Dermal fillers are gel-like injectable treatments used to restore lost volume, soften lines and folds, and gently enhance features such as the lips, cheeks and jawline. At her Harley Street practice in London, female plastic surgeon Ms Anna De Leo offers dermal fillers as a medical treatment, carried out by a consultant plastic surgeon rather than as a quick beauty service, with an emphasis on subtle, balanced results that look like a well-rested version of you.
Fillers can look deceptively simple, but they are not. In the UK, dermal fillers are not licensed as medicines, and there is currently no legal requirement for the person injecting them to be medically qualified. That makes your choice of practitioner one of the most important decisions you will make. A surgeon who understands the layers, blood vessels and ageing patterns of the face is best placed to choose the right product, place it safely and recognise and treat any complication promptly.
01What Are Dermal Fillers?
Most modern dermal fillers are made from hyaluronic acid, a sugar molecule found naturally in the skin, where it binds water and helps to keep tissues hydrated, supple and plump. With age, the body's own hyaluronic acid and collagen decline, fat compartments shrink and shift, and bone gradually remodels. The result is hollowing in the temples and under the eyes, flattening of the cheeks, deepening folds around the nose and mouth, and thinner lips.
Hyaluronic acid fillers come in a range of densities. Firmer gels are placed deeply to restore structure in the cheeks, chin or jawline; softer gels are used in the lips or to smooth finer lines; and very fluid ‘skin booster’ products hydrate the skin and support its quality. Over time, the body gradually breaks the product down, which is why results are temporary, typically lasting from around six months to eighteen months or more, depending on the product and the area treated.
A key advantage of hyaluronic acid is that it can be dissolved. An enzyme called hyaluronidase, a prescription-only medicine, can break down the filler if a result needs adjusting or, much more importantly, if a complication occurs. Because of this reversibility and safety profile, our practice favours hyaluronic acid. Permanent and semi-permanent fillers are generally avoided in modern UK practice, as complications such as late lumps and inflammation are harder to treat.
02Who Are Fillers Suitable For?
Dermal fillers can help people from their late twenties onwards who wish to address specific concerns without surgery, including:
- Volume loss in the cheeks, temples or mid-face
- Nasolabial folds and marionette lines around the mouth
- Thin or asymmetric lips, or fine lines around the lips
- A recessed chin or a softened jawline
- Hollows beneath the eyes (tear troughs), in carefully selected patients
- Acne scarring or skin that has lost hydration and glow
Fillers are not suitable during pregnancy or breastfeeding, in the presence of active skin infection near the treatment area, or for some people with certain autoimmune conditions or a history of severe allergies. In England, it has been illegal since October 2021 to give dermal fillers to anyone under the age of 18 for cosmetic purposes, and we do not treat under-18s.
Fillers also have limits. They cannot lift heavy, loose skin, and overfilling a face to compensate for sagging tends to look unnatural. If laxity is your main concern, a facelift or a combined facial rejuvenation plan may be more appropriate.
03Your Fillers Consultation on Harley Street
Every treatment begins with a proper medical consultation at 64 Harley Street, Marylebone, in central London. Ms Anna De Leo will review your medical history, medications and any previous injectable treatments, and assess your face at rest and in movement. She considers the face as a whole, looking at proportion, symmetry and how volume has changed over time, rather than simply filling individual lines.
You will discuss the areas that concern you, which products are appropriate, how much is likely to be needed, how long results may last and the possible side effects. If fillers are not the right answer for you, she will say so. Responsible practice also means allowing you time to reflect: you will never be pressured to proceed on the day.
The factors that influence the cost of filler treatment include the areas treated, the type and volume of product, and whether a review appointment or follow-up treatments are planned. These are explained clearly in a personalised plan.
04How Dermal Filler Treatment Is Performed
After cleansing the skin, a topical anaesthetic cream may be applied, and many products also contain a small amount of local anaesthetic to keep treatment comfortable. For the lips, a dental-style nerve block may be offered. Ms De Leo then injects the filler precisely, using either a very fine needle or a blunt-tipped cannula, which can reduce bruising and lower the risk of entering a blood vessel in some areas.
- Cheeks and mid-face: structural support that lifts and softens the folds below.
- Lips: gentle definition of the border and natural hydration of the body of the lip, respecting your natural proportions. See also chin and lip reshaping.
- Chin and jawline: improved projection and a cleaner profile.
- Lines and folds: softening, rather than erasing, to keep expression natural.
Treatment usually takes thirty to sixty minutes. A cautious, staged approach is often best: it is always possible to add more at a review appointment, but a subtle start keeps results natural.
Good filler work is invisible: people notice that you look well, never that you have had something done.
ADLSynergy · Harley Street
05Recovery and Aftercare After Fillers
Most people return to normal activities the same day or the next. Mild swelling, redness, tenderness and small bruises at injection sites are common, particularly in the lips, and usually settle within a few days to a week. Lips can look fuller for the first forty-eight hours before settling.
- Avoid make-up on the treated area for the rest of the day
- Avoid strenuous exercise, saunas, steam rooms and alcohol for around 24–48 hours
- Do not massage the area unless advised
- Avoid dental work and facial treatments for two weeks if possible
- Contact the clinic immediately if you notice severe or increasing pain, skin colour change, blanching or any change in vision
A review appointment around two weeks after treatment allows the result to be assessed once swelling has settled. At ADLSynergy on Harley Street in London, fillers can form part of a wider plan to support skin health, including nutrition guidance and treatments to improve skin quality, linked to our longevity approach.
06Dermal Filler Risks and Safety
Dermal fillers are non-surgical, but they are a medical procedure with genuine risks. These include:
- Swelling, bruising, redness and tenderness, usually short-lived
- Lumps, unevenness or asymmetry, which may settle or be corrected
- Infection, or delayed inflammatory reactions weeks or months later
- A bluish discolouration if filler is placed too superficially
- Allergic or sensitivity reactions, which are rare with hyaluronic acid
- Vascular occlusion: if filler blocks a blood vessel, it can damage the skin and, very rarely, cause loss of vision. This is a medical emergency requiring immediate treatment with hyaluronidase.
Rapid recognition and treatment of complications are why it matters so much to choose a qualified doctor who holds hyaluronidase on site and knows how to use it. When looking at filler before and after photographs, remember that results vary and that the product is gradually absorbed, so maintenance treatments are needed to sustain the effect.
07Why Choose Ms Anna De Leo for Fillers on Harley Street
Ms Anna De Leo is a GMC-registered Plastic, Reconstructive and Aesthetic Surgery Consultant and Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery, with more than twenty years of experience in facial surgery and reconstruction. That surgical knowledge of facial anatomy, including the course of blood vessels and nerves, underpins a safe, considered approach to dermal fillers.
As a female plastic surgeon, she favours restraint and harmony: enhancing what is already there, rather than chasing trends. Patients looking for the best filler doctor in London often value precisely this blend of medical expertise and an eye for natural beauty.
To discuss dermal fillers in a relaxed, clinical setting, please book a consultation at our Harley Street practice in London.
