Dermal Fillers
Dermal fillers are injectable gels, most commonly based on hyaluronic acid, used to restore volume, redefine facial contours, and support the structural framework of the face. Applied correctly, they address changes caused by volume loss and skeletal remodelling rather than simply filling individual lines.
How this fits into facial rejuvenation
Facial ageing is, in large part, a volumetric process. Bone resorbs, fat compartments thin and descend, and the structural scaffolding that gives the face its shape gradually diminishes. The skin does not simply wrinkle; it loses its underlying support.
Dermal fillers address this by restoring volume in the appropriate anatomical locations, not by filling surface lines but by rebuilding the support structures beneath them. When placed correctly, the skin above responds by lifting, smoothing, and redraping naturally. This is a different clinical paradigm from treating lines directly, and it produces substantially different results.
Fillers are typically integrated into a broader treatment plan alongside other modalities. The assessment determines whether volume replacement is the priority, and if so, where and in what sequence.
What the assessment evaluates
Volume loss does not occur uniformly. Different fat compartments thin at different rates, skeletal changes are individual, and the way the face compensates, through soft tissue descent and altered movement patterns, varies between patients. Understanding these patterns is essential before placing filler.
Dr. Berns evaluates the face across all structural zones: the midface, the jawline, the temples, the perioral region. The goal is to identify where support has been genuinely lost and what would restore proportion, rather than adding volume in isolation, which can distort the face rather than restore it.
Who may be suitable
Dermal fillers may be considered for patients showing signs of volume loss, facial descent, or loss of structural definition. They are not exclusively for older patients; skeletal structure varies considerably, and some patients benefit from structural support at an earlier stage of ageing.
They are not appropriate for patients whose primary concerns are skin quality or movement-related lines. In those cases, other treatments are likely to produce better outcomes, and filler placed without addressing these factors first may not achieve the desired result.
Important considerations
Hyaluronic acid fillers are reversible using an enzyme called hyaluronidase. This does not eliminate risk, but it does provide an important margin of clinical safety. All filler treatments carry risks including bruising, swelling, asymmetry, and, in rare cases, vascular complications. These are discussed in detail during the consultation.
Dermal fillers in Ireland are classified as prescription-only medicines when used for aesthetic purposes. A face-to-face consultation with a prescribing practitioner is required before any treatment. Results are not permanent; duration varies by product, placement, and individual metabolism, typically ranging from twelve to twenty-four months.