Before and After: Facelift & Neck Lift

What are dermal fillers?

Written by Dr Julian De Silva

Dermal fillers are products that can used to enhance the appearance of a person’s face by non-surgical techniques, thereby avoid surgery. Over the past 10-years, Dr De Silva has found there has been an exponential increase in the demand for filler treatments, as a consequence of technology that has offered an increased range of new, safe, science-based Filler products. The new products are able to provide a natural rejuvenation of your face, when completed by an expert offer both a natural appearance and fast recovery.

Filler treatments to the face can restore lost volume, correct volume loss and can create a fuller, more youthful appearance. In addition fillers can be used to enhance natural curves and emphasise feminine parts of the female face, Dr De Silva’ refers to this as beautification of the female face, or enhancement of the masculine features of the face in men.

A natural rejuvenation of the face with dermal fillers allows filling and smoothing fine lines, depressions and shadows. At The Centre for Facial Cosmetic Treatments we only use the best quality hyaluronic acid that has been approved by the FDA (Gold Standard in safety).

Dermal fillers volumizes, softens and hydrates your skin. It aids collagen and elastin organisation underneath the skin which gives the skin a more youthful texture. Dermal fillers refers to using a substance to fill an area of the face to rejuvenate or enhance an area of the face. Although many fillers have been proposed in the past, over the past 5-years, hyaluronic acid fillers (termed HA-fillers), have in our opinion at The Centre emerged as the ‘Gold-Standard’ in natural rejuvenation. These fillers have multiple advantages over older fillers including, existing naturally in the body (HA exists in the skin, joints and nerves), having an antidote (that can completely reserve fillers), New high-technology ‘Cannula-Technique’ to reduce swelling and bruising ensuring a faster recovery that older techniques. At The Centre, Dr De Silva has presented Nationally and Internationally on advising other doctors on Filler treatments.

At The Centre, we only use the safest, most effective FDA-approved, naturally biodegradable dermal fillers at The Centre for Facial Cosmetic Treatments. These are clear hyaluronic acid gels which closely mimic the natural hyaluronic acid in our skin, joints and natural nerve tissue. The filler are injected just beneath the surface of the skin and are one of the most popular treatments for filling and smoothing fine lines and wrinkles. Hyaluronic acid volumises, softens and hydrates the skin. It also aids collagen and elastin organisation underneath the skin which gives the skin a more youthful texture.

How does facial filler work?

An attractive face is characterised by smooth, round contours, high cheekbones, hollow jowls and a thin, well-defined jawline. These features together comprise the “triangle of beauty” or “heart of face”, with its base at the top and summit below. Dr De Silva has pioneered our understanding of facial beauty with research into the application of the Phi Golden Ratio to the human face, this research has been shown on Sky News, ITV, and Channel 4. Filler enhancement provided with an artistic eye along the natural “Phi-Lines” of facial beauty, is important to provide a natural looking result.

As we age, facial fat loss, gravity, and loss of the skin’s natural elasticity conspire to reverse this triangle’s composition, leading to a narrower, less youthful forehead and temple area, and a wider, heavier jawline. Fillers including, hyaluronic acid, can restore the face’s balance and heart-shaped proportions, revolumising facial hollows and lost volume and recontouring the cheeks, cheekbones, and nose for a fuller, softer, more youthful appearance. HA fillers help to recapture the facial volume that age and weight loss can diminish. With HA fillers, an innovative injectable hyaluronic volumiser, you can enjoy a smoother more youthful appearance of your cheeks, cheekbones, and chin.

Perhaps the best indicator of the advantages and benefits of anti-ageing treatment with hyaluronic acid filler is the level to which those who have used it enjoy their results. A clinical study demonstrated that effects were present even up to18 months after treatment.

Woman's Face, Before and After 2 years, Dermal Fillers - Voluma, oblique view, female patient 1
Woman's Face, Before and After Treatment, Dermal Fillers - Voluma, oblique view, female patient 2

Will I look Natural?

At The Centre for Facial Cosmetic Treatments we specialise in natural looking results. We believe in a natural rejuvenation and enhancement, this means conservative treatments that focus on enhancement. Before treatment The Team at The Centre will always spend time discussing with you the desired effect.

Dr De Silva believes in a natural and conservative in our approach and achieve a subtle effect, that can be built on if you so desire. We use different hyaluronic acid products that are intended for shaping the contours of the face, as each filler has characteristics that give it an advantage in specific areas of the face.

When shaping the contours of the face the crystal-clear gel is injected into the skin in tiny amounts. A treatment takes a few minutes and the results can be seen immediately. Occasionally a touch-up treatment is required within 2-4 weeks after the initial treatment to achieve an optimal correction. The initial treatment is usually maintained with follow-up treatments approximately once a year.

Dr De Silva characterises ageing of the face by three principal changes, loss of volume of the fat and soft tissues in the face, gravitational descent of facial soft tissues and laxity of the skin. Key to natural looking results is an artistic and anatomical understanding of these three elements so the elements of the facial ageing can be both restored to their previous appearance. Dr De Silva is an artist and his office in the World Famous Harley Street is decorated by his own art. In addition The Centre has pioneered our understanding of beauty with the use of the Golden Ratio on the human face, our research has also covered some of the most beautiful and priceless paintings of art in the World.

At The Centre we have pioneered research and understanding into the aesthetics of the face. What makes a beautiful face shape?

For further information please see this link:

Facial Balance & Harmony

For further information on Filler Enhancement at The Centre please see:

Further Information

Further Information on Fillers: How Much Is Too Much
Further Information on 10 Facial Cosmetic Procedures Popular in 2020
Further Information on Why are we commonly dissolving fillers in patients’ noses?

Contact us to make an appointment for a Non-Surgical Treatments
FREE CONSULTATION call +44 (0) 020 8748 2860 or contact The Centre

Consultations with our surgeons and specialists are from £250 and are required prior to surgical treatment.

Dermal Fillers: Meghan Markle

Research completed at The Centre found that Megan Fox has a diamond shaped face, this face shape most women desire with high cheekbones, slim face and narrow jawline and chin. With non-surgical treatments the shape of your face can be enhanced with the use of application of fillers to an individual’s face shape in accordance with the Phi Golden Ratio.

Frequently Asked Questions about fillers

  • What do I need to do BEFORE Filler Treatment?

    • Notify your clinician of any allergies or medications
    • Pregnancy and breast feeding are contra-indications to treatment.
    • Alcohol intake should be reduced at least 24 hours before treatment.
    • Medication such as aspirin may cause bruising as will high doses of vitamin E are best avoided before having treatment for up to two weeks
    • Sun beds, waxing, electrolysis and laser should be avoided at least 48 hours before treatment.
    • Pain sensitivity may be heightened at certain times (pre-menstrual or following excessive alcohol intake).
    • Risk of cold sores may be reduced by the use of acyclovir (Zovirax®) tablets.
  • What do I need to do AFTER Filler Treatment?

    Immediately after the treatment there may be slight redness, swelling, tenderness and an itching sensation in the treated area.
    For most patients swelling subsides overnight, however a smaller proportion of patients (5%), have additional swelling that may last for up to 5-days.
    Light concealer make-up can be applied even 5-minutes after treatment.

    Avoid touching or massaging the treated area for 6 hours after the treatment.
    The area can be gently washed with soap and water and light make-up can be applied.

    Until the initial swelling and redness have resolved, do not expose the treated area to intense heat (e.g. solarium and sunbathing) or extreme cold.

    If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another eruption of cold sores. If you have a cold sore treat as normal with topical acyclovir ointment.

    Avoid taking aspirin or any similar medication unless medically indicated for two days to minimise bruising, be aware that these medications may increase the bruising and bleeding at the injection site.

  • What are dermal fillers made from and how do they work?

    Dermal filler cane be made from different materials. At The Centre we only used fillers that have the ‘Gold-Standard’ level of safety (Termed FDA approval), these fillers are manufactured from hyaluronic acid (termed HA fillers). HA fillers are a naturally occurring sugar that exists in our skin, joints and nerve tissue. Hyaluronic acid is manufactured, it contains no animal products, hence allergies and reactions to the filler are very rare.

  • What products do you use?

    At The Centre we only used fillers that have the ‘Gold-Standard’ level of safety (Termed FDA approval), these fillers are manufactured from hyaluronic acid (termed HA fillers). We use different HA fillers in different parts of the face, as each have unique characteristics that favour specific areas. For example, some fillers have ‘Water-Loving’ (termed hydrophilic) properties, these are best suited to areas around the cheeks, however would not be suitable around your eyes. Fillers we advocate include: Restylane, Juvaderm, Voluma, Volbella, Princess and Volift.

  • How long does it take to see the results?

    One of the Advantages of filler treatment with dermal fillers is that the results are relatively instant, and can be seen at the end of the treatment.

  • How long will I expect to see the results last for?

    Treatment length is dependent on several factors 1. Type of Filler 2. Technique of filler application 3. Location of Filler 4. Lifestyle. Newer generation fillers are made to last longer and have scientifically been proven to last 18-24 months. Technique of filler application can aid longer duration when the filler is placed deeper down with a cannula technique at the level of the natural cheek bone. Fillers in certain areas of the face last for much longer, in the eyes (we have had patients maintained filler for >4 years, and the nose tend to maintain fillers for long time. There are also genetic and lifestyle factors than influence duration of results, excessive aerobic exercise may influence filler duration. On average filler last for between 12-18months.

  • How long will my filler enhancement procedure take?

    Most non-surgical techniques take from between 45-60 minutes will be required to complete your procedure. Each treatment includes a full consultation to ensure we understand the look you’re trying to achieve.

  • Will I experience any discomfort or pain?

    We use a combination of treatments to minimise discomfort, these include the use of a powerful numbing local anaesthetic cream that is specially made for The Centre. We use State-of-The-Art Cannula (no needle) technique to minimise discomfort.
    We use fillers that have incorporated anaesthetic into the injectable fillers to increase patient comfort.
    At The Centre we use additional numbing and vibration devises that use the Nobel Prize winning research on ‘The Gate Control Theory of Pain” to minimise discomfort.
    At The Centre, we take the above measures to ensure most patients only experience minor discomfort.

  • What happens to the dermal filler in my cheeks over time?

    With time the hyaluronic acid (a type of sugar) is broken down naturally and reabsorbed by the skin. This means that over time your results will slowly fade and occasional top up treatment at The Centre will maintain your appearance.

  • When the results fade, will my appearance be worse than before?

    Although hyaluronic acid filler enhance appearance, once they resolve, the natural soft tissues will remain. As a normal part of ageing, each year there is some natural loss of fat volume, some effects of gravity and loss of natural skin elasticity. If you have fillers for some years, and then they resolve your appearance will return to how it was before treatment with the additional years of ageing.

  • I'm pregnant or breast-feeding, can I still have my cheeks done?

    At The Centre we believe that it is of paramount importance to practice ‘Safe-Treatment’ with fillers, and we would advise against undergoing treatment if you are pregnant or breast feeding. There are no scientific studies that show that it is or is not dangerous to use dermal fillers with pregnant or breast-feeding mothers, however we would not advise undergoing treating until you have completed breast-feeding your baby.

  • I am a teenager can I have lip fillers?

    At The Centre we believe that it is of paramount importance to practice ‘Safe-Treatment’ with fillers that is consistent with UK regulation and guidelines developed to support patient welfare. At this time we would not advise or complete fillers to any individual under the age of 18.

  • What is Restylane?

    Restylane is a type of hyaluronic acid filler that treats wrinkles and lines. They contain a crystal-clear gel manufactured from a type of sugar called hyaluronic acid and water. The gel is a biotechnologically produced version of hyaluronic acid, a tissue friendly substance that occurs naturally in the body. Restylane is not made from any animal products.
    Restylane is a non-surgical treatment can be repeated as often as you like. Most patients choose to have a follow-up treatment 6 to 12 months after an initial treatment . A touch-up treatment within 2-4 weeks after the initial treatment may be necessary to achieve an optimal correction. Clinical experience indicates that follow-up treatment normally require a smaller amount of the product.

  • What is Juvéderm Voluma?

    Juvéderm Voluma is an FDA-approved injectable hyaluronic acid volumiser that re-contours the face to restore volume to chin, cheeks, and cheekbones that have become hollow or thin due to weight loss or age-related facial fat loss.
    Immediately after treatment with Juvéderm Voluma should notice that your facial contours appear fuller and rounder, giving your face a softer, more youthful appearance. Voluma was an innovation in that the gel offers a substantially longer effect which has been show to last up to 18 months.

  • What is Juvéderm?

    Juvéderm is a type of hyaluronic acid that is used in facial tissue to smooth wrinkles and folds, especially around the nose and mouth. Hyaluronic acid is a naturally occurring sugar found in the human body. The role of hyaluronic acid in the skin is to deliver nutrients, hydrate the skin by holding in water, and to act as a cushioning agent. Juvaderm has ‘Water-Loving’ (termed hydrophilic) properties, these are best suited to areas around the cheeks and lips, however would not be suitable around your eyes.

  • What did the Juvéderm clinical study show?

    In a US clinical study, 146 subjects were followed for 24 weeks after injection with Juvéderm SMILE injectable gel in one nasolabial fold (NLF) and ZYPLAST® dermal filler (bovine-based collagen) in the other. Injection-site responses were similar in duration and frequency for the Juvéderm SMILE injectable gel and ZYPLAST® dermal filler treated sides, were usually mild or moderate in severity, did not require intervention, and lasted 7 days or less. Juvéderm SMILE injectable gel was found to provide a more persistent wrinkle correction than ZYPLAST® dermal filler over the 24-week course of the study. The percentage of subjects who maintained improvement with Juvéderm SMILE injectable gel at 24 weeks was 88% compared to 36% with ZYPLAST® dermal filler. At the conclusion of the study, 129 (88%) of the 146 subjects expressed a preference for Juvéderm SMILE injectable gel, while only 8 (5%) expressed a preference for ZYPLAST® dermal filler, and 9 (6%) had no preference. Subjects who completed the 24-week study were invited to return for a complimentary repeat treatment. Subjects returned at their (or their doctor’s) convenience, rather than at a prescribed time point. Of the 146 subjects, 116 (79%) returned for repeat treatment, on average at 9 months after their last injection. Forty-eight (48) subjects returned more than 36 weeks (9 months) after their last injection: the percentage of those subjects who had maintained improvement with Juvéderm SMILE injectable gel was 75%.

    At multiple time points in the clinical study, subjects’ nasolabial folds were rated on a scale from 0 to 4: 0 none, 1 mild, 2 moderate, 3 severe, 4 extreme. Using this 5-point wrinkle assessment scale, the mean improvement since baseline was 1.9 at 2 weeks, 1.4 at 24 weeks, and 1.1 beyond 36 weeks after treatment.

    A subset of these subjects enrolled in a second study that followed subjects for 24 to 48 weeks after repeat treatment. Twenty-four (24) subjects were enrolled in the study. Twenty-three (23) were evaluated at 24 weeks (6 months) after repeat treatment with 87% maintaining improvement. Nine (9) subjects returned for evaluation 48 weeks (1 year) after repeat treatment: the percentage of those subjects who had maintained improvement with Juvéderm SMILE injectable gel was 78%. The mean improvement since baseline at different time points after repeat
    treatment was 1.4 at 24 weeks and 1.3 at 48 weeks after repeat treatment.

  • When should I notify my doctor?

    Be sure to report any redness and/or visible swelling that lasts for more than a few days, or any other symptoms that cause you concern, to your doctor.

  • What happens to my treated skin in the sun or in the cold?

    The treated areas must not be exposed to intense heat or extreme cold for the first few days after treatment. This is to avoid risk of inflammation since the area has been disturbed. The gel will not harden or soften as outside temperatures change. Saunas and steam rooms should also be avoided for the first few days after treatment.

  • How can I justify spending money on my looks?

    Feeling good about how one looks is important for self-esteem and confidence. It helps create a sense of well-being. Many women, and an increasing number of men, want to maintain and enhance their looks in a subtle and natural way, without going to the extremes of a surgical facelift or more invasive techniques. Hyaluronic Acid g fillers and make this possible and helps hold back the years. There is no need to feel guilty about feeling good!

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