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Duhan Plastic Surgery Clinic · 두한성형외과 DUHANISM · March 9, 2020
Quick plastic surgery # Plastic surgery # Plastic surgery clinic # Famous plastic surgery clinic # Well-known plastic surgery clinic # Female plastic surgery # Attractive plastic s...
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This page is an English translation of a Korean Naver Blog archive entry. For exact wording and source context, verify against the Korean archive original and the original Naver post.
Clinic: Duhan Plastic Surgery Clinic
Original post date: March 9, 2020
Translated at: April 25, 2026 at 8:31 AM
Medical note: This translation does not guarantee medical accuracy or suitability for treatment decisions.
Filler injections for wrinkle correction
Types of fillers by ingredient
Hyaluronic acid (Juvederm, Restylane, Teosyal, Perlane)
Hyaluronic acid is an intercellular substance present between the dermis and epidermis of the skin. It is a biological substance that binds cells together and acts as a lubricant between cells.
The ingredient in hyaluronic acid-Juvederm is non-animal-derived hyaluronic acid.
It is the most widely used filler, and because it is a biological substance, it is a safe filler with a very low possibility of side effects or inflammation.
There are also three types depending on the intended use: low concentration injected just beneath the epidermis, medium concentration injected into the dermis, and high concentration injected into areas below the dermis.
It must be used according to its intended purpose, and if a high-concentration product is used in the epidermal layer, a side effect may occur in which the skin protrudes, so it is essential to use a filler with the appropriate concentration for the treatment area.
Uses: Mainly used for fine wrinkles around the eyes, glabella, and mouth, and for correcting sunken scars from acne or chickenpox
Polymethyl methacrylate (Artecoll)
Artecoll is composed of PMMA (polymethyl methacrylate) microparticles suspended at a 1:3 ratio in a 3.5% collagen solution.
PMMA (polymethyl methacrylate), also called methacrylic resin, is one type of thermoplastic.
Although inflammatory side effects are not common, when applied superficially in the skin layer it can cause unevenness, hardening, or contour irregularities, so it is not a filler that can be used in delicate areas.
In addition, its viscosity is weak in deep areas, so it is difficult to expect a strong contour-correcting effect for sunken areas.
Uses: Correction of small sunken areas; unsuitable for fine wrinkles or precise procedures
Polyacrylamide (Aquamid, Interpol, Royamid, Bio-Alcamid)
The ingredient consists of polyacrylamide (2.5%) mixed with apyrogen water (97.5%).
It is regarded as highly durable, but since it was imported and used domestically, many cases of side effects such as inflammation have been reported, so caution is needed.
Because side effects occur frequently, some products are banned from import by the Korea Food and Drug Administration.
Uses: Caution is needed because it often causes inflammation
Collagen (Evolence)
Collagen is one of the components in the human body and is a biological substance, so it is relatively safe, but side effects such as allergies can sometimes occur.
Also, because collagen is absorbed in the body by an enzyme called collagenase, its longevity is lower than that of other fillers.
Uses: Used for small sunken areas and correction of fine wrinkles
Radiesse (calcium preparation)
It consists of particles of bone material called calcium hydroxyapatite in a water gel, and is a bone-derived component.
Because the particles are hard, it is unsuitable for correcting fine wrinkles in the skin, but it can be injected under the skin and applied to small sunken scars or contour correction of small areas.
Submucosal procedures in soft tissues such as the lips require caution because hard lumps may form as a side effect.
Uses: Small sunken areas, chickenpox or acne scars
Areas that can be corrected with filler injections (Juvederm)
Forehead wrinkles, glabella wrinkles, eye-area wrinkles, bridge-of-the-nose wrinkles, nasolabial folds, lip wrinkles, other fine facial wrinkles, sunken scars (chickenpox, acne scars)
Features of filler injections (Juvederm)
| Because it is a biological substance, it is safe. |
|---|
| The procedure is convenient and precise procedures are possible. |
| Because it is a highly biocompatible substance, no allergy test is needed before the procedure. |
| Since it is made by cross-linking hyaluronic acid, the procedure effect lasts for a long time. |
| The effect can be confirmed immediately after the procedure. |
Application areas of filler injections (Juvederm)
◎ Forehead wrinkles
◎ Glabella wrinkles
◎ Eye-area wrinkles
◎ Bridge-of-the-nose wrinkles
◎ Nasolabial folds
◎ Lip wrinkles
◎ Other fine facial wrinkles
◎ Sunken scars (chickenpox, acne scars)
Hyaluronic acid (Juvederm)
Juvederm is injected into the dermal layer beneath the wrinkle through a thin 27-gauge needle.
After Juvederm is injected, the increase in volume pushes the wrinkle upward.
By physically supporting the wrinkle from below, Juvederm improves the wrinkle and remains there continuously, suppressing recurrence.
Filler injection (Juvederm) procedure
For eye-area wrinkles, the procedure takes about 10 minutes, and because anesthesia is used, there is almost no pain.
Examples of filler injection (Juvederm) procedures
Application range of filler injections (Juvederm)
As with most fillers, Juvederm is not very effective for deep wrinkles.
It is mainly used to correct fine wrinkles.
The wrinkles it is mainly applied to are fine forehead wrinkles, fine glabella wrinkles, eye-area wrinkles, and nasolabial folds around the mouth.
It is also used effectively for acne, chickenpox, and scars.
Fillers should not be used for deep expression wrinkles or for contouring the face.
Since the effect is almost nonexistent or there is a risk of side effects, caution is needed.
When filler injections (Juvederm) do not work
It has weak or almost no effect on very thick and deep wrinkles.
For forehead and glabella vertical line wrinkles, and for deeply sunken nasolabial folds around the mouth, the treatment effect is insufficient.
Filler injections are for fine wrinkles.
Longevity and number of filler injection (Juvederm) treatments
Juvederm is injected into the dermis of the skin to push up wrinkles.
Juvederm is an advanced hyaluronic acid made by cross-linking hyaluronic acid so that the effect lasts a long time.
Usually the effect lasts about one year, and even if it recurs, the original treatment area tends to recur only mildly, so the more treatments you have, the more the effect accumulates.
The duration of the effect varies depending on the degree of wrinkles, facial expression habits, and the location of the wrinkles.
In some cases, it can last for several years or more.
The number of treatments can be adjusted by repeating them according to the pattern of wrinkle formation; there is no fixed treatment schedule.
Side effects of filler injections (Juvederm)
Because it is made by refining the intercellular substance between the dermis and epidermis of the skin and is highly biocompatible, it is safe enough that no allergy test is needed before the procedure.
For example, in the case of collagen injections, an allergy test is performed to determine biocompatibility, and the procedure is carried out only if it is judged that no allergy will occur, but Juvederm does not require such a test.
Other side effects include a risk that if too much Juvederm is injected into one area due to the practitioner's lack of experience, the injection site may protrude more than the surrounding skin.
If overinjected, it can be removed again or dissolved with hyaluronidase, the antagonist.
Correct knowledge you should have about filler injections (Juvederm)
Safe fillers should be used.
Fillers containing polyacrylamide ingredients (Aquamid, Interpol, Royamid, Bio-Alcamid, etc.) have frequently been reported to cause side effects such as inflammation after being imported and used domestically, so caution is needed.
Some products are currently banned from import by the Korea Food and Drug Administration.
They are promoted as highly durable, but on the other hand, because it is difficult to completely remove injected filler, serious long-term complications can occur after inflammation, so this should be kept in mind.
It should be used according to its intended purpose.
There are many types of fillers, and people tend to focus on whether they are long-lasting, but long-lasting is both an advantage and a disadvantage.
If a problem occurs, most fillers are difficult to remove.
Therefore, if filler spreads between tissues and causes problems, you may suffer serious side effects and long-term complications.
The use of fillers should be limited to correcting fine wrinkles and small sunken scars.
For example, using them to raise the nose, for under-eye surgery, or in the cheeks, forehead, or lips is a procedure that should be strongly discouraged.
This is because, beyond having little effect, the risk of side effects is very high.
Just as even a good medicine becomes harmful if used for the wrong purpose, even a good filler will inevitably have a higher rate of side effects if used inappropriately.
The issue of embolism as a side effect
No matter how safe a filler is, when injected it can block an artery in the subcutaneous layer and cause embolism.
Because of embolism, necrosis can occur in the tissues or skin supplied by that artery.
Necrosis caused by embolism is a serious side effect.
Once necrosis occurs in skin tissue, it recovers over a long period while leaving severe scars, so this is a serious issue.
Therefore, fillers should be used only for small sunken scars or fine wrinkles within the dermis, and it should be kept in mind that if they are injected deep below the dermis for deep wrinkles or contouring, there is a risk of embolism traveling through an artery.
Problems with fillers with high longevity
Fillers with high viscosity and strong longevity can sometimes cause serious problems.
High longevity means the filler hardens firmly, which can lead to uneven protrusions or contours at the treatment site, and problems such as the treated area feeling like a foreign body rather than soft like one's own flesh.
Therefore, fillers with high longevity must be used very carefully to avoid side effects.
Proper understanding of filler longevity
As an example of Juvederm, there are three types of Juvederm.
They are labeled with the numbers 18, 24, and 30, and each has different viscosity.
Although the ingredients are the same, the higher the number, the higher the viscosity, the better the correction effect for sunken areas, and the much stronger the longevity.
Therefore, Juvederm 30, labeled 30, has the best longevity.
You might think that the most durable one should simply be used, but these were released in three types because each has a different purpose.
The least durable, 18, is a filler injected just under the epidermis and is used for the most fine and shallow wrinkles.
However, if 30, which has better longevity, is used for shallow wrinkles just under the epidermis, the treatment area may protrude and cause unevenness, leading to undesirable results.
Therefore, for shallow wrinkles, a lower-viscosity product like 18 should be used for safety and effectiveness.
The purpose of 30 is to be injected just below the dermis, making it suitable for correcting deep wrinkles and sunken scars.
In this way, only by using a filler that matches the wrinkle or sunken area can the procedure be effective without side effects.
If it is judged only by longevity and used in a way that does not match its purpose, there is a high risk of side effects, so this must be kept in mind.
Cautions about using fillers for under-eye surgery or aegyo-sal procedures
Fillers should not be indiscriminately used under the eyes.
Fillers are not made for contouring.
They are simply for correcting fine wrinkles and small sunken scars.
They are often injected into the under-eye aegyo-sal area or sunken areas under the eyes, making the eye shape look awkward or causing side effects.
Because fillers are transparent, when injected under the eyes the area often turns pale and looks unnatural.
They can also create a bumpy shape, or spread so that the wrong area protrudes.
Many people who have had filler injections under the eyes complain that the under-eye shape looks awkward or experience side effects, and to avoid following in their footsteps, fillers should absolutely not be injected under the eyes.
They should also not be injected into the nose, lips, or cheeks.
They should be used only for fine wrinkles around the eyes, fine forehead wrinkles, fine wrinkles around the mouth, and small sunken scars.
In the case of fillers that are not hyaluronic acid-based, if an incorrect shape or side effect occurs from the filler procedure, correction is almost impossible.
There are many cases where people ask our clinic to correct problems caused by filler procedures done at other clinics, but even at our clinic there is no special correction method for this, so getting filler injections under the eyes is strictly prohibited.
How to solve side effects caused by filler use that does not match the intended purpose
In the case of hyaluronic acid fillers, there is an antagonist called hyaluronidase.
It is an enzyme that dissolves hyaluronic acid, and although it was mainly used to reduce swelling in surgical patients, because many clinics have caused problems through indiscriminate filler procedures, hyaluronidase is also used to dissolve hyaluronic acid fillers.
If you were treated with Restylane, Juvederm, or Perlane, it can be dissolved using hyaluronidase.
However, with fillers made of other ingredients, there is no antagonist that can dissolve them, so if side effects occur, correction is nearly impossible.
There are many cases where people ask our clinic to correct problems caused by filler procedures done at other clinics, but even at our clinic there is no special correction method for this, so getting filler injections for contour correction in the under-eye area, nose, or face is strictly prohibited.
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