# Questions and answers: *hyaluronic acid and fillers.*

> Every question and answer on this website about hyaluronic acid: lips, tear trough, jawline, chin, cheeks, durability, dissolving, risks, prices – answered br

- Source: https://www.vivaderm.de/questions-fillers-en.html
- Language: en
- Publisher: VIVA DERM, Privatpraxis für ästhetische Medizin, Rosastraße 6a, 45130 Essen, Germany, +49 1520 8367711
- Responsible physician: Katayoun Mostaghimi (Fachärztin für Allgemeinmedizin)
- Updated: 2026-10-15

Every answer is kept short and links to the page that explains the topic in full. No answer replaces examination and the informed-consent consultation (§ 630e BGB).

## Cheeks & mid-face.

**Doesn't that quickly look «overfilled»?**

That depends on amount, layer and technique. The aim is small amounts at a few anatomically sensible points. A second appointment after two weeks is better than too much at once.

**How much material is usual?**

Often 1–2 ml per side spread over time. The actual amount follows the findings and is discussed beforehand.

**Does it help with the nasolabial fold?**

Often indirectly: supporting the mid-face reduces the pull on the fold. The examination shows whether that applies to you.

**How long does it last?**

Usually nine to eighteen months, depending on material, metabolism and area.

**Is the treatment painful?**

Anaesthetic cream is used if wanted, and many materials also contain a local anaesthetic. Most people describe a feeling of pressure. [Full page: Cheeks & mid-face](https://www.vivaderm.de/cheeks-mid-face-en.html)

## Filler or threads?

**Does hyaluronic acid really lift?**

Indirectly, yes: when the cheek gets its support back, nasolabial fold and jowls visibly shift upward. That replaces no surgery but is enough for many.

**Are threads dangerous?**

Not dangerous, but with their own complication rate; visible threads and dents in particular are hard to correct. [Full page: Filler or threads?](https://www.vivaderm.de/compare-filler-or-thread-lift-en.html)

## Needle or cannula?

**Does the cannula hurt more?**

Differently: instead of several pricks you feel a pressure or pulling sensation under the skin. Most find it more comfortable.

**Is the cannula always safer?**

In most areas yes; it is no safeguard against complications. Very thin cannulas can behave like needles – hence gauges from 25G are preferred. [Full page: Needle or cannula?](https://www.vivaderm.de/compare-needle-or-cannula-en.html)

## Skin booster or filler?

**Can a skin booster smooth wrinkles?**

Fine crinkles yes, through better water binding. Deeper folds and volume loss no – that needs filler or support in the cheek.

**Which first if I want both?**

Usually the filler, because it sets the structure; the skin booster follows after two to four weeks. Both in the same session is possible if the areas are separate. [Full page: Skin booster or filler?](https://www.vivaderm.de/compare-skin-booster-or-filler-en.html)

## Drooping mouth corners.

**What does treating the mouth corners cost?**

Botulinum toxin as an additional zone from €30 (alone from €190); hyaluronic acid from €250 per ml.

**Can I smile normally afterwards?**

Yes. Correctly dosed, the smile stays complete; only the downward pull is gone. [Full page: Drooping mouth corners](https://www.vivaderm.de/concern-drooping-mouth-corners-en.html)

## Jowls.

**Doesn't hyaluronic acid make the jowls heavier?**

Into the jowls themselves yes – which is why it is placed beside and above, never inside.

**What does the combination cost?**

Depending on the building blocks about 600 to 1,200 euros over several sessions; the cost plan is drawn up in writing beforehand. [Full page: Jowls](https://www.vivaderm.de/concern-jowls-en.html)

## Receding chin.

**Can you see the chin filler?**

No – it lies deep on the bone and feels like bone. All you see is a more harmonious profile.

**Does it help with the double chin?**

Often yes, because the neck-chin angle becomes clearer. With a true fat deposit, lipolysis is added. [Full page: Receding chin](https://www.vivaderm.de/concern-receding-chin-en.html)

## Thin lips.

**Lips or lip flip?**

If the upper lip only disappears when smiling, the lip flip is often enough. If the lips are thin at rest, hyaluronic acid is needed.

**Does it hurt?**

Lip fillers contain lidocaine, plus numbing cream; most find it quite bearable. [Full page: Thin lips](https://www.vivaderm.de/concern-thin-lips-en.html)

## Wide lower face.

**How long until the face looks narrower?**

First change after four to six weeks, clearly after three months. The muscle needs time to shrink.

**Does the width come back?**

Without follow-up yes, slowly over months. With regular treatment the gaps get longer. [Full page: Wide lower face](https://www.vivaderm.de/concern-wide-lower-face-en.html)

## Cost of hyaluronic acid.

**Why are lips cheaper than '1 ml' elsewhere?**

Because lips usually need 0.5 ml and have their own price. 1 ml of lips costs from €290.

**What does dissolving filler cost?**

Hyaluronidase is billed by effort; for our own treatments with a complication, dissolving is part of aftercare. [Full page: Cost of hyaluronic acid](https://www.vivaderm.de/cost-hyaluronic-acid-essen-en.html)

## Cost of lip filler.

**Is 0.5 ml enough?**

For contour, moisture and subtle fullness usually yes. Anyone wanting clearly more volume needs 1 ml – better in two steps.

**Why are lips cheaper elsewhere?**

Often because of smaller amounts, unknown products or treatment without a physician. Ask for product, amount and who injects. [Full page: Cost of lip filler](https://www.vivaderm.de/cost-lip-filler-essen-en.html)

## Double chin.

**How many sessions do I need?**

Usually two to three, a few weeks apart, depending on the starting point and how the tissue reacts.

**Is the result permanent?**

The treated fat cells are broken down. With significant weight gain, remaining cells can enlarge again.

**How much will it swell?**

Noticeably in the first days. Don't schedule the treatment right before important events.

**Does it work on the belly or hips too?**

It suits small, clearly defined pads. It is not intended for larger areas. [Full page: Double chin](https://www.vivaderm.de/double-chin-en.html)

## Dissolving filler.

**Does dissolving hurt?**

Similar to a filler injection; the enzyme can sting briefly. Anaesthetic cream is possible.

**Is everything removed completely?**

That can be controlled. Small doses are often used, with a check after one to two days to see whether a second session is needed.

**Can I have filler from another practice dissolved?**

Yes, after examination. It helps to know which product was injected, when and where.

**What does it cost?**

Invoicing follows the GOÄ and depends on the effort involved; the amount is stated in the consultation. [Full page: Dissolving filler](https://www.vivaderm.de/guide-dissolving-filler-en.html)

## Double chin.

**How many lipolysis sessions do I need?**

Usually two to three, with larger pads four. Each session builds on the previous one.

**Does the fat come back?**

Treated fat cells do not form anew. With marked weight gain, remaining cells can enlarge again though. [Full page: Double chin](https://www.vivaderm.de/guide-double-chin-lipolysis-or-exercise-en.html)

## How long does filler last?

**Why does it last less time for me?**

Metabolism, movement in the area, choice of material and whether it is your first treatment: the first often lasts a little less than later ones.

**Can I extend the durability?**

To a limited extent: sun protection, not smoking, no excessive endurance sport right after treatment. Area and material have the biggest influence.

**What happens if I don't top up?**

The material is broken down completely; the area then looks as it did before. The treatment does not cause 'stretching'.

**Is 'permanent' better?**

Permanent fillers are not used here. They cannot be dissolved, do not age with the face, and carry a higher complication risk. [Full page: How long does filler last?](https://www.vivaderm.de/guide-filler-duration-en.html)

## Filler myths.

**Why do some faces look so overfilled?**

Because they were topped up for years without assessment. Hence: small amounts, a check after two weeks, an honest no.

**Are lip fillers different?**

Softer gels, smaller amounts, shorter durability – the principle is the same. [Full page: Filler myths](https://www.vivaderm.de/guide-filler-myths-en.html)

## Nasolabial fold.

**How much hyaluronic acid is needed?**

For the cheeks usually 1–2 ml, for the fold itself 0.5–1 ml. Individually after examination.

**Why do some people show a bulge?**

Too much material too superficially in the fold. That can be corrected with hyaluronidase. [Full page: Nasolabial fold](https://www.vivaderm.de/guide-nasolabial-fold-treatment-en.html)

## Natural lips.

**Can I work the next day?**

Yes. Swelling and possible bruising are visible for one to three days; important appointments better a week later. [Full page: Natural lips](https://www.vivaderm.de/guide-natural-lips-en.html)

## Tear trough.

**Why are my dark circles still dark despite filler?**

Because the cause was pigment or thin skin – filler only lifts the shadow of the trough. That is why the examination beforehand is so important.

**How long does filler last in the tear trough?**

Often 12 to 24 months, longer than in other areas because the tissue hardly moves. [Full page: Tear trough](https://www.vivaderm.de/guide-tear-trough-why-difficult-en.html)

## Warning signs after filler.

**How quickly must a vascular occlusion be treated?**

As fast as possible – within a few hours. That is why you should call immediately on suspicion, even at night.

**Can a vascular occlusion occur days later?**

Very rarely. Typical are the first minutes to hours. Later pain and redness point more towards infection. [Full page: Warning signs after filler](https://www.vivaderm.de/guide-warning-signs-after-filler-en.html)

## Chin (hyaluronic acid).

**Will it look 'done'?**

The aim is a profile that suits the face. Small amounts, deep placement and a check-up after two weeks matter more than a lot of material.

**Does it help with a double chin?**

Indirectly: an emphasised chin makes the transition to the neck look clearer. Fat under the chin is more likely treated with injection lipolysis.

**Can it be reversed?**

Yes, hyaluronic acid can be dissolved with hyaluronidase if needed. [Full page: Chin (hyaluronic acid)](https://www.vivaderm.de/hyaluron-chin-en.html)

## Jawline.

**How much filler do I need?**

For a visible contour usually 2–3 ml, spread over both sides. The exact amount follows from the analysis.

**Will my face look more masculine?**

Not necessarily. Technique differs with the goal: a soft, clear line is something else than an emphasised jaw angle.

**Does it last longer than lip filler?**

As a rule yes. In the jawline area firmer fillers often last 12–18 months. [Full page: Jawline](https://www.vivaderm.de/jawline-en.html)

## Thread lift.

**Is a thread lift an alternative to a facelift?**

Only with mild laxity. With clear skin excess, surgery remains more effective.

**What do you recommend instead?**

After examination usually volume with hyaluronic acid in the mid-face and along the jawline – reversible and well controllable. [Full page: Thread lift](https://www.vivaderm.de/lexicon-fadenlifting-en.html)

## Fat compartments.

**Why do I look tired although I have no lines?**

Often through volume loss of the deep cheek compartments: shadow under the eye, flatter cheek.

**Can descended fat be lifted again?**

Not directly; supporting the compartments underneath makes the face look 'carried' again. [Full page: Fat compartments](https://www.vivaderm.de/lexicon-fettkompartimente-en.html)

## Filler.

**Which filler is best?**

There is no 'best' filler, only the right one for area, goal and tissue. For most uses, dissolvable hyaluronic acid is the safest choice.

**Can you see filler?**

Not with the right amount and placement. Over-filling comes from too much material, not from the filler itself. [Full page: Filler](https://www.vivaderm.de/lexicon-filler-en.html)

## Vascular occlusion.

**What should I do if I notice symptoms?**

Call the practice immediately – outside opening hours via the emergency number. Do not wait.

**Does the cannula protect completely?**

It lowers the risk considerably but does not exclude it. [Full page: Vascular occlusion](https://www.vivaderm.de/lexicon-gefaessverschluss-en.html)

## Hyaluronidase.

**Is everything dissolved at once?**

Usually in small steps with a check after one to two days, to avoid removing too much. [Full page: Hyaluronidase](https://www.vivaderm.de/lexicon-hyaluronidase-en.html)

## Hyaluronic acid.

**Is hyaluronic acid the same as Botox?**

No. Hyaluronic acid gives volume and smooths lines at rest; botulinum toxin relaxes muscles and works on expression lines.

**Are all hyaluronic acid fillers the same?**

No. They differ in cross-linking, firmness, added local anaesthetic and licensing. The choice depends on area and goal.

**Can the body reject hyaluronic acid?**

Allergies are very rare because the molecule is identical to the body's own. Reactions usually concern additives or the injection itself. [Full page: Hyaluronic acid](https://www.vivaderm.de/lexicon-hyaluronsaeure-en.html)

## Jawline.

**Is jawline contouring suitable for men too?**

Yes, often especially so: an angular jawline is seen as masculine and the technique is adapted accordingly.

**What if a double chin bothers me?**

Then injection lipolysis is the more suitable method; the two are often combined. [Full page: Jawline](https://www.vivaderm.de/lexicon-jawline-en.html)

## Blunt cannula.

**Does the cannula hurt less?**

Usually yes, because only one puncture is needed and the tissue is not pierced; a feeling of pressure remains.

**Is the cannula always better?**

No, for very fine, targeted corrections the needle is more precise. [Full page: Blunt cannula](https://www.vivaderm.de/lexicon-kanuele-en.html)

## Marionette line.

**Why do I look sad with it?**

Because drooping mouth corners and the line create the same expression as sadness – the brain reads it automatically as mood.

**Is hyaluronic acid alone enough?**

Usually yes. With strong muscle pull the combination with botulinum toxin makes sense – a medical decision. [Full page: Marionette line](https://www.vivaderm.de/lexicon-marionettenfalte-en.html)

## Nasolabial fold.

**Why treat my cheek when the fold bothers me?**

Because the fold looks deeper when the cheek descends. Supporting the mid-face often smooths the fold too.

**Does Botox help with the nasolabial fold?**

No, it is not an expression line. [Full page: Nasolabial fold](https://www.vivaderm.de/lexicon-nasolabialfalte-en.html)

## Tear trough.

**Does it help against dark circles?**

Against shadow-related circles yes; against pigmentation or visible vessels no.

**Why is the cheek sometimes treated instead of the trough?**

Because the trough appears when the cheek descends; supporting it often makes the groove disappear on its own. [Full page: Tear trough](https://www.vivaderm.de/lexicon-traenenrinne-en.html)

## Tyndall effect.

**Does the blue shimmer go away on its own?**

Only once the material is broken down – that can take many months. Hyaluronidase solves the problem in days.

**Can this happen with Botox?**

No, botulinum toxin leaves no deposit. [Full page: Tyndall effect](https://www.vivaderm.de/lexicon-tyndall-effekt-en.html)

## Cross-linking.

**Is stronger cross-linking always better?**

No. A firm gel in the lips looks unnatural, a soft one on the chin disappears quickly. The fit to the area counts.

**Is the cross-linker dangerous?**

In licensed products the residual amount is minimal and strictly tested; intolerances are very rare. [Full page: Cross-linking](https://www.vivaderm.de/lexicon-vernetzung-en.html)

## Volume loss.

**Is a facelift the solution?**

A lift tightens skin and connective tissue but does not replace volume. For many, volume is the more suitable first step.

**How do I know if volume is missing?**

Photos from ten years ago often show it most clearly – or the physician in the consultation. [Full page: Volume loss](https://www.vivaderm.de/lexicon-volumenverlust-en.html)

## Lips.

**Will people see straight away that I had something done?**

Swelling in the first days is normal and makes the lip look temporarily fuller than the final result. We assess the outcome after about two weeks.

**How many millilitres do I need?**

That can only be said after looking at your lips. Often 0.5 ml is enough to define contour and shape. We prefer to work in small steps.

**Can the result be reversed?**

Hyaluronic acid can be dissolved medically with the enzyme hyaluronidase. That is one reason this material is so widely used in aesthetic medicine.

**When should I not be treated?**

Among others with acute infections or cold sores in the area, known intolerances, and during pregnancy and breastfeeding. This is checked medically before treatment. [Full page: Lips](https://www.vivaderm.de/lips-en.html)

## Marionette lines.

**How much material is needed?**

It depends on the findings. Often 1 ml is used first and the result assessed after two weeks before deciding on further steps.

**Can botulinum toxin also make sense?**

Sometimes, when the muscle pulling the corner of the mouth down is clearly involved. That is a medical decision after examination, not a standard treatment.

**Will my face look changed?**

The aim is a natural impression. Dose and technique are matched to anatomy and facial movement; over-filled areas are explicitly not the goal.

**How long does the result last?**

Usually six to twelve months, depending on material, metabolism and area.

**When is the treatment not suitable?**

Among others with acute infections in the area, known intolerances, certain autoimmune conditions, and during pregnancy and breastfeeding. [Full page: Marionette lines](https://www.vivaderm.de/marionette-lines-en.html)

## Nasolabial folds.

**Is the fold injected directly?**

Not always. It is often more sensible to restore lost volume in the cheek and cheekbone area, because that reduces the pull on the fold. The examination shows what fits your case.

**Will the fold disappear completely?**

No. The nasolabial fold is an anatomical structure; it can be softened but not removed. Very deep folds stay visible.

**Can hyaluronic acid be dissolved again?**

Yes, with the enzyme hyaluronidase. That too is a medical treatment with its own risks and follows a consultation. [Full page: Nasolabial folds](https://www.vivaderm.de/nasolabial-folds-en.html)

## Tear trough.

**Will my dark circles disappear completely?**

Not necessarily. A shadow caused by missing volume can often be softened. Pigment-related circles, or skin so thin that vessels show through, barely respond to filler.

**How long will I look swollen?**

Mild swelling usually lasts a few days. Bruises can stay visible somewhat longer in this area – don't schedule important events right afterwards.

**Is the treatment dangerous?**

The eye area is one of the most demanding regions. That is why it is only treated where the findings are suitable, with small amounts and careful technique. Risks are explained in detail beforehand.

**What if I don't like the result?**

Hyaluronic acid can be dissolved medically with hyaluronidase. [Full page: Tear trough](https://www.vivaderm.de/tear-trough-en.html)

## Sources

- [NHS: Dermal fillers – patient information](https://www.nhs.uk/conditions/cosmetic-procedures/non-surgical-cosmetic-procedures/dermal-fillers/)
- [MPDG – German medical devices act (fillers are medical devices)](https://www.gesetze-im-internet.de/mpdg/)
- [BfArM – Federal Institute for Drugs and Medical Devices](https://www.bfarm.de/)
- [DGPRÄC – German Society of Plastic, Reconstructive and Aesthetic Surgeons](https://www.dgpraec.de/)
- [§ 630e BGB – duty to inform before treatment (German Civil Code)](https://www.gesetze-im-internet.de/bgb/__630e.html)
- [DGBT – German Society for Aesthetic Botulinum Toxin Therapy](https://www.dgbt.de/)
- [AWMF – German clinical practice guidelines](https://www.awmf.org/)

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This page is general information and does not replace medical consultation and informed consent (§ 630e BGB). No guarantee of results. Prices are guide prices per GOÄ. Quoting with attribution (VIVA DERM, Essen) is expressly permitted.