Dermal fillers and Polynucleotides are both injectables, and both are popular, but they are not alternatives to each other. They do fundamentally different things, and understanding this distinction between the treatments is very useful for a patient to know.
Fillers add or restore volume. Polynucleotides improve the quality of the skin itself. Put simply: fillers shape, polynucleotides condition. In many cases, the best outcome comes from using both, but knowing which one addresses your particular concern, and in what order, is the starting point for any good treatment plan.
Dermal Fillers vs Polynucleotides at Health & Aesthetics
How Each Treatment Works
Dermal Fillers
Dermal fillers are injectable gels, most commonly made from hyaluronic acid, a molecule that occurs naturally in the skin and has a remarkable ability to attract and hold water. When injected, the gel physically occupies space beneath the skin surface, restoring lost volume, softening folds, and sculpting features that have flattened or hollowed with age.
The results are immediate and visible. At Health & Aesthetics we work with premium brands including Teoxane and Revanesse, chosen for their consistency, safety record and natural feel in the tissues. We use Hyalase® to dissolve filler when needed, which is one of the reasons we use hyaluronic acid products, as they are the only fillers that can be reversed.
Polynucleotides
Polynucleotides are long chains of DNA molecules, typically derived from highly purified salmon DNA, which has a high degree of biocompatibility with human tissue. When injected into the dermis, they work at a cellular level by stimulating fibroblasts to produce collagen and elastin, improving hydration, reducing inflammation, and supporting the skin’s own repair processes.
They do not add volume. What they do is improve the quality of the skin from within, gradually over a course of treatments. Patients tend to notice their skin looks healthier, feels firmer, and has better texture. The results build over weeks, not days, and can be long-lasting because they are based on genuine tissue regeneration rather than a temporary filler effect.
At Health & Aesthetics we offer Plinest polynucleotides, one of the leading products in this category and particularly well suited to delicate areas including the under-eyes.
Under-Eye Area
This is one area where the distinction between fillers and polynucleotides really matters. Tear trough filler can be very effective for hollowing and shadowing, but it requires careful product selection and expert placement, as the skin here is thin and unforgiving. Polynucleotides are increasingly used in the under-eye zone precisely because they improve the skin itself rather than adding volume beneath it.
This is not something to have done by anyone other than an experienced medical practitioner.
Side-by-Side Comparison
| Dermal Fillers | Polynucleotides | |
| What it is | Hyaluronic acid gel injected to add or restore volume and sculpt facial contours | Purified DNA chains (typically derived from salmon) injected to stimulate the skin’s own regenerative processes |
| Primary goal | Structure, volume and contouring: replacing what ageing has taken away | Skin quality, hydration, elasticity and texture: improving the condition of the skin from within |
| Best for | Cheeks, lips, jawline, chin, nasolabial folds, marionette lines, under‑eye hollows, hand rejuvenation | Fine lines, skin laxity, dull or dehydrated skin, under‑eyes, acne scarring, rosacea, neck and décolleté |
| Not ideal for | Improving skin texture, hydration or overall skin quality. Fillers address structure, not condition | Replacing significant volume loss or sculpting facial contours; polynucleotides do not add volume |
| Results | Immediate: visible as soon as you leave the clinic, with final result settling over 2–4 weeks | Gradual: a course of 3–4 sessions is typically needed, with results building over 12–16 weeks |
| Duration | 6–18 months depending on product, area and individual metabolism | Results can last 12–18 months or longer due to the cellular changes stimulated; maintenance sessions recommended |
| Sessions needed | Usually one session per treatment cycle, with review at 2–4 weeks if needed | Typically a course of 3–4 sessions spaced 3–4 weeks apart, then maintenance |
| Downtime | Mild swelling and possible bruising for 3–7 days, particularly in the lips or under‑eyes | Minimal; mild redness or small injection‑site bumps, usually resolving within 24–48 hours |
| Reversible? | Yes; hyaluronic acid fillers can be dissolved with Hyalase® if needed | Not reversible, but naturally biodegrades. No dissolving agent is available or required |
| Combine with? | Pairs well with polynucleotides; fillers address structure while polynucleotides improve the skin they sit within | Excellent alongside fillers, anti‑wrinkle injections, Profhilo, and energy‑based treatments |
Which One Do I Need?
This is genuinely one of the more nuanced questions in aesthetics right now, because these two treatments are so often complementary rather than competing. Here is a practical framework:
- Choose dermal fillers if you have visible volume loss: hollowed cheeks, flattened lips, a softened jawline, or deep folds that are present even at rest. Fillers replace what ageing has removed.
- Choose polynucleotides if your main concern is skin quality: dullness, dehydration, fine crepey texture, early laxity, or areas like the under-eyes, neck or décolleté where you want regenerative improvement rather than volume.
- Consider both if you have volume loss and skin quality concerns, which is very common from the late thirties onwards. A typical approach would be to begin polynucleotides first to improve the skin foundation, then place fillers into better-conditioned tissue. Some evidence suggests this may also improve filler longevity.
- If you have acne scarring, rosacea, or significant skin texture issues, polynucleotides are often the more appropriate first step, as they address the underlying skin condition rather than trying to mask it with volume.
- If you are unsure, come in for a consultation.
Frequently Asked Questions
Can polynucleotides replace my fillers?
No, and this is probably the most important thing to understand. Polynucleotides cannot replace lost volume. If you have hollowed cheeks, thinning lips or significant nasolabial folds, you need a volumising treatment. Polynucleotides will not do that job, no matter how many sessions you have. They are regenerative treatments, not volumisers. However, for patients who are nervous about fillers or who want to start with something more subtle, polynucleotides are a genuinely excellent option for improving overall skin quality.
Can I have both treatments at the same time?
Yes, though the timing and sequencing depends on your individual treatment plan. In many cases we recommend starting polynucleotides first to optimise skin quality, then introducing fillers once the tissue is in better condition. In some patients, both can be done on the same day. This will be discussed and planned during your consultation.
Are polynucleotides safe?
Yes. Polynucleotides have an excellent safety record and have been used in aesthetic medicine for many years, particularly in South Korea and Europe where they are well established. The purified salmon DNA used in products like Ameela has a high degree of biocompatibility with human tissue. As with any injectable, there is a small risk of bruising, redness or swelling at the injection site, but serious complications are rare when the treatment is performed by an experienced medical practitioner.
How many sessions of polynucleotides will I need?
Most patients require a course of two to three sessions, spaced roughly two to four weeks apart, to see optimal results. After the initial course, maintenance sessions every six to twelve months are typically recommended. Because the results are based on genuine tissue regeneration, they tend to be longer-lasting than treatments that simply sit in the skin.
Is there much downtime?
Polynucleotides involve minimal downtime: most patients experience only mild redness or small bumps at the injection sites, which settle within 24 to 48 hours. Dermal fillers can cause more visible swelling and occasional bruising, particularly in delicate areas like the lips or under-eyes, which may take up to a week to fully resolve. We will give you detailed aftercare instructions before you leave the clinic.
Is it accurate to describe polynucleotides as a ‘natural’ treatment?
It is a fair description in the sense that polynucleotides work by stimulating the body’s own processes rather than introducing a foreign substance in the way a synthetic filler might. The DNA used is highly purified and biocompatible. That said, I’d caution against assuming ‘natural’ automatically means risk-free or superior; all treatments carry some degree of risk, and the most important factor in safety is always the skill and experience of the person performing the treatment.
Which Treatment Is Right for You?
Dermal fillers and polynucleotides are among the most useful tools in modern aesthetic medicine, but they work best when used with a clear understanding of what each one does. Fillers restore structure and volume. Polynucleotides rebuild the quality of the skin. Used together, thoughtfully and in the right order, they can deliver results that look genuinely natural and last well.
If you’re not sure which one is right for you: book a consultation. We’ll assess your skin, listen to what you want to achieve, and give you an honest recommendation. No pressure. Just good clinical advice.
