blindness or stroke.

Dermal filler treatments can be performed by doctors, registered nurses, and dentists who are trained and authorised to carry out cosmetic procedures. These practitioners must work within their scope of practice that is determined by their responsible authority.

NZSCM recommends choosing a provider who:

• Is registered with the Medical, Nursing, or Dental Council of New Zealand
• Has specific training in cosmetic injectables
• Uses only Medsafe-approved products
• Works in a clinical environment that follows safety and hygiene standards
• Offers a thorough consultation and informed consent process
• Provides out-of-hours contact details and aftercare instructions
• Patients can trust that NZSCM-accredited doctors as they have had thorough, assessed training across all of these domains. 

To help reduce the chance of bruising or swelling and to ensure the best outcome:

• Avoid alcohol and anti-inflammatory medications (such as ibuprofen or aspirin) for 24–48 hours before your treatment, unless otherwise advised by your provider
• Let your provider know about any medications, supplements, or health conditions
• Make sure you have time for a proper consultation to discuss your goals, medical history, and any concerns

Before you agree to treatment, it’s helpful to ask:

• What type of filler will be used, and why?
• What results should I expect, and how long will they last?
• What are the risks, and how would any complications be managed?
• What does aftercare involve?

Before your treatment begins, your practitioner will carry out a comprehensive consultation. This includes discussing your goals, medical history, and any concerns you may have. You will be informed about the type of dermal filler being used, the expected results, and any potential risks or side effects. This ensures that you understand the procedure fully and gives you the opportunity to ask any questions. Your informed consent will be obtained, meaning you have agreed to the treatment with a clear understanding of the process and any associated risks.

All NZSCM-accredited doctors are required to have Hyalase on-site during dermal filler treatments. Hyalase is a prescription medication that must be provided by a registered medical practitioner. It is used to dissolve hyaluronic acid-based fillers in the rare event of complications, such as overfilling, lumps, or vascular occlusions (blockage of blood vessels). Having Hyalase available ensures patient safety, and practitioners can act swiftly should any issues arise during or after treatment.

During the treatment:

The area will be cleaned, and a topical numbing cream may be applied to reduce discomfort. You may feel mild pressure or a slight sting, but many fillers contain a local anaesthetic to make the procedure more comfortable. Small amounts of filler will be injected using a fine needle or cannula. Your practitioner will proceed carefully to achieve the desired result while respecting your natural features.

After treatment:

You may experience mild redness, swelling, or tenderness at the injection sites, which typically resolves within a few days. Some bruising is common and may take a few days to subside. Your practitioner will provide you with detailed aftercare advice, including avoiding certain activities like heavy exercise or makeup for the first 24 hours. Results are often visible immediately, but it may take up to two weeks for the filler to fully settle and for you to see the final outcome.

After treatment, you may notice some temporary effects:

• Mild swelling, redness, tenderness, or bruising at the injection site is common and should settle within a few days
• Avoid strenuous exercise, makeup on the treated area, or alcohol for 24 hours unless your provider advises otherwise
• Results can often be seen immediately, but may take up to two weeks to fully settle
• You should always be provided with aftercare instructions and contact details for your practitioner or an emergency contact in the rare event of any adverse reactions.
• If you experience any unusual pain, changes to vision, or skin colour, contact your provider straight away

Dermal Filler, Medical Device Class III to smooth facial wrinkles and folds, correct facial atrophic scars, restore or enhance the lips, or restore facial volume. Dermal filler has risk and benefits. Ask your doctor if dermal filler is right for you. For product information, check with your doctor or from product details with the supplier.