Fillers

What are dermal fillers and how do they work?

Most fillers are hyaluronic acid gels. Hyaluronic acid occurs naturally in the skin and binds water; with age there is less of it, and the cheeks, lips and under-eye area lose support, which the gel restores. The body breaks it down gradually, so the effect is temporary, and it can be dissolved with hyaluronidase if needed.

Melior Clinics also uses two other materials: Biofiller, a gel made by heating the patient's own blood plasma, with no hyaluronic acid; and Ellansé, polycaprolactone (PCL) microspheres that give immediate volume and stimulate collagen over time. Neither can be dissolved with hyaluronidase.

Filler treatments at Melior Clinics

• Lip filler injections – volume, outline and symmetry.
• Filler injections for superficial wrinkles – fine lines around the mouth, chin and eyes.
• Filler treatment for nasolabial folds.
• Lifting and contouring with dermal fillers – cheekbones, jawline, chin, marionette lines.
• Teosyal® Redensity II under-eye filler – tear trough hollows.
• Plasma Biofiller for the eye area.
• Biofiller plasma injections – jawline, cheekbones, nasolabial folds.
• Fillers + collagen stimulation Ellansé – the mid and lower face.
• Full Face – a whole-face plan combining treatments.
• Prices – the full price list.

What happens during the treatment?

The consultation covers your facial proportions, skin, health and expectations, and a filler is chosen for the area. After cleansing and disinfection, the gel is placed with a fine needle or a blunt-tipped cannula.

• Duration: 30–45 minutes for lips, wrinkles and under-eyes, 45–60 for contouring, about an hour for Biofiller (with blood draw) and Ellansé.
• Numbing: cream or gel when needed; many hyaluronic acid fillers also contain the local anaesthetic lidocaine.
• The change is visible straight away; lip swelling usually settles within 2–5 days, when the final shape can be judged. The collagen effect of Ellansé develops over 1–3 months.
• Sessions: one is usually enough; Biofiller is sometimes repeated after 4–6 weeks.

Who should not have fillers?

• pregnancy and breastfeeding;
• a cold sore flare-up, inflammation or infection in the area;
• allergy to filler ingredients such as hyaluronic acid or lidocaine;
• an active autoimmune disease, bleeding disorders or blood thinners;
• recent laser, peel or other treatment in the same area;
• acute illness or fever; for Ellansé also facial implants and recent vaccination.

The final decision is made by the specialist at the consultation.

After the treatment

For 24 hours, touching, massaging and make-up on the area are not recommended; for 48 hours, saunas, hot baths and intense exercise. SPF 50 is advised outdoors. Swelling, redness, tenderness and bruising usually settle within a few days, and the filler may be palpable at first. Severe or increasing pain, pale or darkening skin, fever or unusual swelling are reasons to contact the clinic straight away.

Frequently asked questions

How long do dermal fillers last?

Hyaluronic acid typically lasts 6–12 months in the lips and nasolabial folds, 4–8 months in superficial wrinkles and 9–12 months under the eyes. Biofiller usually lasts 3–6 months and Ellansé up to about two years.

Can filler migrate?

With a suitable product, amount and technique, filler stays where it was placed. Migration is uncommon, and hyaluronic acid can then be dissolved in a separate filler dissolving treatment.

What is the difference between dermal fillers and botulinum injections?

Fillers add volume and support; botulinum toxin relaxes a muscle and softens expression lines. The two are sometimes combined.

The service is provided by Melior Clinics (Star Company OÜ, Estonian Health Board licence L04198), Liivalaia 53, Tallinn, Stockmann department store, 5th floor.