Filling Substances Program


Filling Substances Program

Aging skin changes and actinic exposure leads to the appearance of lines, creases, and dyschromia.

Soft-tissue atrophy, with its associated volume loss, and progressive bony remodeling of the facial platform, result in deterioration, descent, and deflation (the 3Ds of aging) of the facial envelope.

Age‐related skin changes are the result of genetically programmed changes (intrinsic factors) and environmental wear‐and‐tear on the skin (extrinsic factors).

Positional shifting and malalignment of facial fat pad cause an aged facial phenotypes such as sunken temple, eye bags, nasolabial folds, Marionette lines, jowls.

Hyaluronic acid (HA) is a sugar found naturally in our skin that holds water and helps keep it hydrated and plump. The HA within our bodies holds a thousand times its weight in water to retain all that moisture in our skin and joints.

Just like collagen and elastin, the amount of naturally-occurring hyaluronic acid in our bodies decreases as we get older.

Injectables hyaluronic acid use a synthetic gel form of hyaluronic acid to add volume to the dermal layer of the skin. With a few pricks of a needle, the gel plumps sunken areas, smooths fine lines, hydrates skin, lifts facial folds, and decreases shadows - then slowly dissolves over the course of one year.

Non‐biodegradable fillers

In Europe and the USA, there are only a few non‐biodegradable or permanent fillers currently available. Several products were removed from the market due to very severe adverse reactions, both acute and delayed, which negated any potential advantages.

Examples: Silicones , Calcium hydroxylapatite (CaHa), Paraffin, Polyalkylimide gel

Biodegradable fillers

Bovine collagen, human collagen, and hyaluronic acid fillers are biodegradable fillers.

Hyaluronic acid fillers are overwhelmingly the most popular type of product used for injectable volume enhancement. They are long-lasting with low allergenic potential and other relative risks, and have an improved safety profile compared with non‐HA fillers due to the ability to reverse effects with the use of hyaluronidase.

Injectable Fillers can use to volumize and lift many facial areas.

  • Sunken temples
  • Tear trough
  • Nasolabial fold
  • Marionette line
  • Chin augmentation
  • Jaw line contouring
  • Lip augmentation
  • Facial shaping
  • Skin hydration

How long the fillers last?

6 - 24 months depend on types of fillers

The incidence of foreign body reactions to HA is much lower (0.4%) than that reported for bovine collagen (3 – 4%).

What to do before fillers injections?

7 days before injections

  • Avoid blood-thinning over-the-counter medications such as aspirin, ibuprofen, and other NSAIDs.
  • Avoid supplements, including St. John’s Wort, Gingko Biloba, primrose oil, garlic, ginseng, and Vitamin E.

24 Hours Prior to Injections

  • Do not drink alcoholic beverages 24 hours prior.

General Recommendations

  • If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another eruption of cold sores. Please let your physician assistant know if you are prone.
  • Do not use dermal fillers if you are pregnant or breastfeeding, are allergic to any ingredients such as Lidocain.
  • If you have
    • Any inflammation, infection around area to be injected such as active pimples, dental caries.
    • Any recent dental procedures.
    • Please delay filler injection until the infection, inflammation subsides.

The day of treatment

  • Arrive at the office with a “clean face”—washed and without makeup.
  • In order to maximize your comfort during the procedure, a topical anesthetic may be applied.
  • In some cases, a local numbing medication will be injected into or around the area(s) to be treated.

 After Treatment

  • Until the swelling and redness have resolved, avoid intense heat in the treated area(s). This includes sunbathing, tanning, saunas, hot tubs, or hot wax.
  • If there is a visible bump, you can massage the area. Depending on the areas treated and the product used, you may feel “firmness.” These areas will soften and settle with time (usually 1-2 weeks).
  • Sunscreen and makeup can be applied, and you may use a gentle cleanser in the area.
  • Avoid drinking alcohol or partaking in strenuous exercise, as it may result in additional bruising.

Please contact us immediately if you:

  • Have fever and/or chills
  • Have discolored blotches in areas not injected
  • Have blanching of injected areas
  • Notice the area appears red and/or hot to the touch
  • Have severe or increasing pain

*Side effects are minimal: you may experience some swelling or bruising that can last for two or three days. The most important thing to remember when getting any kind of filler or injectable os to go to a trained and board-certified dermatologist.


Filling Substances Program

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Dr.Pamwad Thanadka

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Dr.Wipawee Phuangsai

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Dr.Parin Sujijantararat

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Dr.Nudcha Chandayani

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Dr.Nutthicha Kannawat

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Dr.Nuttha Meesuntorn

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พญ.ชนิกา ทิพยศรี

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Dr.Manucha Chanchek

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Dr.Pakorn Kitiratchai