Filler Treatments

Dr. med. Axel Arlt

  • Specialist in Plastic Surgery
  • Specialist in ENT medicine

Facts on Volume Treatments

Duration:appx. 1/2 hour
Anesthetization:local anesthesia
Down time:none
Price:depending on amount / dose
Payment:directly after treatment in the practice

Facial contouring - even without surgery?

Anyone seeking more than superficial wrinkle treatments, but not necessarily interested in surgery, should look into the possibilities afforded by modern filler injections, which can do so much more than merely improve the surface of the skin. 

Attractiveness, freshness, radiance, health: all things we associate with the clear, high facial contours and characteristic “V” shape young faces have. But both of these things fade as we age; our facial volume begins to shift, and our soft facial tissue develops deficits, particularly in its deeper layers.

And it is these deep layers that modern filler treatments can act upon. They can help fill in hollows and lift sunken areas to balance and harmonize facial contours in a targeted way. Fillers restore and bring out characteristic facial features in a natural way, leaving patients’ faces looking fresher and younger without surgery.

Such effects go far beyond superficial wrinkle smoothing, yet do not require surgery. The impressive results often give rise to names like “liquid lifting” or “non-surgical lifting”. Although there is certainly room for criticism of such terms, we think there’s no question that Deep filler treatments open up extremely impressive alternatives for refreshing faces “from the ground up” in the truest sense of the phrase. 

Fillers require special injection techniques as well as very thorough knowledge of facial anatomy, because the volumizing filler substances are injected directly into the deep layers of facial tissue, and then layer by layer back towards the surface. Here in our clinic in Hamburg, we use special needles, for example atraumatic (tissue-conserving) needles or needles with a special profile.

The filler substances are different from those used in surface wrinkle treatments as well: these volume treatments primarily involve particularly stable, long-lasting filler substances.

In the hands of an experienced specialist, these substances can provide astonishing results, even harmonizing facial contours in an individually tailored way. 

We prefer to use facial filler substances that provide the best possible, longest lasting volume-enhancing effects. Some of the fillers we may employ in our injection treatments include:

  • Volume®, Voluma® (long-acting viscous hyaluronic acid for deep-tissue applications)
  • Radiesse® (dual effect: immediate effect, stimulates collagen formation)
  • Fat transfer (e.g., as part of liposuction)
  • Juvederm 4®, Belotero Intense® (for mid-layer and deep-tissue injections, or as a supplementary treatment)

We will talk with you to choose the substances that are most suited to your needs, based on your individual situation and the facial areas you wish to treat. We have a whole range of different fillers at our disposal, formulations that have been coordinated to one another or go well together; accordingly, we use a variety of injection procedures here at our practice in Hamburg, and combine different procedures as necessary.

These individualized combination treatments (using different substances and injection techniques) and so-called “multi-layer” injections (= injections into several different layers of tissue) often help “bring out” a great deal more of your face, which is why we always start by analyzing your individual diagnostic findings and then work with you to develop your personal facial treatment plan.

In addition to the well-known preparations used in superficial wrinkle treatments, there are also special hyaluronic acid-containing formulations designed for use in middle- and deep-layer tissue. Just like the superficial treatments, these fillers contain hyaluronic acid molecules, but the molecules are linked to one another more effectively through what is known as cross-linking. This gives these substances different properties: they are more viscous, they provide more dramatic volumizing effects, and they remain in the tissue for longer.

The last two characteristics make these formulations especially appealing for use in facial treatments. However, it is important to note that these substances are only suitable for mid-layer and deep-layer injections, not for surface treatments.

Another issue is that different hyaluronic acid preparations are necessary depending on the area of the face being treated and the individual patient’s circumstances. Only then can the specialist make wise use of the different fillers’ specific characteristics in order to give the patient the best possible results.

Attractiveness, freshness, radiance, vitality: all things we associate with the clear, high facial contours and characteristic “V” shape young faces have. Both of these things fade as we age; the face shifts downward, the “V” shape disappears and is eventually flipped upside down. Hollow cheeks leave the face looking a great deal older.

But Radiesse® can restore and bring out the natural contours of the face - providing immediate, long-lasting results. What makes Radiesse® so unique is the dual effect it can provide:

1)    Immediate effect

(The “gel matrix” it contains provides an immediate volumizing effect)

2)    New collagen synthesis

(Long-term tightening effect thanks to the calcium hydroxyl apatite microspheres it contains, which stimulate the body’s own cells to form collagen)

The filler effect is evident immediately following treatment; It contours the face and helps restore the “V effect” to lend patients a fresher, younger appearance. It can help restore or bring out characteristic facial features. Over time, the newly formed collagen provides a long-term tightening effect, essentially counteracting the effects of aging.

Radiesse® also is an absorbable injectable filler, and has been approved by the US-FDA (Food and Drug Administration) for many years for use in injection treatments. Refresher treatments are possible at any time once the body has broken down the substance, or is in the process of breaking it down.

Because Radiesse® is only designed for use in deeper layers of tissue, it belongs in experienced hands. A professional specialist can make optimum use of its sculptability to create beautifully soft and harmonious transitions. Radiesse® is primarily used in:

  • Contouring zygomatic arches/cheekbones
  • Contouring the lower jaw (chin-jaw line)
  • Filling in sunken cheeks
  • Treating nasolabial folds (running from the nose to the mouth on either side)
  • Treating marionette lines (running down from the corners of the mouth)
  • Adding volume to the temples or chin; treating traverse chin lines
  • Rejuvenating the backs of the hands!

Radiesse® is especially suited to contouring the cheekbones and filling in hollow cheeks; it can also provide wonderful results on the backs of the hands. Its long-lasting volumizing effect creates beautiful contours and a harmonious appearance, which lends faces more vitality and a more youthful charisma. It can give hands a suitably younger look as well. Accordingly, here in our practice in Hamburg, we offer Radiesse® treatments for the face and the hands, either alone or in combination. 

Fat transfer (e.g., as part of liposuction).


Dr. Axel Arlt
Practice community

Esplanade 31 / Ecke Stephansplatz
D - 20354 Hamburg