Facial Fillers (Juvederm, Restylene)

Fillers are substances that are injected under the skin or lips to plump up the tissues. For the lips, fillers can provide an increase in lip size as well as enhancing the definition and to show more of the red lip. They can also plump out "lipstick lines" that develop in many female patients. For nasolabial folds (laugh lines) the filler is injected to plump the fold. Instead of being eliminated, the fold is blunted (adults would look unnatural without any smile lines). 

Injectable fillers can be placed in the corners of the mouth to actually uplift the down-turned appearance which make us look older and sad, giving a more youthful and happy appearance. They can also be used to augment facial anatomy to make bigger cheeks, chin or to fill in defects and scars and the lines that are underneath the lower eyelids called the "tear troughs". This area makes patients look hollow and by injecting fillers, it plumps out the depression and improves the "dark circle" look. They can be used on most areas of the face and neck where augmentation is required.

What are the fillers made up?

Restylene, Juvederm and Perlane are injectable fillers that include hyaluronic acid, a natural complex sugar that bolsters skin elasticity, providing a smooth and supple appearance. It is biocompatible, supplementing the body's natural hyaluronic acid, which age has depleted. Other fillers like silicone and Radiesse are synthetics.

How is the procedure performed?

All patients are first treated with numbing cream on the areas to be injected, then several small dental injections of local anesthetic are given to totally numb the lips and related areas for a truly painless procedure. The filler is then injected in the lips, wrinkles or folds. The actual injection only takes minutes. Ice is placed on the lips immediately after the injections. For most patients a single syringe of filler is adequate to plump both lips. Careful attention to detail allows very natural enhancement. Just making lips bigger is not the answer and can look quite fake. For those with moderate to deep nasolabial folds (smile lines) a syringe of filler for each side is needed. The lips generally swell somewhat but most patients are able to return to work the next day. Rarely, some patients experience more significant swelling.

Occasionally a touch up may be performed at the follow up appointment. It is important to view filler injection as a sculpting process and in some cases several appointments are required to provide that special result the patient’s desire.


Fillers such as Restylane and Juvederm last up to 8-12 months. Radiesse has been shown to last over a year and silicone and Artefil are permanent. Fillers may not last as long in areas of increased movement such around the mouth. Different fillers will last different periods of time in different patients.