Dermal Fillers

Dermal Fillers


Introduction to Dermal Fillers

Dermal fillers are FDA-approved products that are injected directly into the skin of the targeted area to restore volume and reduce the appearance of deep lines and wrinkles (especially those that are not well treated with Botulinum). Many are made from substances either found or mimicked in the body.

As we age, we develop tell-tale signs of aging such as hollowing in the cheeks and deepening of the smile lines. Dermal fillers can create more volume in hollow areas and soften age lines, leaving you looking younger and refreshed. During your consultation, we will help you decide which dermal filler will provide you the best possible results for your individual needs.

Areas Treated

Thin Lips

Full, luscious lips look youthful and attractive. But as we age, the lips thin and lose projection. The borders of the lips, which are well defined in youth, flatten over the years. Dermal filler may be placed in the lip border to accentuate it and/or in the lip body to improve fullness and projection. In general, we like to concentrate dermal filler to the central lip and taper to the corners of the mouth. Dermal filler may also be injected in such a way as to create more of a pout.

Laugh Lines

The laugh lines, or nasolabial folds, extend from the side of the nostril down next to the corner of the mouth. For many, they are among the first signs of facial aging and worsen as the we lose volume and gain laxity with aging. Dermal filler is injected under the laugh line crease to soften it. We do not believe in trying to flatten the area completely to avoid an unnatural appearance.

Marionette Lines & PreJowl Area

Marionette lines extend from the corner of the mouth down between the chin and jowl (prejowl area). The jowl, which is cheek fat that has fallen over the jawline, may deepen the marionette lines and accentuate indented prejowl area. Dermal filler may be placed into the marionette line and prejowl area to make the jawline appear smoother from chin to the ear. Any downturn at the corners of the mouth may also be filled and raised into a more upturned position.

Recessed Chin

A recessed chin may be a feature one was born with or accentuated with aging. In profile, it makes the jawline and neckline appear shorter. For men, a “weak” chin may not look masculine. Dermal filler adds projection while mimicking the natural feel and contour of the chin. It may also be used to soften a double chin or the crease above the chin.

Hollow Cheeks

Hollow cheeks are a result of age-related loss of cheek bone and descent of cheek fat into the jowl. This may lead to a gaunt, tired appearance. Dermal filler may be injected to fill the cheek. Different parts of the cheek may need different amounts of filler depending on the patient's unique anatomy and pattern of volume loss. 

Nonsurgical Rhinoplasty

Bumps and depressions on the bridge or tip of the nose may attract unwanted attention. Dermal filler may be injected to conceal contour irregularities and create a smoother nose. We use blunt cannulas in this area to reduce risks. Full correction may be achieved in one to two treatments.

Tear Trough & Dark Circles

Dark circles under the eye can add years to your appearance. Patients with this problem are tired of being asked if they are tired. The tear trough is the part of the dark circle that extends from the inside corner of the eye to the central cheek. Dermal fillers elevate the tear trough and dark circle to blur the boundary between the cheek and the lower eyelid. Skilled injection technique and proper patient selection is critical for preventing worsening of lower eyelid bags. Generally, full correction may be achieved in one to two treatments.

Hollow Eyes

The eye socket, or orbit, gets larger as we age and creates a deepening between the eye and eyebrow. With this deepening, the upper eyelid may appear too tall and sunken. Dermal filler may be placed above the upper eyelid to fill the hollow and shorten the height of the upper eyelid.

Frown Lines

While frown lines are best treated with Botulinum injections, deeply etched “eleven” lines between the eyes may require more volume. Dermal filler may be injected to help conceal these lines. Blunt cannulas are used in this area to reduce risks.

Indented Scars

An indented scar may be improved with scar revision, but a more simple solution with less downtime may be to inject dermal fillers in the region. This may elevate the scar to the level of the surrounding skin, thus concealing it.

Planning Your Procedure

Types of Dermal Fillers

Restylane and Juvederm are FDA-approved dermal fillers composed of hyaluronic acid, a material that is already present in our skin. They are both used for moderate to severe facial wrinkles and folds. Various formulations of both Restylane and Juvederm have been developed for special use in particular parts of the face.

Radiesse is an FDA-approved dermal filler composed of calcium hydroxylapatite within a water-based gel. It is thicker than the hyaluronic acid fillers, which makes it more useful for deeper injections that simulate adding bone volume (e.g. cheeks, chin, bridge of nose). Studies show that Radiesse stimulates the natural production of collagen in the skin.

How Its Done

Patient comfort and safety is a priority. Prior to injection, the skin is cleansed and, per the patient’s preference, anesthesia is applied. The combination of topical numbing cream and ice provides very effective anesthesia. The needles used for the treatment are very small. In some areas, we use blunt cannulas instead or needles for a safer treatment. The injections only take minutes to perform.


Most have little-to-no downtime after treatment. Temporary redness and/or swelling at the injection site is common but resolves quickly. As with any injection, bruising is also a possibility. Some areas, like the under-eye, potentially bruise more than others.


The results of this procedure are visible right away and are never permanent. Depending on the filler and the areas placed, results may last 6 to 15 months.

Safety Profile & Side Effects

Dermal filler injections have been used for decades for cosmetic purposes without serious or long-term side effects. The risk of cosmetically disturbing results like an unnatural look or skin necrosis is minimized with a skilled injector who has extensive knowledge of facial anatomy.
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