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Your face is the first thing you see in the mirror each morning and the first thing people see when they meet you: it reflects how you feel. Expensive serums and creams can take good care of your skin and maintain elasticity, but they cannot solve one crucial consequence of ageing: loss of volume. Where a young face has ample volume and plumpness in crucial places, conversely, the loss of volume makes a face look tired and sometimes grumpy. Fillers are used to return volume and/or soften wrinkles, so your face will have a friendlier, fuller, and less tired appearance and will, above all, look natural. The treatment is almost painless, and the results usually last between a year and 18 months.


“The secret is to achieve the most natural result possible with minimal means.” 

Different types of fillers:

  1. Permanent fillers such as silicone oil, Artecoll®, Artefill®, Aquamid®, Dermalive®, and Bioalcamid® are associated with the formation of bumps and with chronic side effects such as severe infections. The Dutch Society of Plastic Surgeons has therefore banned the use of permanent fillers. Dr Pirayesh specialises in removing and correcting the (sometimes disastrous) complications that incompetent doctors have caused by using these fillers on patients *.

    Static wrinkles are visible even when the muscle is at rest; therefore, Botox® alone does not offer a solution for these wrinkles. Fillers, laser treatments, or Platelet Rich Plasma therapy treat static wrinkles.

  2. Semi-permanent fillers such as Sculptra or Ellanse® are meant to have more impact but often cause scar-like tissue under the skin, and repeated use of these agents should be discouraged. Naturally, APS does not use these fillers.

  3. Temporary fillers such as Belotero®, Juvéderm® (Volbella®, Volift®, Voluma®), Teoxane® (RHA 1-4 Redensity 2, specially developed for tear ducts) and Radiesse® are entirely safe and consist of endogenous substances and hyaluronic acid — in the case of Radiesse® - calcium. These fillers come in the form of a clear gel — with different strengths — and degrade naturally within a few months to a year. They are not known to cause allergic reactions. Modern fillers are longer lasting and provide a smoother, more natural look. The effects will be visible in most patients for about a year because hyaluronic acid causes the skin to produce more collagen.

  4. Lipofilling is a way to return volume using fat cells harvested from your body. Dr Pirayesh has developed a technique that leads to longer-lasting results than was previously the case. 

Example applications of fillers

Fill Frown lines

Hollow temples
Side of the eyebrows
Deep tear troughs
Sunken cheeks
Nasolabial lines (noes-mouth)
Lip lines (smokers lines')
Lip augmentation (for thinning lips)
Marionette lines (mouth-chin)
Chin or nose that lacks definition
Sagging jawline
Acne scars
Filler procedure

First, we clean the treatment area with antiseptic wipes. No anaesthesia is required because we use very thin needles and fillers often contain the anaesthetic lidocaine. Dr Pirayesh will mark the locations where you need more volume. When these areas are injected, you will feel tiny pinpricks that last a few seconds per injection. Afterwards, the treated areas are cleaned, and you can touch up your makeup. The treatment takes about ten to fifteen minutes from start to finish. You can expect slight swelling around the injected areas, which lasts up to four hours. The next day, this will have completely subsided.

Few complications with temporary fillers

We rarely see complications in the use of our safe fillers. Occasionally, a blood vessel may be punctured, causing some bruising and red, tender, or swollen skin. These side effects disappear within two to three days.

Removing permanent fillers:

Serious complications with (semi-) permanent fillers

We rarely see complications in the use of our safe fillers. Occasionally, a blood vessel may be punctured, causing some bruising and red, tender, or swollen skin. These side effects disappear within two to three days.

Specialised in the removal and correction of (semi-) permanent fillers

Dr Pirayesh is always affected by these cases and specialises in removing (semi-) permanent fillers. He gets a lot of satisfaction and joy from repairing the faces or bodies of patients whose poorly performed procedures have been damaged. Often this is done through a small incision on the inside of the cheek, using a micro liposuction technique that he developed. In many cases, the only alternative is to remove the remnants of the fillers through surgery. If you have developed severe side effects of (semi-)permanent fillers, you will find Dr Pirayesh fighting in your corner. He will do everything possible to restore the damage as much as possible, using only safe and natural techniques and resources.

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