Dr. Levent Ünal
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Dermal Fillers.

No. 1 Workshop

Dermal Fillers.

Dermal fillers aim to support lost volume, define contours and preserve facial proportion by placing gels, most often hyaluronic acid based, at specific depths under the skin. Hyaluronic acid is a molecule that occurs naturally in the body and holds water very well. In filler products it is cross linked into a gel so that it stays in the tissue longer. At his clinic in Nişantaşı, Istanbul, Dr. Levent Ünal applies fillers across different areas, from the cheek and mid face to the jawline, and from the lips to the under eye region.

What changes in the face over time

Ageing does not happen only on the surface of the skin. Over the years the fat compartments of the face lose volume, bone support recedes and connective tissue loosens. The mid face flattens, shadows deepen, lines around the mouth become more visible and the contours tend to drift downward. The point of a filler is not to stretch the skin but to reinforce that weakened inner support at selected points. In a well planned treatment nobody notices what was done; they simply think the face looks more rested.

Treatments grouped under this heading

  • Cheek and mid face filler: volume support and cheek definition in the mid face.
  • Temple filler: for hollowing and flattening in the upper face.
  • Nasolabial filler: for the fold between the side of the nose and the mouth corner.
  • Chin and jawline filler: for profile balance and lower face definition.
  • Nose filler: limited, non surgical contour corrections.
  • Lip filler: for volume, proportion and the lip border.
  • Forehead and glabella filler: for settled static lines.
  • Under eye light filler: for hollowing and shadowing below the eye.

Each area has its own goal, preferred product consistency, depth and technique. A treatment with the same name can call for a completely different plan on two different faces.

Why product choice depends on the area

Fillers differ in consistency, elasticity, how much water they attract and how they spread within tissue. Areas where structure is wanted, such as the chin tip, usually call for firmer products, while mobile or thin skinned areas such as the lips, the under eye and the temples call for softer products that draw less water. This choice matters both for a natural look and for the comfort of the tissue. The product and the amount are decided after the whole face has been assessed during the visit.

Who it suits, and who needs closer assessment

It can be considered for adults with realistic expectations who are bothered by volume loss, blurred contours or a tired appearance. On the other hand it may not be appropriate during pregnancy and breastfeeding, when there is an active skin infection in the area, in uncontrolled autoimmune disease or bleeding disorders, or with a known hypersensitivity to the product. Planning is entirely different in people who have had permanent filler in the past, so that history should be shared during the visit. Suitability is always determined by a medical assessment.

Onset and duration of the effect

The volume effect is usually noticeable right after the application. Mild swelling in the first days means the look settles over the following few days. Duration depends on the product, the area, the amount used, the person's metabolism and lifestyle, and it fades gradually rather than suddenly. No exact timeframe or guaranteed outcome can be promised; results vary from person to person.

Points that are often confused

Filler and botox are not the same thing. Botox softens movement lines by reducing the activity of the expression muscles, while filler supports hollows and shadows by adding volume. The two often complement each other and can belong to the same plan. Another common expectation is that filler will lift sagging tissue. Where sagging is pronounced, filler alone may not be enough and other methods may need to be planned alongside it. Finally, more product does not mean a better result. A measured plan, completed in a second session if needed, is usually the safer and more natural route.

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