Most people searching for dermal fillers in Singapore are not asking whether the product works. They are asking whether it will still look like them, whether it can be undone, and why some faces come out of repeated treatment looking heavier rather than younger. None of those questions is answered by the brand on the box.
A dermal filler is a gel placed beneath the skin to occupy space. That is the whole mechanism. Everything else follows from three decisions made before the syringe is opened: which material, which tissue plane, and whether missing volume was the problem at all. Every plan is made individually at consultation.
Dermal fillers in Singapore are HSA-registered gels, most often hyaluronic acid, injected by a doctor to restore volume or structure in areas such as the cheeks, chin, temples, lips and tear troughs. A filler occupies space; it does not lift or tighten. The material, the tissue plane and whether volume is truly missing are decided at assessment.
- Key Facts
- What a Dermal Filler Is — and What It Is Not
- Dermal filler or anti-wrinkle injection: which problem each treats
- The Types of Dermal Filler
- Fillers by area: where each is explained
- The Areas — and What the Filler Is Doing in Each
- The Assessment: Why the Whole Face Is Examined
- Who It Suits — and Who It Does Not
- Before your filler appointment: what to tell the doctor
- What Happens at the Appointment
- Recovery
- Risks, Stated Plainly
- Filler risks by how often they happen
- How Over-Filling Is Avoided — and Corrected
- Why this page has no before-and-after photographs
- What Determines the Cost
- Dr Sin Yong explains
- Lip fillers in Singapore: what decides the result
- Under-eye filler: who it suits and who it does not
Key Facts
- Hyaluronic acid (HA) fillers
- Cross-linked HA gel, typically 15–24 mg/mL; BDDE (1,4-butanediol diglycidyl ether) is the usual cross-linker
- G′ (elastic modulus)
- The rheological property matched to the zone: higher G′ for projection on bone (chin, jawline, cheek), lower G′ for thin, mobile tissue (lips, tear trough)
- Calcium hydroxylapatite (Radiesse)
- 30% CaHA microspheres of 25–45 µm in a 70% carboxymethylcellulose (CMC) gel; FDA premarket approval P050037
- Polycaprolactone (Ellansé)
- 30% PCL microspheres in a 70% CMC carrier; the carrier gives volume, the microspheres act as a collagen scaffold as it is absorbed
- Poly-L-lactic acid (PLLA)
- A biostimulator: stimulates fibroblast collagen production rather than occupying space at injection
- Reversal
- Hyaluronidase degrades HA fillers. It has no action on CaHA, PCL or PLLA, which are resorbed over time
- Injection planes
- Supraperiosteal (on bone), subcutaneous (within fat), intradermal (within skin) — chosen per area and per product
- Classification (Singapore)
- HSA-registered medical devices; an injectable medical treatment performed by a registered medical practitioner after assessment
Dermal fillers for folds, lines and scars: where filler helps and where it does not
Dermal fillers in Singapore are injectable gels, most often hyaluronic acid, placed by a doctor to restore volume or structure. Laugh lines, marionette lines, fine lines and depressed acne scars are among the commonest reasons people ask about them. Filler softens a fold or line when missing volume is the cause. When the cause is laxity, muscle movement or skin quality, another treatment fits better.
| Concern | What filler can do | Tends to suit | Not for |
|---|---|---|---|
| Laugh lines (nasolabial folds) | Soften a fold where the midface has deflated, often by supporting the cheek first | A fold deepened by volume loss | A fold from sagging, where filling makes the lower face heavier |
| Marionette lines | Support the corner of the mouth and the area beside the chin | Early lines with volume loss | Heavy jowls sitting over the line |
| Fine and etched lines | A very soft gel, or a skin booster, within the skin | Static lines in thin skin | Lines that appear with movement, which follow the muscle |
| Depressed acne scars | Support a rolling scar from below once it has been released | Rolling scars after subcision has freed the tether | Ice-pick and boxcar scars, and any scar still tethered |
Who filler for folds and lines suits, and who it does not
- Suits: a fold or line where volume has genuinely been lost.
- Suits: lines in skin that still has reasonable support from the ligaments beneath.
- Not for: lines that appear with expression; botulinum toxin, which acts on the muscle, is the usual answer.
- Not for: sagging skin or jowls; laxity needs a lifting approach, not more volume.
- Not for: filler offered in a non-medical setting. In Singapore, filler is an injectable medical treatment given by a registered doctor.
How Dr Sin Yong approaches it
Every filler treatment is performed by Dr Sin Yong after an in-person assessment of the whole face. He treats the cause of a fold rather than its shadow: a deflated midface deepens the nasolabial fold, so the cheek is assessed before the fold, as part of volume restoration planned across the face. Cumulative volume from earlier treatment is checked at every visit, with ultrasound where the history is unclear. Where a face may hold fat graft as well as filler, he first checks what is actually there: fat, filler or both. Excess filler is dissolved under ultrasound guidance rather than layered over; see filler correction. For acne scars, filler follows subcision and never replaces it.
What decides the plan
- Whether the cause is volume loss, laxity, muscle or skin quality.
- The areas treated and what the examination finds in each.
- Product and plane: soft or firm gel, in the skin, the fat or on bone.
- Filler, fat graft or other product already present.
- Whether filler is combined with toxin, a skin booster or energy-based tightening, and how the plan is staged.
What a Dermal Filler Is — and What It Is Not
A dermal filler occupies space. Placed on the bone, within the fat or within the dermis, it adds volume where volume has been lost or was never there: a flattened cheek, a short chin, a hollow temple, a low nasal bridge. It restores structure.
It is not a skin booster, which is lightly cross-linked or uncross-linked hyaluronic acid or a polynucleotide placed within the dermis to act on hydration and skin quality, without projecting or contouring. It is not botulinum toxin (BTX), which acts on muscle by reducing the contraction that folds skin into a dynamic line. A filler does nothing to a muscle, and a toxin does nothing for a hollow. Which of the three fits depends on which tissue is responsible for what you see, and that is what the examination decides.
“Everyone says they want natural results. Almost nobody can define it.”
Dr Sin YongOn what natural means · from his Instagram explainer series
Dermal filler or anti-wrinkle injection: which problem each treats
Dermal filler and anti-wrinkle injection are often spoken of together, but they treat different problems and work in different ways. Many plans use both, with the order decided at assessment.
| Question | Dermal filler | Anti-wrinkle injection (botulinum toxin) |
|---|---|---|
| What it is | A gel (hyaluronic acid) or microsphere material placed under the skin | A purified protein that relaxes a chosen muscle |
| What it is used for | Lost volume, hollows, contour and support | Lines made by movement, such as frown lines, forehead lines and crow’s feet, and muscle bulk such as the masseter |
| How it works | Adds or supports structure | Reduces the contraction of the injected muscle |
| What it cannot do | Does not relax muscles or stop expression lines forming | Does not replace lost volume or fill a hollow |
| Reversibility | Hyaluronic acid can be dissolved; CaHA, PCL and PLLA cannot | Wears off as the nerve endings recover; it cannot be reversed on demand |
| Common side effects | Swelling, bruising, small lumps; vascular occlusion is rare but serious | Bruising and headache; brow or eyelid heaviness if it affects a nearby muscle |
Anti-wrinkle injection is covered on botulinum toxin in Singapore, and the two are compared side by side on botulinum toxin vs dermal fillers.
The Types of Dermal Filler
Hyaluronic acid
Hyaluronic acid is a polysaccharide already present in the dermis. In a filler it is cross-linked, usually with BDDE, so the gel resists enzymatic breakdown and holds its form; concentrations are typically 15–24 mg/mL. Where a gel belongs is governed by G′, the elastic modulus: a high-G′ gel where the filler must project against bone, a low-G′ gel where tissue is thin and mobile and a firm product would show as a ridge. HA is the usual first choice because it is the one material that can be reversed.
Calcium hydroxylapatite
Radiesse is 30% calcium hydroxylapatite microspheres, 25–45 µm in diameter, in a 70% carboxymethylcellulose gel. The gel gives volume at injection; as it is absorbed, the microspheres remain as a scaffold on which fibroblasts lay down collagen. It has a higher G′ than most HA gels and cannot be dissolved with hyaluronidase.
Polycaprolactone
Ellansé works on the same principle: 30% polycaprolactone microspheres in a 70% CMC carrier. It is likewise not reversible by enzyme, so placement has to be right the first time.
Poly-L-lactic acid
PLLA is a biostimulator rather than a filler: it does not occupy space at injection but prompts fibroblasts to make collagen, and it belongs under collagen biostimulators. The materials are set side by side in the Radiesse, Ellansé and HA comparison.
Dermal fillers in Singapore: material by area
Dermal fillers in Singapore come in four main materials, and the area decides which of them is even a candidate. Hyaluronic acid (HA) is a gel that can be dissolved with an enzyme and comes in firm and soft versions. Calcium hydroxylapatite (CaHA, such as Radiesse) and polycaprolactone (PCL, such as Ellansé) are microspheres in a carrier gel that give support and then prompt collagen; neither can be dissolved. Poly-L-lactic acid (PLLA, such as Sculptra) is a collagen stimulator rather than a volume gel and is used for diffuse, broad loss rather than a point. The matrix below crosses the four materials with the eight areas most often asked about.
| Area | HA | CaHA | PCL | PLLA | Page |
|---|---|---|---|---|---|
| Cheek | Usual: firm, high-G′ gel deep on bone | Option where reversibility is not the priority | Option where reversibility is not the priority | Considered for diffuse midface deflation with good skin thickness | Cheek fillers |
| Chin | Option, chosen at assessment | Option, chosen at assessment | Option, chosen at assessment | Not used for a point of projection | Chin fillers |
| Nose | Where a dissolvable option is preferred | Usual, for the support it gives on the bridge | Usual, for the support it gives on the bridge | Not used | Nose filler |
| Temple | Usual, placed deep | Occasionally, deep on bone | Occasionally, deep on bone | Considered for broad temporal hollowing | Temple fillers |
| Under-eye | Only a soft, low-G′, low-hydrophilic gel in small amounts, or nothing | Generally avoided | Generally avoided | Not used | Under-eye filler |
| Lips | Usual: the softest gels only | Not used | Not used | Not used | Lip fillers |
| Jawline | Usual: firm gel along the border and angle | Option on bone | Option on bone | Not used for an edge | Jawline filler |
| Hands | Usual, in the plane over the tendons | Usual, in the same plane | Assessed case by case | Assessed case by case | Hand fillers |
Three patterns run through the matrix. Areas that sit on bone and need to hold a shape, such as the nose bridge, cheekbone and jawline, accept firm HA, CaHA or PCL, because the bone carries the load and the gel only needs to project. Areas that move constantly or sit close to the surface, such as the lips and the under-eye, accept only soft HA, because a firm product would show, feel wrong or hold water, and because the option of dissolving it matters most where a problem would be most visible. Broad, diffuse loss across the midface or temples is the one place a collagen stimulator such as PLLA is weighed against a volume gel; see collagen biostimulators.
The matrix is a map of what is reasonable, not a prescription. Two people asking for the same area can leave with different materials, because skin thickness, earlier filler, how much the area moves and whether reversibility matters to you all change the answer. Materials that cannot be dissolved are considered once a shape has been confirmed, not as a first step, and where earlier product of unknown type is present it is identified with ultrasound before anything is added.
Firmer gels and microsphere fillers suit areas that need support on bone, while soft hyaluronic acid suits thin, mobile tissue where a firm product would show or feel wrong, and where reversibility matters most.
Fillers by area: where each is explained
Each area of the face asks something different of a filler. The cards below link to the page that covers each area in detail.
Cheek fillersLift, volume or both, and the over-filled look to avoid.
Chin fillersProjection, length or a V-shape taper.
Nose fillersBridge, tip and profile, placed by fine needle on the bone.
Lip fillersBorder, height and proportion before volume.
Under eye fillerHollow, bag or shadow, and when filler is the wrong answer.
Forehead fillerContouring a flat forehead, and what filler cannot fix.
Nasolabial foldsWhy the fold forms, and support versus filling.Temple fillerHollow temples, material and plane.Jawline fillerDefinition along the jaw, and when lifting fits better.Hand rejuvenationVolume loss on the backs of the hands.The Areas — and What the Filler Is Doing in Each
- Cheek. The malar fat pads deflate and the maxilla remodels with age. A firm gel on the periosteum of the zygoma restores anterior projection where the midface catches light.
- Chin. A retruded chin shortens the lower face in profile. Supraperiosteal filler at the pogonion adds forward projection and can lengthen or narrow the chin depending on placement.
- Jawline. Filler along the mandibular border and angle sharpens the edge between face and neck. It defines a line; it does not lift a jowl sitting over it.
- Temples. Hollowing exposes the bony rim of the orbit. Filler placed deep on the bone or within the temporal fascia restores the natural convexity.
- Forehead. A flat or concave forehead is a skeletal shape, not a skin problem. A soft gel in the supraperiosteal plane restores a gentle curve, placed with the supratrochlear and supraorbital vessels in mind.
- Nose. Filler raises a low radix or camouflages a dorsal hump by adding above and below it, so the profile reads straighter. It never makes a nose smaller, and the nasal arteries make it a high-risk zone.
- Tear trough. The hollow between lower lid and cheek takes a low-G′ gel placed deep to the orbicularis in small increments; too much or too shallow shows as puffiness or a blue tint.
- Lips. Filler adds volume to the body of the lip or defines the vermilion border. The lip is mobile, so a soft gel is used and proportion to the face governs the plan.
- Hands. Loss of dorsal fat exposes tendons and veins. HA or CaHA in the dorsal subcutaneous plane restores the cushion over them.
“A filler adds volume. It does not lift, and it does not tighten. Asking it to do either is how faces end up over-filled.”
Dr Sin YongOn what a filler cannot do
The Assessment: Why the Whole Face Is Examined
Facial ageing is three processes at once: volume loss (fat-pad deflation and bone resorption), laxity (ligaments and skin losing their hold) and declining skin quality. A filler acts on the first. Given to someone whose main change is laxity, it produces a heavier lower face with the same sag. The examination separates the three, and it covers the whole face because the face is one structure: a deflated midface deepens the nasolabial fold, and filling the fold treats the shadow rather than the cause. Volume restoration is planned across the face, not per syringe.
The pillow face pattern comes from the opposite habit: the same zones filled repeatedly over years, each addition layered on product still present, without asking whether the hollowing was structural. Cumulative volume is assessed at every visit, and ultrasound is used where the history of previous filler is unclear.
How Dr Sin Yong chooses a filler
Dr Sin Yong chooses a filler after an in-person assessment of the whole face, and the rule he applies is simple to state: the material follows the tissue it has to sit in, and the tissue is decided by examination, not by the name of the area. Four habits follow from that rule.
Bone-support areas usually get CaHA or PCL. Where filler is placed on bone to project a shape, such as the nose bridge, cheekbone and jawline, he usually chooses calcium hydroxylapatite or polycaprolactone for the support they give, with a firm hyaluronic acid where a dissolvable option is preferred or the shape has not yet been confirmed. The bone carries the load; the gel only has to hold a point.
Mobile areas get a softer HA. Lips, the fold beside the nose and any zone that moves with expression take a soft hyaluronic acid in small increments. A firm gel in a mobile area shows as a ridge when the face animates, and these are also the areas where a result most often needs to be adjusted or dissolved, so reversibility is kept.
The under-eye gets a low-hydrophilic HA, or nothing. The skin here is the thinnest on the face and the tissue beneath it holds water readily. He uses only a soft, low-concentration hyaluronic acid that draws little water, placed deep on the bone in very small amounts and left short of a flat correction. Where the examination finds a fat bag, fluid, festoons or very thin skin rather than a hollow, the answer is no filler at all; see when not to have tear trough filler.
The nose is treated with a fine needle on the bone. For the bridge he places CaHA or PCL supraperiosteally, that is directly on the bone, with a fine needle and in small amounts, because the nasal arteries make this a high-risk zone and the bone is the shelf a projecting product needs. Filler can raise or straighten a bridge; it cannot make a nose smaller, and that is said before anything is planned. See nose filler.
Before any of these choices, he maps what is already there. Where a face may hold earlier filler or fat graft, he scans with ultrasound to tell fat from filler from tissue, and excess is dissolved under ultrasound guidance rather than layered over; see filler correction. For acne scars, filler follows subcision and never replaces it. Every treatment is performed by him, after an in-person assessment, and the plan is written down with the option of no treatment included.
Who It Suits — and Who It Does Not
Filler suits a change that is genuinely volumetric — deflated cheeks or temples, a hollow tear trough — in a face whose skin and ligaments still provide support, and shapes that were never age-related: a retruded chin, a low nasal bridge, thin lips.
Treatment is deferred in pregnancy and breastfeeding and where there is active infection at or near the site, including a cold sore. Autoimmune and inflammatory conditions are assessed individually rather than excluded outright. Previous non-resorbable fillers — silicone, PMMA — must be declared, because layering HA over them raises the risk of nodules and infection. Filler is declined where the expectation is something it cannot do: lift a jowl, tighten loose skin, make a nose smaller.
Before your filler appointment: what to tell the doctor
A safe filler plan starts with your history. Dr Sin Yong asks about the points below at consultation, and it helps to have the details ready.
- Medicines and supplements: blood-thinning medicines and supplements such as fish oil or ginkgo raise the chance of bruising. Do not stop a prescribed medicine without advice from the doctor who prescribed it.
- Allergies: to local anaesthetic, hyaluronidase, hyaluronic acid or any previous filler.
- Previous treatments: which fillers were used, where, and roughly when; any non-dissolvable filler, fat grafting, threads or implants; and any complication you had before.
- Health: pregnancy or breastfeeding, autoimmune disease, a bleeding disorder, a tendency to keloids, and cold sores if the lips are to be treated.
- Timing: upcoming events or travel, because swelling and bruising need time to settle.
What to ask in return: which product will be used and whether it is registered with Singapore’s Health Sciences Authority, who will inject it, whether hyaluronidase is kept on site, and who will see you if there is a problem. A registered doctor should be able to answer each of these plainly.
What Happens at the Appointment
The appointment begins with the examination, photographs and a plan naming the areas, the product and the plane for each. The skin is cleaned and a topical anaesthetic applied; most HA fillers also contain lidocaine. Product is delivered by needle or cannula. A needle is precise and suits small deposits placed directly on bone. A cannula is blunt-tipped, enters through a single port and glides through the subcutaneous plane, tending to push vessels aside rather than pierce them. The choice is made per area. Product is placed in small increments, moulded and checked against the other side before more is added.
Recovery
Recovery varies. Swelling, tenderness and some bruising at the entry points are expected; lips and tear troughs swell more than bony areas. Temporary asymmetry while swelling settles at different rates is common and is not a reason for more product. What warrants review is different in kind: pain out of proportion to the injection, skin that blanches, turns dusky or develops a net-like mottling, or any change in vision. These are reported the same day.
Risks, Stated Plainly
Vascular occlusion. Filler can enter or compress an artery, and the tissue it supplies loses its blood flow. The signs are blanching, dusky or net-like discolouration and pain out of proportion; in the rarest cases filler reaching the ophthalmic circulation affects vision. It is an emergency treated with high-dose hyaluronidase, which is why HA is used in the highest-risk zones and the enzyme is kept in the room.
Nodules. Non-inflammatory (product in the wrong plane or too much in one spot) or inflammatory, sometimes appearing late.
Migration. Filler can drift, most often in mobile areas like the lips and when placed too superficially or in too large a volume.
Tyndall effect. HA placed too close to the surface scatters light and reads as a blue-grey tint, particularly under the eyes.
Infection. Uncommon with sterile technique; the risk rises with previous non-resorbable filler or active skin infection nearby.
Reversibility runs through all of these. With HA a misplaced deposit can be dissolved and the plan revisited; with CaHA and PCL the alternative is waiting for resorption. That is a reason to begin with HA, not a reason to avoid the other materials where they are the right tool.
Filler risks by how often they happen
The risks above are easier to weigh when they are grouped by how often they tend to occur. The risk for any one person depends on the area, the material, the depth of placement and the injector.
| How often | What can happen | What is done |
|---|---|---|
| Common and expected | Swelling, redness, tenderness, bruising and small bumps at the injection points | Settles on its own; cool compresses; review if it does not settle |
| Uncommon | Lumps or irregularity, asymmetry, a bluish Tyndall tint under thin skin, delayed swelling, filler migration | Moulding, or dissolving hyaluronic acid with hyaluronidase; non-dissolvable materials are managed differently, sometimes under ultrasound guidance |
| Uncommon | Infection | Early medical treatment |
| Rare but serious | Vascular occlusion: filler blocking an artery, with pain, blanching or dusky skin, and very rarely loss of vision | An emergency: treated at once, with high-dose hyaluronidase where the filler is hyaluronic acid; seek help immediately |
The warning signs of a blocked vessel are listed on filler vascular occlusion warning signs.
How Over-Filling Is Avoided — and Corrected
Over-filling is avoided by asking what is missing before asking what to add: structure before volume, bone before soft tissue, and a plan for the whole face rather than a count of syringes. The endpoint is proportion, not fullness.
Where previous treatment has gone too far, correction begins with high-frequency ultrasound, which shows where existing filler sits, in which plane and in what relation to vessels. Hyaluronidase is then delivered under ultrasound guidance so the excess is targeted rather than the whole area, and the face is re-assessed from the beginning. The approach is set out on the filler correction page.
Why this page has no before-and-after photographs
Many clinic websites show before-and-after photographs for dermal fillers. This page does not, because Singapore’s rules on healthcare advertising do not allow licensed clinics to publish before-and-after or after-only images, or patient testimonials, to promote treatment. The images on this page are illustrative and are not patients.
A photograph of someone else’s face also says little about yours. Bone structure, fat pads, skin thickness and how a face moves decide where filler is placed, how much, and whether filler is the right tool at all.
What replaces the photographs is an examination. At consultation Dr Sin Yong explains what the assessment shows, what the treatment can and cannot change for you, and records the plan in writing. Your own skin is photographed under standard light for your medical record, so that it can be compared at review.
What Determines the Cost
Cost is set out at consultation, once the plan exists. The factors are the areas treated and how many, what the examination finds in each, the product chosen and the quantity the anatomy calls for, whether filler is used alone or combined with toxin or a biostimulator, and whether the plan is staged across more than one visit. Correction of previous filler is costed separately from new treatment.
Ready to Book a Consultation?
All treatments performed personally by Dr Sin Yong on Orchard Road, Singapore.
WhatsApp +65 8023 7170Dr Sin Yong explains
What "natural" means in technical terms: movement preserved, proportions unchanged, no new shapes. A short video from Dr Sin Yong’s Instagram, with captions.
Lip fillers in Singapore: what decides the result
Lip filler adds volume to the body of the lip, defines the border or corrects asymmetry, and the plan is built around proportion rather than size. The lips are assessed against the rest of the lower face: the ratio of upper to lower lip, the shape of the Cupid's bow, the position of the corners of the mouth, and how the lips move in speech and in a smile.
A soft, low-G′ hyaluronic acid gel is used because the lip is constantly moving and a firm product would feel and look wrong. Product goes in small amounts, and the vermilion border is treated separately from the body of the lip, because overfilling the border is what produces the shelf-like upper lip that reads as treated. Migration above the border is more likely when volume is excessive or placed too superficially.
Lips swell more than most areas, so they look fuller at first than they will once settled, and judging the result early is unreliable. A history of cold sores should be mentioned, since injection can trigger an outbreak. As with any area, cost follows the plan and is set out at consultation rather than quoted in advance.
Under-eye filler: who it suits and who it does not
Under-eye filler suits a tear trough that is a genuine hollow: a groove between the lower lid and the cheek, in skin that is not too thin, under lids that are not puffy. It is a poorer choice where the main problem is herniated orbital fat, fluid that comes and goes, marked lower-lid laxity or pigment, because filler adds volume and none of those is a shortage of volume.
Where it is appropriate, a low-G′ hyaluronic acid is placed deep, beneath the orbicularis muscle, in small increments, often by cannula. Hyaluronic acid is chosen because it can be dissolved: this is an area where the Tyndall effect, persistent swelling and vascular events are taken especially seriously, and reversibility matters. Calcium hydroxylapatite and polycaprolactone are generally avoided here.
People who already retain fluid under the eyes, or who wake with puffiness that settles through the day, tend to do less well with filler, because hyaluronic acid attracts water. In some of these cases supporting the cheek below, or addressing laxity with an energy-based approach, is the better route, and where fat herniation dominates, a surgical opinion is the honest answer.
How long do dermal fillers last?
How long a dermal filler lasts depends on the material, how densely it is cross-linked, where it is placed and the individual, so no single figure applies. Hyaluronic acid is broken down gradually by the body's own enzymes; more highly cross-linked, higher-G′ gels placed deep on bone tend to persist longer than soft gels in mobile areas such as the lips.
Imaging studies have reported hyaluronic acid filler remaining in tissue well beyond the period in which it is visible, which is one reason repeated treatment on a fixed schedule leads to accumulation. Calcium hydroxylapatite and polycaprolactone are resorbed as the carrier is absorbed and the microspheres break down, while poly-L-lactic acid acts through the collagen it stimulates rather than through the product itself.
So the question at a review is not whether it is time for more filler, but what the face needs now. Existing product is assessed first, with ultrasound where the history is unclear, and nothing is added simply because time has passed.
| Option | What it does | What it cannot do | Typical recovery | Who it tends to suit |
|---|---|---|---|---|
| Hyaluronic acid filler | Cross-linked gel that occupies space to restore volume or projection, with G′ chosen to suit the area | Does not lift a jowl or tighten loose skin; does not act on muscle | Swelling, tenderness and possible bruising while it settles | Volume loss or shape in the cheeks, chin, temples, lips and tear troughs; the usual first choice because it can be dissolved |
| Calcium hydroxylapatite (Radiesse) or polycaprolactone (Ellansé) | Carrier gel gives volume; microspheres act as a scaffold for collagen as the gel is absorbed | Cannot be dissolved with hyaluronidase; generally avoided in thin, mobile areas such as the lips and tear troughs | Swelling, tenderness and possible bruising | Structural support on bone, such as the jawline, chin or cheek, where reversibility is not the priority |
| Poly-L-lactic acid (collagen biostimulator) | Prompts fibroblasts to produce collagen over time rather than filling at injection | Does not give shape on the day; cannot be dissolved | Swelling and tenderness as the injected fluid settles | Gradual, diffuse volume loss across the face rather than a single hollow |
| Skin booster | Lightly cross-linked or uncross-linked hyaluronic acid, or a polynucleotide, placed within the dermis for hydration and skin quality | Does not project, contour or replace lost volume | Small raised bumps at the injection points while they settle | Dull, dehydrated or crepey skin over adequate underlying structure |
| Energy-based tightening (HIFU, VF Lift – Vertical Facelift) | Heats deeper layers to provoke a collagen response in lax tissue | Does not replace lost volume or change skeletal shape | Transient redness, tenderness or swelling | Laxity rather than volume loss, the change a filler cannot address |
| Surgery (facelift, rhinoplasty, implants, fat grafting) | Repositions or removes tissue, reshapes the nose, or adds volume surgically | Not reversible in the way hyaluronic acid filler is; involves incisions and anaesthesia | The longest recovery of these options, set out by the operating team | Marked laxity, a nose that needs to be made smaller, or change beyond what filler can do; referred for a surgical opinion |
| Area | What the filler is doing | Usual material | Plane |
|---|---|---|---|
| Cheeks | Restoring projection and support over the cheekbone | High-G′ hyaluronic acid; CaHA or PCL where reversibility is not the priority | Deep, on bone, with softer layering above where needed |
| Chin and jawline | Adding projection and definition to the lower face | High-G′ hyaluronic acid, CaHA or PCL | On bone |
| Temples | Softening a hollow that lets the tail of the brow fall | Hyaluronic acid | Deep on bone, or in the superficial fat by cannula |
| Nose bridge | Raising or straightening the bridge; it cannot make the nose smaller | Usually CaHA or PCL; hyaluronic acid where a dissolvable option is preferred | Deep, close to bone and cartilage, in small amounts |
| Lips | Volume, border definition or symmetry | Soft, low-G′ hyaluronic acid | Within the body of the lip and along the border |
| Tear trough | Softening a genuine hollow between the lower lid and cheek | Soft, low-G′ hyaluronic acid; CaHA and PCL generally avoided | Deep, beneath the muscle, often by cannula |
Frequently Asked Questions
Filler adds volume to restore support where tissue has deflated, and it treats lines present at rest. Botulinum toxin relaxes a muscle and treats lines made by movement; it adds nothing. The two address different problems, and the examination at rest and in movement decides which, if either, applies.
No. The cheekbone, chin and jawline sit on bone and accept firm hyaluronic acid, CaHA or PCL, while the lips and under-eye move or sit close to the surface and accept only soft hyaluronic acid. A collagen stimulator such as PLLA is weighed against a volume gel only for broad, diffuse loss. Dr Sin Yong matches the material to the tissue found at examination, not to the name of the area.
Hyaluronic acid (HA) is a gel that can be dissolved with an enzyme and comes in firm and soft forms. CaHA (Radiesse) and PCL (Ellansé) are microspheres in a carrier gel that support a shape and then prompt collagen; neither can be dissolved. PLLA (Sculptra) is a collagen stimulator used for diffuse loss rather than a point. Reversibility and the area decide which is reasonable.
Sometimes. A laugh line, or nasolabial fold, often deepens because the cheek above it has lost volume, and supporting the cheek can soften the fold more naturally than filling the line itself. Where the fold comes from sagging, filler adds weight without lifting. The examination decides whether the fold, the cheek, both or neither should be treated.
The terms describe how firm a gel is. Firmer, high-G′ gels hold their shape against pressure and are used on bone for the chin, jawline and cheek. Softer, low-G′ gels spread more and suit thin, mobile areas such as the lips, the tear trough and fine lines. Using a firm gel in a delicate area can show as a ridge, so the product follows the area.
Check that the injector is a registered doctor who examines you before proposing a plan, that the product is HSA-registered and named to you, and that hyaluronidase is kept on hand to dissolve hyaluronic acid filler if needed. Ask who will review you afterwards and how to reach them. Filler from a non-medical setting carries risks that cannot be managed there.
Not before the area is assessed. Earlier filler can persist longer than it shows, and fat graft and filler can sit in the same area, so the first step is to find out what is actually there, using ultrasound where the history is unclear. Excess hyaluronic acid may be dissolved first. Adding product over an unknown layer is a common route to over-filling.
Common areas are the tear trough, cheeks, temples, chin, jawline, nose and lips. Each area uses a filler of different firmness at a different depth, which is why one product is rarely right for the whole face.
Dermal fillers are registered with the Health Sciences Authority (HSA) as medical devices, and injecting them is a medical treatment performed by a registered medical practitioner. Regulation covers the product; it does not remove the risks of injection, which are managed by assessment, choice of material and plane, and having hyaluronidase available.
A dermal filler is a cross-linked gel that occupies space and restores structure, such as a cheek, chin or temple. A skin booster is lightly cross-linked hyaluronic acid or a polynucleotide placed within the dermis to act on hydration and skin quality. One adds volume, the other acts on the skin itself, and neither does the job of the other.
Hyaluronic acid filler can be dissolved with hyaluronidase, an enzyme that breaks the gel down so the body clears it. Calcium hydroxylapatite (Radiesse), polycaprolactone (Ellanse) and poly-L-lactic acid cannot be dissolved by enzyme and are resorbed over time. Ultrasound guidance lets the enzyme be directed at the misplaced product rather than the whole area.
Pillow face is the rounded, heavy appearance that results from too much filler, usually accumulated over repeated treatments in the same zones. Each addition is layered on product still present, so the total volume rises past what the facial skeleton supports. It is corrected by dissolving the excess hyaluronic acid under ultrasound guidance and re-assessing the face from the beginning.
A filler adds volume; it does not lift tissue or tighten skin. Restoring a deflated cheek can improve how the midface is supported, but jowls and loose skin are laxity, a different process addressed by energy-based or thread-based methods that act on the supporting layers by a different mechanism. Filling a lax face makes it heavier, not lifted.
A vascular occlusion happens when filler enters or compresses an artery and blocks blood flow to the tissue it supplies. The warning signs are skin that blanches or turns dusky or mottled, pain out of proportion to the injection, and in rare cases any change in vision. It is an emergency treated with high-dose hyaluronidase and should be reported the same day.
Filler treatment is deferred during pregnancy and breastfeeding. Fillers have not been studied in these groups, and the fluid shifts of pregnancy alter how the face looks in any case. Treatment is also deferred where there is an active infection at or near the site, including a cold sore, and is assessed individually in people with autoimmune or inflammatory conditions.
Cost depends on the areas treated and how many, what the examination finds in each, the product chosen and the quantity the anatomy calls for, whether filler is used alone or with toxin or a biostimulator, and whether the plan is staged across more than one visit. Correction of previous filler is costed separately. Cost is set out at consultation.
Most people describe pressure and a brief sting rather than significant pain. A topical anaesthetic is applied beforehand, and most hyaluronic acid fillers contain lidocaine, a local anaesthetic that numbs the area as the product is placed. The lips are the most sensitive area and comfort there is managed accordingly.
Avoid pressing or massaging the treated area unless advised to, and keep make-up off the entry points until they have closed. Strenuous exercise, saunas, alcohol and facial treatments that apply heat or pressure are postponed for a short period. Dental work, vaccinations or travel planned close to the treatment date are worth mentioning beforehand. Specific aftercare is given for the areas treated.
Often, yes. They act on different tissues, filler on volume and botulinum toxin on muscle contraction, and both can be planned within one appointment where the assessment calls for it. Sometimes the toxin is given first and filler later, so the effect of relaxing a muscle is seen before volume is added. The sequence is decided individually.
Here, nose filler is usually calcium hydroxylapatite or polycaprolactone, chosen for the support they give the bridge, with hyaluronic acid where a dissolvable option is preferred. CaHA and PCL cannot be dissolved with hyaluronidase, so placement and quantity are planned conservatively. The nose also carries a higher vascular risk than many areas, which shapes the technique and the amount used.
No. Filler follows anatomy rather than age: a retruded chin or low nasal bridge can be addressed in younger adults, while volume loss from fat-pad deflation and bone change tends to appear later. The useful question is whether volume is genuinely missing, which the examination decides. Starting early with repeated top-ups is one of the routes to over-filling.
No. When hyaluronic acid filler breaks down, the area returns towards how it would have looked without it; filler does not speed up ageing. Some people notice the change because they have become used to the treated look. Non-dissolvable materials such as CaHA, PCL and PLLA are also gradually broken down. Whether to top up, change material or stop is a decision for review, not an obligation.
Filler looks unnatural when too much is placed, when it is placed in the wrong layer, or when an area needed lifting or a different treatment rather than volume. Dr Sin Yong assesses the whole face, uses conservative amounts and reviews before adding more. How an over-filled look is avoided and corrected is explained on this page.
Contact the clinic and come for review. Some early unevenness is swelling and settles. Hyaluronic acid can be dissolved with hyaluronidase, in part or completely, after assessment and sometimes with ultrasound guidance. CaHA, PCL and PLLA cannot be dissolved, which is one reason they are placed in stages and kept away from areas where reversibility matters.
Medically reviewed by Dr Sin Yong, MBBS (NUS), MRCS (Edinburgh) · Last updated 25 October 2026 · Editorial policy
- Nose Fillers Singapore: What They Can and Cannot Change — Nose fillers Singapore guide: how CaHA or PCL raises a flat bridge or lifts the tip, when dissolvable HA is used, the ri…
- Chin Fillers Singapore: A Complete Guide — Chin fillers add projection and height to a weak or recessed chin. What decides the amount and cost, which filler suits,…
- Dermal Fillers Singapore: HA, CaHA, PCL, PLLA — Dermal fillers in Singapore compared by material: hyaluronic acid, CaHA, PCL and PLLA. What each does, which can be diss…
References
- Dermal Fillers (Soft Tissue Fillers) — U.S. Food and Drug Administration.
- Radiesse — Premarket Approval P050037 — FDA.
- Comparison of the rheological properties of viscosity and elasticity in two categories of soft tissue fillers: calcium hydroxylapatite and hyaluronic acid — Dermatologic Surgery, PubMed.
- New High Dose Pulsed Hyaluronidase Protocol for Hyaluronic Acid Filler Vascular Adverse Events — Aesthetic Surgery Journal, PubMed.