Dermal fillers (Injectable soft-tissue fillers)

What are dermal fillers?

Dermal fillers are gels injected under the skin to add volume or smooth out lines. They are most often used in the lips, cheeks, and the folds running from the nose to the mouth, and to soften static lines that are present even when the face is relaxed.

Most fillers used in the UK are made from hyaluronic acid, a substance that occurs naturally in the body. A key advantage of hyaluronic acid fillers is that, in an emergency, they can usually be dissolved with an enzyme called hyaluronidase. Some fillers are made from other, longer-lasting or permanent materials, which are harder or impossible to remove if something goes wrong.

Fillers add volume and fill lines. They do not relax muscles (that is anti-wrinkle injections), tighten loose skin, or improve skin texture and sun damage. The result is visible straight away but takes a week or two to settle.

Unlike botulinum toxin, most dermal fillers are not classed as prescription-only medicines. But in the UK anyone can currently buy and inject them regardless of training, which is exactly why choosing a properly trained, regulated practitioner matters so much.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your injection

• Have a proper consultation and choose a trained, insured practitioner on an accredited register who can manage complications.
• Ask which exact product will be used, whether it is hyaluronic acid, and whether the clinic stocks hyaluronidase to reverse it in an emergency.
• Tell the practitioner about cold sores, allergies, autoimmune conditions, blood-thinning medicines, pregnancy or breastfeeding, and any previous fillers.
• Avoid alcohol and, if advised, blood-thinning medicines or supplements for a few days before, to reduce bruising.
• Do not book treatment for anyone under 18; this is illegal in England for cosmetic purposes.
• Be clear about the look you want and discuss what fillers realistically can and cannot do.
• Expect a cooling-off period; do not feel pressured to decide on the day.

What happens

After the consultation and agreement on a plan, the area is cleaned. Numbing cream or a local anaesthetic injection may be used, and many fillers also contain a local anaesthetic.

The filler is injected under the skin using a fine needle or a blunt-tipped cannula. The practitioner may massage or mould the area to shape the result. Some practitioners use techniques such as injecting slowly and drawing back on the syringe to reduce the chance of injecting into a blood vessel.

The appointment usually takes around 20 to 45 minutes. You can see a result immediately, but it will be affected by swelling at first and takes a week or two to settle into its final shape.

Is this injection right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

The serious risk to understand is vascular occlusion: filler blocking or pressing on a blood vessel. It is rare, but if not recognised and treated urgently it can cause skin loss and scarring and, extremely rarely, permanent blindness. Warning signs include severe or unusual pain, the skin going pale or blotchy, or any change in vision. This is why a practitioner who is trained to recognise and treat it, and who has hyaluronidase available, matters so much. The highest-risk areas are between the brows, the nose, the forehead and the folds beside the nose.

Published figures to discuss

Most filler side effects are mild and temporary. The serious concern is vascular occlusion. Published reviews describe it as rare, but exact rates are uncertain: complications are under-reported, much UK treatment happens outside regulated settings, and rates vary with the area injected, the product and the practitioner's technique. Reported figures should be treated as rough guides, not guarantees, and the consequences of a missed occlusion can be severe.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is usually little downtime, but bruising and swelling are common in the first days, particularly with lip fillers. The final result settles over about one to two weeks.

• Swelling and bruising for several days, often most noticeable with lips
• Tenderness when touching or pressing the treated area
• Small lumps that usually settle in the first week or two
• Slight asymmetry early on as swelling goes down
• A result that looks fuller at first and softens as it settles

Aftercare

• Avoid touching, pressing or massaging the area unless your practitioner tells you to.
• Avoid strenuous exercise, saunas, sunbeds and very hot environments for the first 24–48 hours.
• Avoid alcohol for a day or two to limit bruising and swelling.
• Use a cool compress for swelling if advised, and simple pain relief if needed.
• Avoid facials, other facial treatments and dental procedures for the first weeks if advised.
• Know the warning signs of a blocked vessel and how to reach your practitioner urgently.
• Attend any review so the result can be checked and adjusted.

• Exact product name and that it is hyaluronic acid confirmed
• Confirmation the clinic stocks hyaluronidase for emergencies
• Written aftercare advice and what is normal
• A direct, urgent contact route for problems
• Clear list of warning signs (severe pain, skin colour change, vision change)
• Date for any review to check and adjust the result

Scars and how they heal

Fillers are injected with a fine needle or blunt cannula, so there are no surgical cuts or scars. You may get small puncture marks and bruising that fade within days. Rarely, if a blocked blood vessel causes skin damage, this can leave a scar — another reason urgent treatment of any problem matters.

⚠ Get urgent help if…

• Severe, increasing or unusual pain at or near the injection site — this can signal a blocked vessel
• Skin going pale, white, blotchy, dusky or mottled near the treated area
• Any change in vision, double vision or vision loss — seek emergency help immediately
• Skin that becomes very painful, blisters or darkens (possible tissue damage)
• Spreading redness, heat, swelling, pus or fever (possible infection)
• Sudden severe headache, drooping face or weakness (seek emergency help)

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result looks balanced and natural for your face, with volume or smoothing where you wanted it. Because there is swelling at first, the true result is best judged after about one to two weeks.

Fillers cannot lift sagging skin, relax muscle lines or improve skin texture, and overfilling can look unnatural. The effect is temporary for hyaluronic acid fillers and fades over months to around two years. A responsible practitioner aims for a subtle, reversible result rather than the most dramatic one.

How long fillers last depends on the product, the area treated and your body. Hyaluronic acid fillers commonly last from several months up to around 18 months before being broken down naturally. Lips often fade faster than firmer areas. Permanent and semi-permanent fillers last much longer but cannot be dissolved, which makes any problem or unwanted result far harder to fix — many specialists advise caution with them.

Related tests, treatments or support

Fillers are sometimes used alongside anti-wrinkle injections, which treat different things: fillers add volume and fill static lines, while toxin relaxes movement lines. Some people also combine fillers with skin treatments such as peels or laser for texture. A careful practitioner treats what actually needs treating, in stages, rather than selling a large combined package in one sitting.

Follow-up & long-term care

Many practitioners review the result at around two weeks, when swelling has settled, to check it and adjust or dissolve if needed. After that there is no fixed schedule; people return for a top-up when the effect fades, if they choose to.

• Top-up treatments are needed periodically to maintain the result, as filler fades over time.
• Have a fresh assessment at each visit rather than repeating the same plan automatically.
• Keep a record of which product was used and where, in case of any later problem.
• Tell your practitioner about any new health conditions, medicines or previous fillers before further treatment.

Repeat, follow-on and what comes next

• Hyaluronic acid fillers can usually be dissolved with hyaluronidase to adjust or remove an unwanted result.
• Permanent and semi-permanent fillers cannot be dissolved, so correcting problems may need surgery and can leave lasting issues.
• Lumps and asymmetry are sometimes corrected by massage, dissolving or a small top-up.
• Maintaining a result needs repeat treatment as the filler fades.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Written aftercare advice and a clear list of complication warning signs.
• Hyaluronidase available on site and a practitioner trained to manage a blocked vessel.
• A named contact and a fast, urgent route to be seen if a problem occurs.
• A review to check the settled result and adjust or dissolve if needed.
• Clear instructions to seek emergency care for any vision change or severe pain.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Who injects it, and their training, experience and ability to manage complications
• The type and amount of filler used
• The area treated and its complexity (lips, cheeks, under-eyes)
• Whether the clinic stocks hyaluronidase and provides aftercare and review
• Clinic location and setting
• Whether the price includes a proper consultation and follow-up

• The practitioner's fee and their registration and insurance
• The exact product, whether it is hyaluronic acid, and how much is used
• Whether review and adjustment are included
• Whether dissolving the filler (hyaluronidase) is available and what it costs
• A named contact and urgent route if a complication occurs
• Cancellation policy and what is covered if there is a problem

On the NHS? Cosmetic dermal fillers are private only and not funded by the NHS, though you should always seek urgent NHS care if a serious complication such as a blocked blood vessel occurs.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• What are your qualifications and registration, and are you on an accredited register such as JCCP or Save Face?
• Exactly which product will you use, is it hyaluronic acid, and can it be dissolved?
• Do you keep hyaluronidase on site, and are you trained to recognise and treat a blocked blood vessel?
• What are the warning signs of a complication, and how do I reach you urgently if one happens?
• What result is realistic for me, and what will fillers not be able to change?
• What happens, and what does it cost, if I need the filler dissolved or adjusted?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my injection, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this injection not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for dermal fillers

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Advice about cosmetic procedures DHSC — Botulinum toxin and cosmetic fillers for under 18s (guidance) JCCP — Choosing a practitioner and treatment standards Save Face — Government-approved register of accredited practitioners Vascular occlusion after dermal fillers — systematic review/meta-analysis (PMC) Management of HA filler-induced vascular occlusion — guideline (PMC) Visual loss after cosmetic filler injection — review (PMC)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.