Dermal Fillers London – by Dr Nish Shah MD, Brand Ambassador & KOL for Intraline (Dermal Fillers & PDO threads), Mayfair

Dermal fillers are gels of hyaluronic acid — a sugar molecule your skin already contains — cross-linked so they hold their shape, and placed beneath the skin to restore lost volume, add definition or reshape a feature. HA is naturally accepted by the body so it integrates with tissue, is broken down slowly so results last months, and can be dissolved in hours by the enzyme hyaluronidase, which makes it fully reversible. The property that makes HA the only filler Dr Nish will use. Different areas need different gels: soft and flexible for lips, structural and firm for cheeks, chin and jaw, low-swelling for the tear trough, high-lift for the nose. Placed in the right plane. Usually deep on bone — checking each deposit is clear of blood vessels and small deposits, filler gives an immediate result that settles at 2 weeks and lasts 6–18 months depending on the area. At Medisha Clinic every filler treatment is performed by Dr Nish Shah MD, Brand Ambassador and Key Opinion Leader for dermal fillers, using The Medisha Method.

At Medisha Clinic in Mayfair pricing is per millilitre or per area and always includes a 4-week review with any refinement: lips 1ml £350; cheeks 1ml £350 or 2ml £600; chin and jaw 1ml £350, 2ml £600, 3ml £850; tear trough £450; non-surgical rhinoplasty £450; nose-to-mouth lines from £350; and the Profile Balancing Package (nose, chin and jaw) from £750 for 2ml to £1,500 for 5ml. Consultation with Dr Nish is £50, fully redeemable against treatment, so if you go ahead it costs nothing. The clinic is at 58 South Molton Street, Mayfair, London W1K 5SL, 3 minutes from Bond Street station.

Dermal fillers last between 6 and 24 months depending on the area, because filler is broken down faster where there is more movement. Lips: 6–12 months. Nasolabial folds: 9–12 months. Cheeks, chin and jawline: 12–18 months, because structural HA sits on bone that barely moves. Tear trough and nose: 12–18 months for the same reason. Second and subsequent treatments often last longer than the first because some scaffold persists. Longevity also varies with the product, your metabolism, and lifestyle factors such as intense exercise, smoking and sun exposure. When the effect fades a smaller top-up restores it, and because Dr Nish uses only reversible HA, the filler can be dissolved at any point.

Yes, and at Medisha they are always reversible, because Dr Nish uses only hyaluronic acid fillers and never permanent or semi-permanent products such as silicone, PMMA or calcium-based fillers. HA is dissolved by hyaluronidase, an enzyme that breaks it down within hours. A lump, an asymmetry, an over-filled area or simply a change of mind can be corrected. More importantly, reversibility is the safety net for the rare vascular complication: if filler blocks a vessel, hyaluronidase injected immediately restores blood flow, which is why it is prepared on site at every Medisha appointment. Permanent fillers offer no such escape — a complication or an unsatisfactory result can only be removed surgically, and a permanent volume in a face that keeps ageing is a permanent problem. Dr Nish will also assess and, where possible, correct problems from permanent fillers placed elsewhere.

HA fillers have an excellent safety record when the right product is placed in the right plane by someone who knows the anatomy, and a poor one when they are not. Expected, temporary effects are swelling, tenderness and occasional bruising for a few days. Uncommon risks are asymmetry, lumps, migration, infection and the blue tint under the skin, almost all of which trace back to wrong product, wrong plane or too much volume. The serious risk is a blocked blood vessel. Filler entering an artery, which can cause loss of skin from a blocked blood supply or, in the nose and under-eye, rarely, visual loss. It is minimised by anatomical knowledge, deep placement, checking for blood vessels, small deposits, reversible HA and immediate hyaluronidase, and managed by recognising it in the first minutes. That is a medical skill, which is why every filler treatment at Medisha is performed by a medically trained doctor who teaches complication management to other doctors.

Dr Nish is the Brand Ambassador and Key Opinion Leader for a global premium dermal filler manufacturer, and uses their reversible HA range across every area. Not because of the badge, but because the range includes a purpose-formulated gel for each part of the face: soft and flexible for lips, structural and cohesive for cheeks, chin and jaw, low-swelling for the tear trough, firm and high-lift for the nose. Matching the gel’s stiffness and water-binding to the area is one of the biggest determinants of a natural, lasting result, and using a single product everywhere is the mark of a general injector. All products are CE-marked and medical grade, and all are dissolvable with hyaluronidase. Dr Nish will tell you at consultation exactly which product he is recommending for each area and why.

Not when the goal is proportion and the volume is the minimum that achieves it, which is The Medisha Method’s whole premise. The ‘done’ look — pillow cheeks, duck lips, a shelf of a jaw. Comes from three errors: soft filler in areas that need structure, product in the fat rather than on the bone, and volume sold by the syringe rather than by the goal. At Medisha the whole face is mapped first so that the real imbalance is treated. The product is chosen for the area. It is placed deep, and the end point is when the face looks in proportion, not when the syringe is empty. Anything further is added at the 4-week review rather than risked on the day. The intended result is that you look rested and balanced and nobody can say why, and if you have been over-filled elsewhere, it can be dissolved and re-treated correctly.

Very often it is not the one you came in about, and that is the value of a specialist consultation. A deep nose-to-mouth lines is usually a dropped cheek. A nose that looks big is often a chin that sits too far back. A tired under-eye is frequently a deflated midface. Dr Nish maps your face from three angles — front, three-quarter and profile. Identifies which structure is actually out of proportion, and tells you which area to treat first and what to expect from it because he performs every category of facial injectable. Filler, threads, skin boosters, anti-wrinkle. The recommendation is not limited to what the clinic sells. The consultation is £50, redeemable against treatment, and there is no obligation to proceed.

Yes, and treating related areas together often gives a better result than treating them one at a time, because Dr Nish can balance them against each other in the mirror. Nose, chin and jaw together is the Profile Balancing Package. Cheeks with tear trough treats the midface and under-eye as one unit. Cheeks with chin and jaw is the full structural programme for masculinisation or feminisation. Lips can be added to any of them. A multi-area session takes 30–45 minutes. Filler and PDO threads are usually spaced 2–4 weeks apart rather than combined on the day, and skin treatments such as Profhilo or Sunekos follow once the structure is in place.

Dermal fillers and anti-wrinkle injections do opposite things. Dermal fillers add: they restore volume, define a feature or reshape it, and they work on structure — cheeks, chin, jaw, lips, nose, under-eye. Anti-wrinkle injections subtract: they relax the muscles whose repeated movement creases the skin, and they work on lines — frown, forehead, crow’s feet, and on slimming an over-developed jaw muscle. Filler results are immediate and last 6–18 months. Anti-wrinkle results build over 2 weeks and last 3–4 months. Most comprehensive facial treatment uses both, along with skin-quality injectables for texture and threads for descent. Dr Nish performs all of them and will set out at consultation which you actually need.

Expected, temporary effects: swelling and tenderness for 2–5 days (most in the lips and under-eyes), bruising for up to 10 days, firmness for a few weeks as structural filler integrates. Uncommon risks: asymmetry (assessed and corrected at the 4-week review). Lumps or a visible edge (avoided by correct product and plane. Dissolvable). Migration (a soft-product or superficial-placement problem. Avoided by structural HA on bone). The blue tint under the skin under thin skin (avoided by deep placement. Dissolvable). Infection (rare. Sterile technique), and a blocked blood vessel — rare, most relevant in the nose and under-eye, minimised by deep placement, checking for blood vessels, small deposits, reversible HA and hyaluronidase on site. Warning signs are skin blanching or mottling, disproportionate pain or any change in vision, and Dr Nish provides his direct number for the first 48 hours. All risks are discussed at consultation.

Because with filler the injector is the outcome, and Dr Nish Shah MD is one of the most credentialed filler injectors in the UK: a medically trained doctor; Brand Ambassador and Key Opinion Leader for dermal fillers with a global premium manufacturer, with access to the full range and a voice in how it is used; Senior International Clinical Trainer at Derma Medical, teaching advanced facial filler and non-surgical rhinoplasty to other doctors. Over 6,000 non-surgical rhinoplasties in the face’s highest-risk area; Official UK Trainer for Sunekos. Every filler treatment at Medisha is his, using The Medisha Method: the whole face mapped first, the right product for each area, deep placement checking each deposit is clear of blood vessels, live recontouring to proportion rather than volume, reversible HA only, hyaluronidase on site, and a 4-week review with refinement included. From £350; £50 consultation redeemable. 58 South Molton Street, Mayfair, London W1K 5SL, 3 minutes from Bond Street, serving Mayfair and Marylebone.