Look Good & Feel Great At Any Age

Jane Iredale

Appearance Medicine, Beauty

What Exactly Are Wrinkle Fillers?

Wrinkle fillers? Injectables? You’ve heard of them right? But do you know exactly what they are?  Never fear, Dr Joanna Romanowska of Auckland’s Clinic 42, is here to tell you all about them. Technically known as dermal fillers they’reused to fill in lines and wrinkles and are behind the infamous ‘trout pouts’. However, that is NOT a look to aim for. As with any cosmetic enhancement, subtlety is key to an attractive and appropriate outcome…

Dr Jo



Hi everyone. This technology started with collagen about 25 years ago. It was derived from cowhide and only lasted three or four months. However, this was improved upon with the introduction of hyaluronic acid (HA) harvested from rooster combs.

Neither of these options appealed to everyone due to the animal source. However, not long after this, instead of having to extract the fillers from animals, scientists devised a way to ‘copy’ HA and make it in the laboratory.


Hyaluronic Acid As An Injectable Filler

Hyaluronic acid may sound intimidating, but it’s not actually an acid – that is merely its chemical name. In reality, HA is a very complex carbohydrate that is naturally present in our bodies. It’s a gel like substance that sits between the cells giving structure and support to the tissues.

The first non-animal stabilised hyaluronic acid was called Restylane. It came out about 18-20 years ago and it is now very established and is proven to be safe and effective. Indeed, it is still widely used today.

Since Restylane was first introduced there has been an explosion of other dermal fillers. Most are HA’s, and are copies of Restylane in some stage or form.

Another common dermal filler you will see in New Zealand is Juvederm. MedSafe approves both Juvederm and Restylane, which is why you will see them used most often.

Should We Go For Permanent Fillers?

At about the same time as Restylane emerged, many permanent fillers came on to the market such as Artecol, Dermalive and Radiesse and Sculptra.

When it comes to these permanent fillers, I have to put out a word of caution. Although the idea of a permanent filler may sound appealing, they are nowhere near as safe as the HA’s. Permanent fillers carry a higher incidence of infection, granuloma formation, inflammation and other complications. In addition, the ageing process obviously continues after the procedure and what might have looked good in your 40s may look peculiar at 70 or 80. At our clinic, we choose to only use HA fillers because we want our patients to still be looking great in decades to come, not just at the time of their treatment. We also think it’s important to have the flexibility of choosing to have newer treatments in the future and not be limited by a permanent substance as they age.

Cosmetic Medicine is a very rapidly evolving field. Who knows where we’ll be in 10 years’ time? Who knows in 30 years??? Our focus is on only using products that we know are effective and safe. We see lovely results with HA’s and using them doesn’t limit options for the future. The beauty of hyaluronic acid is that it is very gradually broken down into simple sugars by the body’s own processes and used for energy. For me, as a Doctor/practitioner, that provides a huge safety profile and allows me to be confident in using the product.

Scared Of Looking Weird?

Many people shy away from these things because of scary photographs in the media of overdone work where people have ‘trout pout’ lips and ‘pillowface’ cheeks and other disfiguring effects. That’s why a skilled practitioner is of paramount importance. If a doctor is talking you OUT of procedures being done, you are more likely to look like yourself following the treatment. When a job is well done you won’t necessarily look younger, but you will look refreshed and rested and no one will be able to tell.  It’s all about subtlety (or should be!).

If you are thinking of having a cosmetic medicine procedure, you should ask people for recommendations. The problem may be that when a procedure has been executed very well, one may not be able to tell anything has been done, which makes it difficult to know whom to ask for a recommendation. And then of course, the over-treated are obvious to see and get bad publicity, while all the happy stories go under the radar!

How Long Do Fillers Last?

Hyaluronic acid lasts a minimum of six months. However with subsequent treatments in some less mobile areas, we are seeing effectiveness for two to three years. One of the reasons for the longevity is that it stimulates the body’s own collagen production in the area that’s been treated. It’s not exactly clear why this happens, but it’s clinically visible and histologically proven that collagen neogenesis (production) is set in motion

HA lasts particularly well in the tear trough, cheeks and jawline. However, anywhere there is a lot of movement such as the lips it tends to last a shorter period of time as the movement dissipates the product more rapidly.

Where Fillers Are Used

  • Lips
  • Nasolabials (these are the smile lines that around the side of the nose to the mouth)
  • Marionette lines (these are the lines that can run straight from the mouth to the jawline giving an unhappy look)
  • Pre-jowls (the sides of the chin)

Newer Techniques

  • The brow:
  • As we age we lose definition of the brows and these can be redefined.
  • Temples:
  • Some people develop hollowing in the temples and can look like a ‘peanut head’. A dermal filler easily corrects this.
  • The X Lift
  • Filler is used around the cheekbones and jawline and gives the appearance of a mini facelift.

How Much Does It Cost?

Pricing can vary from about $700 up to $1500-$2,000 depending on how much is done.

A liquid facelift costs up to $2,000 and lasts nine to 12 months and longer with subsequent treatments.

Because of the collagen stimulating effect of the fillers you need less product over time. From a practitioner’s point of view it’s rather gratifying looking after a patient over a long time because it becomes so much easier to maintain a desired effect and it calls for less product, less cost, and less time.

Important: if you are being offered a wrinkle filler find out what the long-term consequences of using it are. Click To Tweet


To reiterate what Dr Joanna has said; if you decided to go down this road your practitioner is hugely important. It can be difficult to know who to ask for a recommendation. Asking people like me(!) 🙂 – a beauty editor – is a good place to start.

You can find Dr Joanna and Clinic 42 here.

And you can read more about Dr Joanna here.









Print Friendly



Leave a Comment