The internet can educate you. It can’t examine you.
If you’ve spent any time on social media recently, you could be forgiven for thinking that дермальные наполнители have no place in modern aesthetics. Headlines about “pillow face”, celebrity filler dissolving stories and viral videos warning against injectable treatments have led many people to question whether dermal fillers are still safe, appropriate or even necessary.
At the same time, patients have never had access to more information. Social media, podcasts, online articles and AI-powered tools have made it easier than ever to learn about aesthetic treatments before booking a consultation. In many ways, that’s a positive change. We actively
Why Has Public Opinion on Dermal Fillers Changed?
There is no denying that the conversation around дермальные наполнители has changed dramatically over the past few years.
For a long time, fillers became one of the most talked-about treatments in aesthetic medicine. As their popularity grew, so did the number of practitioners offering them and, inevitably, the range of results being shared online. Social media became filled with images of overfilled lips, exaggerated cheeks and faces that no longer looked quite as balanced or expressive.
It’s hardly surprising that this has changed public perception.
At the same time, celebrities and influencers began speaking openly about dissolving their fillers or moving towards a more natural appearance. Regenerative treatments such as полинуклеотиды, skin boosters и collagen-stimulating procedures have also become increasingly popular, often being presented as the modern alternative to dermal fillers.
I am a great advocate for many of these treatments and regularly recommend them to my own patients where I feel they are appropriate. The increased focus on skin quality, collagen production and working with the body’s own regenerative processes is something I very much welcome and it has given us more ways to achieve subtle, natural-looking results.
The problem is that social media often turns a much more complicated conversation into very simple statements.
“Fillers are bad.”
“Everyone should dissolve their filler.”
“Natural treatments have replaced fillers.”
The reality isn’t quite that simple.
Dermal fillers haven’t suddenly become a bad treatment, just as regenerative treatments aren’t automatically the right choice for everyone. They do different things and address different concerns.
And that’s really where the conversation around modern aesthetics needs to move: away from which treatment is supposedly “in” or “out”, and towards understanding what each treatment can actually do.
What has changed considerably is the way we understand and use them.
Dermal Fillers Have Changed – And So Has the Way We Use Them
It’s worth remembering that dermal fillers themselves have changed considerably over the past few decades.
Early injectable fillers were very different from the hyaluronic acid (HA) fillers commonly used today. Some of the earliest products were collagen-based, while others were permanent or semi-permanent fillers designed to remain in the tissues for many years.
Modern HA fillers are temporary, have an established safety profile when used appropriately, and can also be dissolved if medically necessary.
But it isn’t only the products that have changed. Our techniques and our understanding of how the face ages have evolved too.
Years ago, treatment was often much more focused on the individual line or wrinkle. If a patient was bothered by their nasolabial folds – the lines that run from the nose towards the corners of the mouth – filler might simply have been placed directly into those lines.
Today, we understand much more about why those changes happen in the first place.
As we age, we naturally lose some of the support and volume through the cheeks and mid-face, and this can have an effect further down the face. So, for the right patient, carefully restoring some of that support higher up can help to soften the nasolabial folds without needing to fill the lines themselves.
It’s a much more natural way of approaching the face. Rather than looking at one line and asking, “How do we fill this?”, we can step back and look at what is actually causing it.
And that approach is continuing to evolve.
We now have treatments such as Профиль структуры, which works with the superficial fat layers of the face to help restore some of the support that can be lost as we age, without adding the same type of volume or definition we might create with traditional dermal filler.
For some patients, particularly those who are starting to notice that their face looks a little less supported or more drawn than it used to, but don’t necessarily want or need additional volume, this gives us another option.
That doesn’t mean Profhilo Structura has replaced dermal filler, or that one treatment is better than the other. They simply do different things.
The same applies to the growing number of regenerative treatments now available. Полинуклеотиды, skin boosters и collagen-stimulating treatments can be wonderful for improving skin quality, hydration and supporting the skin’s natural repair processes, but they don’t necessarily do the same job as a dermal filler.
What it does mean is that we have far more options available to us than we did even a few years ago.
And for me, that’s where modern aesthetic medicine becomes really interesting. It’s less about deciding which treatment is currently popular and much more about looking at the person in front of me and asking: what does your face actually need?
Natural Results Aren’t a New Trend
The move towards more natural-looking results is something I welcome, but for me, it isn’t a new approach.
My philosophy has always been to work with someone’s face rather than change it.
I am not trying to make every patient look younger, give everyone the same cheek shape or create a particular style of lip. I am looking at the individual person and thinking about what might subtly restore balance, support or freshness while still allowing them to look completely like themselves.
Very large lips, for example, aren’t part of my own aesthetic, and techniques such as Russian lips aren’t something I personally offer. That isn’t a judgement on someone who prefers that look, or on practitioners who specialise in it. It simply isn’t my style of injecting.
For me, the best results are often the ones nobody can quite put their finger on.
Someone might tell you that you look well, rested or particularly good that day. They shouldn’t necessarily be able to identify exactly what you’ve had done.
And increasingly, achieving that result isn’t about choosing between filler or regenerative medicine.
For one patient, a small amount of dermal filler might provide exactly the structural support they need. For another, improving skin quality may make the biggest difference.
Sometimes we may combine approaches over time, and sometimes I may recommend doing nothing at all.
Having more treatments available doesn’t mean we need to use more of them. It simply gives us more choice.
Who Is Holding the Syringe Matters
There is another part of the current conversation around dermal fillers that I think is important.
There are simply far more people offering injectable treatments than there were when I first started working in aesthetics. And while greater access to treatments isn’t necessarily a bad thing, it does mean there is now a much wider range of experience and training amongst the people providing them.
Dermal fillers are not regulated in the UK in the same way as prescription-only injectable treatments, and this is something I don’t think every patient realises. You do not have to be a doctor, nurse, dentist or other healthcare professional to offer dermal filler treatments.
Someone with no previous medical training can attend a short training course – in some cases lasting just one day – receive a certificate and go on to offer filler treatments.
So, two people offering exactly the same treatment could have completely different backgrounds. One may have years of medical training and clinical experience, while another may have entered aesthetics through a short injectable training course.
This isn’t about criticising individual practitioners or suggesting that every poor result comes down to someone’s professional background. But when considerably more people are performing considerably more treatments, with such different levels of training and experience, it naturally follows that we are going to see a greater number and wider variety of outcomes. Social media then gives those outcomes a very visible platform.
For me, this is why choosing your practitioner matters just as much as choosing your treatment.
Injecting the filler itself is only one part of being a good injector. Before I pick up a syringe, I want to understand the person in front of me, not just their face. How has their face changed? Where has support been lost? What is their skin like? What is bothering them and what are they hoping to achieve?
I also need to understand their medical history, any medications they are taking and relevant lifestyle factors that may affect whether a treatment is suitable or how we approach it. All of that forms part of the consultation before we even get to the question: is filler actually the right treatment for this patient?
Medical training and a detailed understanding of facial anatomy are incredibly important, but so is experience. There is an aesthetic judgement that develops through treating many different faces over many years, understanding how they age and seeing how they respond to treatment over time.
Knowing where filler can be placed doesn’t necessarily mean it should be placed there.
Sometimes the right decision is to use less than the patient expected. Sometimes it’s to suggest another treatment. And sometimes it’s simply to say, “I don’t think you need anything.”
The Treatment Doesn’t End When You Leave the Clinic
There is another reason I feel strongly about medical training and experience when it comes to injectable treatments: aftercare.
Dermal fillers have become so commonplace that I think it’s sometimes easy to forget that they are still injectable treatments and, like any procedure, they come with potential risks.
Most treatments are straightforward and serious complications are uncommon, particularly when filler is used appropriately. More common side effects can include swelling, bruising, tenderness or temporary asymmetry, which will usually settle as the area heals.
There are also less common complications that require a practitioner to recognise what is happening and act appropriately. These can include infection, lumps or nodules, an inflammatory reaction or filler affecting a blood vessel. Vascular complications are rare, but they can be serious, which is why recognising the early signs and knowing how to respond is so important.
I don’t say this to make patients nervous about having dermal filler. Quite the opposite. I think patients should be able to feel confident about their treatment because they understand both the benefits and the potential risks, and know that the person treating them is equipped to look after them properly.
For me, the question isn’t only, “Who is performing my treatment?”
It’s also, “Who is looking after me if something doesn’t go to plan?”
Being able to inject well is one skill. A practitioner also needs to know what is normal after treatment, recognise when something isn’t right and understand what needs to happen next. They need to be available to support the patient afterwards rather than viewing the appointment as finished once the injection has been performed.
That is a part of aesthetic medicine that perhaps isn’t as visible on Instagram or TikTok, but it matters enormously.
When you’re choosing a practitioner, it is perfectly reasonable to ask about their medical background and experience, but also about what happens after your appointment. What aftercare do they provide? Who do you contact if you’re worried about something? And if there is a complication, are they able to recognise and manage it?
Aesthetic medicine isn’t only about achieving a beautiful result. It’s about making sure the patient is properly cared for before, during and after their treatment.
So, Are Dermal Fillers Really the Problem?
I don’t think дермальные наполнители are the problem.
But I also don’t believe that everybody needs them.
Aesthetic medicine has changed enormously. We understand facial ageing better, our injecting techniques have become more sophisticated, and we have regenerative and skin-quality treatments available to us that simply didn’t exist when I first began working in this field.
That gives us more choice – but it can also make things more confusing for patients.
Social media can introduce you to a treatment. Google can help you research it. AI can explain how treatments work, help you explore different options and even suggest questions to ask at your consultation.
I see real value in that. In fact, I have my own AI version of myself, Доктор Прима AI, which has been developed to help patients learn more about the treatments we offer and answer some of the questions they may have before coming into the clinic.
But I have always seen it as an enhancement to the patient experience, never a replacement for a face-to-face consultation with me.
AI can provide information based on what you tell it. What it can’t do is sit opposite you, examine your face, understand the nuances of your medical history, watch how your features move, feel the tissues beneath the skin or use the clinical and aesthetic judgement that comes from years of treating real patients.
And sometimes, when I see a patient in person, my recommendation may be completely different from the treatment they thought they needed before they walked through the door.
That doesn’t make the information they found online wrong. It simply means that information is only the starting point.
The consultation is where we make it personal.
So if you’ve read that fillers are “out”, regenerative medicine is “in”, or that there is one particular treatment everyone should be having, my advice would be not to worry too much about choosing the treatment before you’ve had the consultation.
Start with the concern.
Find an experienced medical practitioner whose results and approach feel right for you, explain what you’re noticing and what you would like to improve, and allow the treatment plan to come afterwards.
And sometimes, that may mean being advised that the best treatment for you isn’t one that particular practitioner or clinic offers. A good consultation should be about finding the most appropriate solution for the patient, even if that occasionally means recommending another practitioner or clinic that may be better placed to help.
Because ultimately, good aesthetic medicine isn’t about following what is currently fashionable, or trying to make every patient fit the treatments available.
It’s about choosing what is right for the individual person sitting in front of you.
Автор: Доктор Прима Виг, Medical Director at Dr Preema London Clinc
