Mr Matthews favours the use of hyaluronic based fillers, such as the Restylane range, which require a top-up after 4 to 6 months, or fat transfer, rather than permanent fillers with ‘foreign material’ as these can sometimes cause great trouble if, for instance, infection occurs.

Filling by fat transfer has improved dramatically in the last 10 years with a much greater survival rate of the transferred fat.  Fat survival varies from person to person and also with the area targeted.

Restylane injections are carried out on an outpatient basis, with or without local anaesthetic as necessary, whilst fat transfer is performed on a Day Case basis under local anaesthesia with sedation or occasionally under general anaesthesia (asleep).

Restylane causes some localised redness which tends to settle quickly (approximately 24 hours), whilst swelling following fat transfer subsides more gradually.  It is quite common to need to repeat fat transfer to achieve the desired effect, whilst longer term repeat injection will depend on the degree of reabsorbtion that may occur.  Fat may be taken from anywhere else where it is to be found and easily accessible (eg the tummy) and is generally still possible on quite thin people.