Dermal Fillers


Dermal Fillers

Some clients can be anxious about the cost implications being unknown prior to attending for a specialist consultation. You are much more relaxed and focused on the expert advice in the consultation when this is transparent. If you wish to attend for hyaluronic acid temporary dermal filler injections with Mr Blackburn 2022 indicative prices for the Juvederm range at Spire Cheshire are:

1 syringe £380, 2 syringes £590, 3 syringes £774, 4 syringes £958. Most clients only need one or two syringes – and it is often easier to add additional syringes after an interval and, in this circumstance, you would only be charged the difference between e.g. the first and second syringe costs – as if you had 2 syringes on the first occasion i.e. a total of £590 across both visits. If you are familiar with the information and proceed to a same day injection, the consultation fee reduces to £54. Otherwise, the usual £230 consultation fee only applies to the first consultation (for the time discussing your aims, the treatment options, recording your medical history, medical photographs, information sheets and consent form completion). After this has been completed on the first visit, repeat injection treatments usually occur at longer intervals ~12 months and in my experience generally not before 14 months). There is no additional consultation fees for the subsequent visits.


Some patients may like to have a trial injection of saline only to see what the changes may look like (and take ‘selfies’ to take time to consider their options). This attracts a fee of £51 for a saline trial injection for dermal filler planning.

Dermal Fillers – Overview

Wrinkles from with ageing and the loss of elasticity of the skin causes sagging and deeper folds. A wide range of commercial injectable fillers exist – reputable practitioners would almost always use temporary resorbable fillers which are the subject of this information sheet. It is important that your treatment is tailored to you by a specialist with knowledge of the wide range of potential solutions for wrinkles / sagging – from botox injections, injectable fillers, chemical peels, laser therapy, facial implants, fat transfer to surgical procedures such as blepharoplasty, brow lifts or face-lifts.


What are Dermal Fillers?

The key component in most dermal fillers – such as Juvederm® or Restylane®, is hyaluronic acid, is a naturally occurring, biodegradable complex sugar found in the human body and in all mammals. The hyaluronic acid can be made by clinical fermentation from streptococci bacteria in a pharmaceutical laboratory environment. Among other things, hyaluronic acid hydrates the skin and adds volume, contributing to the overall appearance of the skin. Hyaluronic acid is a normal constituent of skin tissue. The ability of cells to produce hyaluronic acid diminishes with age, often resulting in the formation of facial wrinkles and folds as the skin loses volume.

Dermal filler is biodegradable and has demonstrated its safety and effectiveness in patients of all skin colours. Studies have demonstrated no increased risk of hyperpigmentation or hypertrophic scarring of all skin colours.

They can be administered in a smooth-flowing injection, providing your doctor with a high level of control for individualized, tailored wrinkle treatment and for achieving a smooth and natural look.

Only products with approval of the European Union (CE marked) and United States of America Food and Drug Administration and should be used and should be administered by trained and qualified practitioners.


How does it work?

Dermal fillers are administered in small doses by intradermal injection directly into moderate to severe facial wrinkles and folds, such as nasolabial folds (along the side of the nose and mouth), temporarily filling and augmenting the treated area. The folds are made more smooth as the underlying tissue is given greater volume or filled-out. They may be used in conjunction with other products such as botulinum toxin type A (Botox) injections because some deep or long-standing wrinkles may have ‘memory’ still be visible (like creases in a straightened out shirt) after Botox treatment. In these circumstances, the best result may be gained with additional dermal filler injections to plump out such wrinkles.


1 Syringe


2 Syringes


3 Syringes


4 Syringes


Dermal Fillers – Frequently Asked Questions

It is a safe and simple procedure when delivered by an appropriately trained practitioner. Precise amounts of hyaluronic gel are injected with a very fine needle into the tissue under the fold. These injections are associated with only a little pain and some dermal fillers such as Juvederm and some Restylane products contain local anaesthesia e.g. 0.3% lidocaine (a local anaesthetic agent used by your dentist). You may well develop slight bruising at the injection sites and require cover make-up although every effort is made to reduce this risk to a minimum. There may be a pinky-red flushing of the skin for an hour or so as a reaction to the needle itself.

The filler injections can be placed incrementally into one side. You can then review the outcome in a mirror to judge the degree of correction achieved – and then can be replicated on the opposite side. You will feel more comfortable if you bring a good friend with you – to affirm any judgements being made between yourself, Mr Blackburn (and your friend) about an adequate volume and natural look. You will inevitably be a little nervous so a friend can be a great support for your first time.

Nasolabial folds, frown (glabellar) lines, oral commissures and marionette lines (marionette is the French word for puppet / ventriloquist’s doll; the vertical folds down from the corners of the mouth), tear trough lines, crows feet / laughter lines, radial lip lines, to volumize thin lips, chin wrinkles and cheek augmentation.

This kind of treatment is a temporary solution because the gel disappears over time. This has the benefit of allowing the first treatment to be a more subtle trial as is preferred by some clients. The Juvederm and Restylane dermal fillers can last about 6 months and some clients report up to 12 months of satisfactory treatment.

You cannot be breast-feeding or pregnant or under the age of 18 when receiving dermal filler treatment. Those with a history of anaphylaxis, multiple severe allergies or a history of allergy to gram-positive bacterial proteins should not have the injections. Clients who take aspirin, clopidogrel, dipyridamole, warfarin and non-steroidal analgesics such as ibuprofen are at increased risk of bruising. Those taking immunosuppressive therapy are at greater risk of infection from any injection and should be considered with caution. Dermal fillers have not been tested on those with a history of excessive scarring – keloid or hypertrophic – or those with pigmentation disorders. There is a rare risk of blindness in one eye from the gel being injected into a blood vessel – (around 1 in 20 000) and so if you have poor sight or blind in one eye already it is particularly important to tell your consultant.

Any patient can suffer known complications such as prolonged puffiness (likely to relate to localised lymphoedema of local retention of natural tissue fluid eg from reduced drainage of lymphatic vessels in the facial soft tissues) / enlarged lymph glands at the jawline / under the jaw (granulomatous lymphadenopathy) – which can persist as long as the filler remains. In my practice from 2009 – 2021 I have seen ~7 patients (treated elsewhere) presenting with prolonged localised puffiness up to 3.5 years and 2 patients with granulomatous lymphadenopathy (also from treatment in other clinics) – to give you an idea of prevalence. I have managed 6 patients for whom another practitioner injected non-dissolvable agents and for 2 of these I have performed surgical removal of product (this is sometimes not possible to do, depending on the product).

You should ensure you inform the consulting practitioner of your full medical history. People with a history of cold sores may experience a recurrence after the treatment, although this can be minimized by the use of antiviral medicines. I agree to consult with my doctor if I have a history of cold sores or shingles prior to this treatment. Dermal fillers should not be administered directly after laser treatment, chemical peeling or microdermabrasion as the skin surface is not intact and there is a greater risk of infection.

This kind of treatment is a temporary solution to unwanted dynamic wrinkles because the injections only last about 3 or 4 months. This has the benefit of allowing the first treatment to be as subtle as a client wishes if there is a preference for having a trial treatment first. You will need 3 to 4 treatments per year to maintain best results and it is common for treatments to be offered in packages of 3 over 9-12 month time periods.

You must inform any medical practitioner who may prescribe you medication that you have had the injection treatment for up to 3 months after the treatment. After treatment, you should not exercise vigorously or have a hot bath for 12 hours. It is best to leave the area to settle for 1-2 days before considering any gentle massage to smooth any small collections of the filler into the tissues – this proposed delay is to theoretically minimise any risk of infection via the needle-track.

It dissolves away over time, but if necessary (this would be very unusual) this could be hastened by the injection of an enzyme hyaluronase into the product within the tissues. Before you start treatment – consider the following questions carefully:

  1. Would I want someone to inject an enzyme that dissolves hyaluronic acid into my face (we have natural collagen in our face before the filler gel is injected, of course)?
  2. A test patch of hyaluronidase injection is wise prior to injection and if you react to it then dissolving the gel may not be an option for you either.
  3. Dissolving injection test patches and delivery attract further costs.

No-one ‘needs’ cosmetic treatments, however, many thousands of these types of treatments are safely performed each year and it has become established as a reliable and exciting mainstream treatment for improving the visible effects of ageing. Of course, the best long-term holistic approach for healthy youthful skin includes not smoking, protection from sun-radiation, keeping well hydrated, a healthy diet, exercise and plenty of sleep.

    • Call Mr. Blackburn on 01925 215 008 or email

    • Consultation with Mr. Blackburn
      30 minutes: £230. Written information about procedure and aftercare, letter to patient / GP.

    • Preoperative assessment with nurse and doctor support. Cosmetic Surgery with ward care, removal of stitches + postoperative review consultations with Mr. Blackburn all included in the cost of surgery.