Dermal Fillers

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Dermal fillers are cosmetic injectables used to enhance facial contours, augment certain features, replenish volume loss, and provide a more youthful appearance. Now more than ever, patients are looking to reverse signs of aging and skin concerns like facial volume loss, fine lines and wrinkles, undereye hollows, and acne scars in order to look and feel like their best selves again. With dermal fillers, patients can look forward to a more smooth, youthful appearance without the need for invasive plastic surgery. Dermal fillers are among one of the most popular non-invasive cosmetic procedures worldwide due to their consistently stunning facial rejuvenation results, lack of downtime, and ease of injections. When an expert injector, such as Dr. Michele Green in New York City, performs your dermal filler treatment, the results are natural, beautiful, and long-lasting.

Dermal fillers are comprised of distinct compounds, technologies, and formulations, allowing each dermal filler to suit a specific skin concern or target area. Hyaluronic acid fillers like Juvederm, Restylane, and Belotero are excellent for providing immediate volume restoration to the injected area. Poly-l-lactic acid fillers like Sculptra or calcium hydroxylapatite fillers like Radiesse work to gradually stimulate collagen production in the injected area to replenish lost volume and smooth the area. Many patients seek dermal fillers in the cheeks, lips, jawline, chin, and nasolabial folds; however, dermal fillers are not limited to facial rejuvenation. Restylane fillers are often injected into the hands to smooth crepey skin, while Sculptra injections can be injected into the hips or buttocks for body contouring. Due to the variation in injectables and the expertise required for properly administering them, seeking dermal filler treatment from an experienced board-certified dermatologist like Dr. Green is crucial to achieving optimal results and understanding the best dermal filler for you.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing some of the world’s most discerning individuals with the best non-invasive cosmetic procedures, including dermal filler treatments. Regarding facial rejuvenation, Dr. Green takes a holistic approach and embraces a less-is-more philosophy, customizing each patient’s treatment plan to cater best to their particular skin concerns and personal aesthetic goals. She is consistently identified as one of NYC’s best dermatologists by Castle Connolly, New York Magazine, Super Doctors, and the New York Times for her dedication to her patients and expertise. When you consult with Dr. Green in her private New York City dermatology office, she will discuss your specific aesthetic goals to provide you with a customized dermal filler treatment plan for beautiful, natural-looking results.

SC Before and after 1 treatment botox masseter MGWatermark

1 treatment of Botox to Masseter area

What are dermal fillers?

Dermal fillers are a cosmetic injectable treatment for eliminating fine lines and deep wrinkles, restoring volume loss, and enhancing certain features. Unlike invasive plastic surgery, dermal fillers offer facial rejuvenation and body contouring without the need for long recovery times or adverse side effects. Dermal fillers are composed of various substances, each with its own distinct properties and ideal applications. Some of the most common dermal filler products are composed of hyaluronic acid, calcium hydroxylapatite, and poly-l-lactic acid. Dermal fillers have been extensively studied for their safety and efficacy, and many dermal fillers are FDA-approved to treat a specific area, such as the cheeks or lips. The cosmetic effects of dermal filler injections are semi-permanent, lasting between six months to five years, depending on the patient’s metabolism and the type and amount of dermal filler used. Most patients choose to have dermal filler treatment sessions regularly, adjusted to their specific needs, to maintain the best results. Dr. Green uses a variety of FDA-approved dermal fillers for facial rejuvenation and body augmentation.

What are dermal fillers used for?

Dermal fillers are used to restore lost facial volume, enhance facial contour, and smooth out fine lines and deep wrinkles. Part of the aging process involves the loss of collagen and subcutaneous fat from the face, which provide us with a youthful, supple appearance. Dermal fillers can replenish some of this volume loss and create a rejuvenated, refreshed appearance. Some of the most common applications for dermal fillers include:

Restoration of lost volume in the cheeks, temples, and midface
“Smile lines” (nasolabial folds)
Deep wrinkles and skin folds
Marionette lines (creases running vertically from the mouth to the chin)
Oral commissures
Lip augmentation
“Smoker’s lines” / Perioral lines (fine lines around the lips)
Tear troughs (under eye hollows)
Horizontal neck creases
Jawline enhancement
Chin augmentation
Hand rejuvenation
Rejuvenating the décolletage, upper arms, thighs, hips, and knees
Non-surgical buttocks augmentation (BBL)
Reducing the appearance of depressed acne scars, stretch marks, and surgical scars
Enhancement or contouring of natural facial features

Regardless of your cosmetic concern, Dr. Green can customize your dermal filler treatment to provide optimal, natural-looking, long-lasting results.

Before & After Photo: Aquagold, Dermal fillers and VBeam

What are dermal fillers made of?

Many of the popular dermal fillers on the market, including Restylane, Juvederm, and Belotero, are made of hyaluronic acid. Hyaluronic acid is a substance that naturally occurs in the skin and supplies it with essential hydration and youthful suppleness. Hyaluronic acid fillers are gel-like substances that, when injected, bind with the water that is present in the skin. The result is a lifting, plumping effect and a smoother skin texture. Recent clinical studies have demonstrated that, over time, dermal filler treatments with hyaluronic acid injections stimulate the production of new collagen in the skin. Collagen is a protein in the skin that supports its underlying structure, providing a firm foundation and contributing to a youthful appearance. Hyaluronic acid injectable fillers are an incredibly common type of dermal filler for enhancing facial contours and features, replenishing volume loss, and reducing the appearance of fine lines and deep wrinkles.

While dermal fillers like Sculptra, Radiesse, and Bellafill are not hyaluronic acid-based, they are also excellent for restoring lost volume and creating a more youthful appearance. Sculptra is made of poly-L-lactic acid (PLLA), a biocompatible substance that triggers collagenases once injected. By stimulating the production of new collagen, Sculptra can create tighter, smoother skin and reduce signs of aging. Radiesse is made of calcium hydroxyapatite, which creates a supporting scaffolding once injected for new collagen to grow. Another biostimulating dermal filler on the market is Bellafill, which consists of purified bovine collagen and polymethylmethacrylate (PMMA) microspheres. The purified bovine collagen provides an immediate plumping and volumizing effect on the skin when injected. Similar to the calcium hydroxylapatite technology in Radiesse, the PMMA microspheres in Bellafill create a matrix to support the body’s own natural collagen production. The benefit of using collagen-stimulating dermal fillers like Sculptra, Radiesse, and Bellafill is that the process of collagenases continues long after the filler dissipates from the body. As a result, many patients find that these biostimulating fillers last longer than hyaluronic acid fillers after an initial series of treatments.

Dr. Green takes a holistic approach to dermal filler treatment for her patients, customizing each treatment plan according to the patient’s facial anatomy, skin concerns, and desired cosmetic results. During your consultation with Dr. Green, you will have the time to discuss your particular cosmetic goals and determine with her an appropriate treatment plan and timeline that will provide you with the best results.

Types of dermal fillers

Juvederm collection

The Juvederm collection of dermal fillers consists of various hyaluronic acid fillers, each with a unique composition and ideal application to achieve facial rejuvenation. Allergan, the pharmaceutical company that also makes Botox, makes Juvederm dermal fillers. The XC in many of the Juvederm fillers denotes that the filler is compounded with lidocaine, a local anesthetic that helps reduce discomfort associated with the injection process.

Juvederm Ultra XC is best for augmenting the lips and restoring lost volume in mild to moderate smile lines, marionette lines, and nasolabial folds. Results with Juvederm Ultra XC typically last nine to twelve months.
Juvederm Ultra Plus XC is ideal for injection into the mid and lower face to treat deep wrinkles, such as the nasolabial folds and marionette lines. It is also an excellent injectable for lip augmentation. Juvederm Ultra Plus XC lasts for about nine to twelve months.

Juvederm Voluma is one of the most popular dermal fillers in the Juvederm collection. It was designed to enhance contour and replace volume loss in the cheekbones and malar area. Juvederm Voluma helps restore youthful contours by plumping up the cheeks and chin where the aging process has caused volume loss. This advanced formulation of hyaluronic acid can produce natural-looking cosmetic results that last up to 12 months.

Juvederm Volbella was designed to subtly enhance the lips and smooth fine lines, particularly those around the mouth (perioral lines) and vertical lines above the upper lip (“smoker’s lines”). Volbella can also be used to treat under-eye hollows (tear troughs) and lasts for approximately one year.

Juvederm Vollure was designed to treat smile lines, marionette lines, and nasolabial folds. Its longevity of 18 months is very appealing due to the decreased need for constant re-injection.

Juvederm Volux is the first ever dermal filler designed and FDA-approved specifically for jawline enhancement. Made with patented Vycross technology for long-lasting, natural-looking results, Juvederm Volux can be used to enhance jawline definition, erase lower facial creases, reduce the appearance of jowls, and provide the ideal facial contour. Juvederm Volux is a relatively thicker hyaluronic acid gel offering rejuvenation results lasting 6-18 months.
SkinVive is a new, unique Juvederm filler used to promote hydration and smoothness in the cheeks. This FDA-approved filler consists of hyaluronic acid microdroplets to help the skin retain necessary softness and moisture. SkinVive typically lasts for six months before another session is needed.

Before & After photo: Juvederm Voluma 2 weeks

Restylane family

The Restylane family of hyaluronic acid dermal fillers, manufactured by Galderma, are a popular option for reducing fine lines and wrinkles and enhancing contour. The complete Restylane line of dermal filler products includes Restylane-L, Restylane Silk, Restylane Lyft, Restylane Defyne, Restylane Refyne, Restylane Kysse, Restylane Contour, Restylane SkinBoosters, Restylane Eyelight, and Restylane Volyme. These injectables produce overall skin rejuvenation and a more youthful appearance, described further in the sections below.

Restylane-L was designed to correct moderate facial wrinkles around the corners of the mouth, marionette lines, laugh lines, and the tear trough area (under the eye area). It is also a favorite dermal filler product for providing natural, soft lip augmentation. The cosmetic effects of an injection with Restylane-L last approximately 6 to 9 months.

Restylane Lyft, originally marketed under the name Perlane, is an ideal injectable for treating deep wrinkles and volume loss correction in the face and hands. It is also FDA-approved for cheek augmentation and is commonly injected into oral commissures. The cosmetic effects of injections with Restylane Lyft typically last 9 to 12 months.

Restylane Silk was specifically formulated with a smaller particle size to rejuvenate the lips and fine lines in the perioral area. Improvements in lip fullness and contouring with Restylane Silk can last for six months or more.

Restylane Refyne & Restylane Defyne are some of the newest Restylane products designed with XpresHAn Technology™, which allows easy movement of the face in the injected areas. Restylane Refyne treats moderate lines and wrinkles, whereas Restylane Defyne treats moderate to deep wrinkles. Both Restylane Refyne and Restylane Defyne can last for twelve months.

Restylane Eyelight is the first dermal filler to be FDA-approved specifically for treating under-eye hollows. The hyaluronic acid filler is made with NASHA technology and specially designed to fill in tear troughs, erasing the appearance of dark circles under the eyes caused by volume loss or a natural hollow. The Restylane Eyelight filler can provide results lasting up to 18 months.

Restylane Kysse was designed with innovative XpresHAn Technology™ to provide volume and hydration to the lips while maintaining a natural look. Additionally, the formulation’s ability to mold to your natural tissues means that less product is required for optimal results. Results are incredibly long-lasting, with volumizing and rejuvenating effects for up to twelve months.

Restylane Contour was FDA-approved in 2021 for volume loss correction and contouring in the cheeks and midface. Its unique formulation, using patented XpresHAn Technology, allows for maximum motion and natural expression after injection. Results with Restylane Contour can last up to twelve months.

Restylane Volyme is a soft dermal filler used to restore volume along the midface, cheeks, chin, and jawline. Its small particle size makes it excellent for creating smooth, natural-looking results that last up to one year.

Restylane SkinBoosters is a dermal filler treatment formulated to restore hydration and moisture to the skin. Microinjections of Restylane SkinBoosters work to increase skin cell turnover rate and improve the texture and look of the skin. Typically, three treatments spaced one month apart are required for optimal results, with patients returning biannually for maintenance treatments.

Belotero Balance

Belotero is a thin, smooth, flexible hyaluronic acid filler manufactured by Merz that treats fine lines. Made with the proprietary Cohesive Polydensified Matrix (CPM) process, this hyaluronic acid filler easily integrates into the skin, making it an exceptional option for filling fine lines. Its unique properties offer a soft, even correction to those delicate areas of the face, such as lip lines and the tear trough area under the eyes. Unlike other undereye fillers, Belotero is much less likely to cause the Tyndall effect, which is a side effect of undereye fillers that causes a blue hue in the treatment area.

Sculptra

Sculptra is a cosmetic injectable that is composed of a substance called poly-L-lactic acid. Once injected, Sculptra stimulates the production of new collagen in the skin. Collagen is a protein in the skin that provides structural support and a firm skin texture. As part of the natural aging process, collagen in the skin is broken down over time, leading to the signs of aging. By restoring collagen to the treatment area, Sculptra injections can replenish lost volume and create a youthful appearance. The cosmetic effects are long-lasting, with results remaining up to two years after completing an initial short series of injections with Sculptra. Due to Sculptra’s ability to be used in multiple anatomic locations in the face, it is an ideal product for pan-facial rejuvenation. Sculptra can also be used to treat other areas of the body, including the neck, décolletage, and buttocks.

Radiesse

Radiesse is an FDA-approved injectable dermal filler made of calcium hydroxyapatite (CaHA). Using patented microsphere technology, each injection of Radiesses starts a process called collagenases. This process stimulates new collagen production, replenishing collagen around the injection site. Additionally, the CaHA gel microspheres themselves provide immediate volume to fill in visible deep lines and wrinkles. Radiesse typically lasts a year and, in some cases, up to two years. Radiesse is ideal for treating deep wrinkles, volume loss, and creases, and it is also FDA-approved for hand rejuvenation.

Bellafill

Bellafill was originally FDA-approved in 2007 as Artefill. It comprises non-resorbable polymethylmethacrylate (PMMA) microspheres suspended in a water-based gel compounded with bovine collagen and lidocaine. This synthetic injectable was originally approved to reduce the appearance of smile lines, although it can also diminish the appearance of acne scars. Since this product contains bovine collagen, skin tests are required to ensure the patient is not allergic to the dermal filler. Bellafill has been reported to last for more than five years.

Who is a good candidate for dermal filler treatment?

Healthy individuals over the age of 21 are good candidates for injectable dermal filler treatment. Pregnancy or breastfeeding are contraindicated in dermal filler treatment, as safety has not yet been established. Other contraindications for treatment include a history of severe reactions (anaphylaxis), bleeding disorder, allergy to gram-positive bacterial proteins used to make hyaluronic acid, and allergy to lidocaine. If you have any active rash, infection, or breakout, Dr. Green may recommend holding off on any filler injection until your skin condition has been resolved. During your initial consultation with Dr. Green, she will review your medical history to determine if you are a good candidate for dermal fillers.

What is the process of having dermal filler treatment?

The first step in having dermal filler treatment is consulting an expert injector, such as board-certified dermatologist Dr. Michele Green. During your consultation, Dr. Green will collect a thorough medical history, review any previous cosmetic procedures you may have undergone, and discuss your particular skin concerns and aesthetic goals with you. Photographs of the treatment area will be taken for your private medical record to enhance the discussion and track future progress. If you are a good candidate for dermal filler treatment, the injections may be performed on the same day as your consultation or scheduled later, depending on your preferred time allowance.

Before any type of injection, Dr. Green recommends avoiding blood thinners, NSAIDs like Aspirin, Motrin, and Aleve, multivitamins, vitamin E, and fish oil for one week to minimize the risk of bruising. Patients prone to bruising can additionally take Arnika Forte, an herbal supplement, to prevent bruising and accelerate the healing of any bruising. Arnika can be taken several days before and after the injection procedure to prevent unwanted bruising.

On the day of your dermal filler treatment, a topical lidocaine cream should be applied to the entire treatment area one hour before your injections. The numbing cream will desensitize the site to enhance your comfort during the dermal filler injections. Once you arrive at Dr. Green’s office, the numbing cream will be removed and the skin sterilized. Dr. Green will then masterfully inject the dermal fillers selected for your rejuvenation protocol. Ice packs are applied directly to the treatment area immediately after the injections to minimize bruising or swelling side effects. You will be provided with all of the pertinent aftercare information required for achieving and maintaining ideal results, which can vary slightly depending on the type of dermal filler used. Dr. Green will invite you to return for a follow-up appointment approximately two weeks after your injections. At your follow-up appointment, Dr. Green will assess the cosmetic results of your dermal filler procedure to determine whether any touch-up is needed.

What can I expect after dermal filler injections?

Patients enjoy the fact that dermal filler treatment involves no aftercare and essentially no downtime. Most patients experience mild swelling, redness, or bruising that will resolve independently within two weeks of treatment. After the procedure, an ice pack will be applied to the injected area to minimize swelling. To prevent excessive swelling or bruising, refraining from strenuous exercise, saunas, or hot tubs for at least 48 hours following dermal filler injections is recommended. Dr. Green also recommends continuing to avoid blood thinners like Coumadin, Aleve, Aspirin, or fish oil for an additional week to minimize the risk of bruising.

What are the side effects of dermal filler injections?

Some of the most common side effects of dermal filler injections include:

Redness
Bruising
Swelling
Lumps
Discoloration
Pruritus
Tyndall Effect

Lumps or nodules are a potential side effect of dermal fillers. If lumps develop or if you are unhappy with your injection results, hyaluronic acid fillers like Juvederm, Restylane, and Belotero can easily be reversed with hyaluronidase injections. Hyaluronidase is an enzyme that breaks down hyaluronic acid, reversing the effects of injections. Unfortunately, dermal fillers like Sculptra and Radiesse cannot be dissolved by any agent, and patients must wait for their bodies to metabolize the filler naturally. Additionally, if dermal filler injections are improperly performed, serious side effects and poor cosmetic results can occur. For example, if dermal filler is inadvertently injected into a blood vessel, side effects can include blindness, stroke, and skin necrosis. It is crucial to carefully select an expert injector like board-certified dermatologist Dr. Green to avoid poor cosmetic results and make sure that your dermal filler treatment is both safe and effective.

How long does it take for dermal filler to settle

Though the amount of time it takes for dermal fillers to settle will vary from filler to filler, most dermal filler products settle within the first two weeks of treatment. There may be mild swelling and bruising after the injection that takes up to two weeks to resolve, at which point the results from treatment will be visible.

How long does dermal filler last?

Dermal filler treatments produce semi-permanent results lasting anywhere between six months to five years. The longevity of one’s dermal filler results depends on their metabolism and the amount and type of dermal filler product used. For instance, hyaluronic acid fillers like Juvederm, Restylane, and Belotero create immediate results after one treatment and can last for six to twelve months. Biostimulators like Sculptra and Radiesse can last for one and a half, two, or even five years after an initial series of treatments. Most patients have regular dermal filler treatments every six months to two years, depending on the type of dermal fillers used, their metabolism, and their overall aesthetic goals. When you consult with Dr. Green, she will work with you to establish a timeline for your dermal filler treatment sessions that are best suited to your needs.

Do dermal fillers dissolve?

All hyaluronic acid dermal fillers can be dissolved. Hyaluronic acid fillers can be dissolved with an agent called hyaluronidase, an injectable enzyme that breaks apart hyaluronic acid and reverses the effects of the filler injections. However, dermal fillers like Sculptra and Radiesse, however, cannot be dissolved by any agent. To guarantee ideal cosmetic results, it is essential that an experienced board-certified dermatologist, such as Dr. Michele Green in New York City, perform your dermal filler injections.

Does dermal filler hurt?

No! Dermal filler injections are not usually painful. Still, a topical lidocaine cream can be prescribed and applied to the entire treatment area to reduce discomfort. The numbing cream should be applied thickly to freshly cleansed skin one hour before injections. Additionally, most dermal filler products are compounded with lidocaine, minimizing any potential discomfort.

Are dermal fillers safe?

Yes! Dermal fillers are completely safe, provided that your treatment is done by an experienced and knowledgeable healthcare provider in a medical setting. Although it is often more expensive to have dermal filler treatment with a board-certified dermatologist like Dr. Green, you must be selective when choosing your provider to avoid unnecessary complications and unwanted side effects. When you choose to work with Dr. Green, you can feel confident that you have an injector with both the expertise and experience to deliver dermal filler treatment in a safe, effective, and satisfactory manner. All dermal filler and injectable products Dr. Green uses at her private dermatology office are FDA-approved and proven safe and effective in clinical studies. If you have had an adverse event related to dermal fillers in the past, discuss this with Dr. Green during your consultation.

Combining dermal filler treatment with other non-surgical cosmetic procedures

Dermal fillers work beautifully to smooth out age-related fine lines and deep wrinkles, provide facial contour, and restore lost facial volume in the cheeks, midface, chin, and lips. Dr. Green often combines dermal fillers with innovative non-surgical cosmetic procedures to treat a myriad of skin concerns, including dynamic wrinkles, skin laxity, and skin texture. When you consult with Dr. Green in her private Upper East Side dermatology office, she will assess your skin and aesthetic concerns to create the perfect tailored treatment plan for your pan-facial rejuvenation.

Botox is one of the most popular cosmetic procedures across the world due to its ability to erase dynamic wrinkles. Dynamic wrinkles are caused by repeated movement, such as facial expressions. The most common dynamic wrinkles of the face are forehead lines, glabella lines (frown lines), and crow’s feet (the lines around the eyes). Botox is an injectable form of botulinum toxin, a neuromodulator that “freezes” and reduces contractions of targeted muscles responsible for facial expression. This ultimately softens the appearance of fine lines and prevents the formation of new dynamic wrinkles in the treatment area. Botox lasts three to four months before another treatment session is needed to maintain results. During a single visit, Dr. Green can perform both Botox and dermal filler injections to provide total facial rejuvenation and a refreshed, youthful, natural appearance.

Skin laxity is a common concern for many patients, as aging results in decreased collagen levels and the appearance of sagging, crepey skin. Many patients choose to combine their dermal filler treatment with Thermage, a gold-standard laser treatment for skin tightening. This laser relies on radiofrequency energy to stimulate gradual new collagen production in the treatment area, improving skin texture and laxity. There is zero downtime with Thermage, meaning patients can easily schedule their treatment and resume normal daily activities afterward. Results are attained in a single treatment session and can last for a year and a half or more. As it can take two to three months for results to be visible, patients often engage in annual treatments with Dr. Green. The Thermage procedure can be used nearly anywhere on the face or body, including the neck, chest, décolletage, upper arms, abdomen, thighs, and buttocks, for a lifting and smoothing effect that firms and tightens loose skin.

Patients with textured skin can greatly benefit from pairing their dermal filler treatment with the Fraxel Dual laser. As its name suggests, the Fraxel Dual laser combines two lasers for total rejuvenation – a 1550nm Erbium laser to treat skin texture, acne scars, fine lines, wrinkles, and pore size, and a 1927nm Thulium laser to treat sun damage and discoloration. The laser delivers fractionated energy deep into the dermis, stimulating collagen production and increasing the rate of skin cell turnover. After just a short series of treatments, patients can look forward to clear, radiant skin. Patients can expect 48 hours of redness following Fraxel treatment. When being treated with the 1927nm setting, patients may have an additional three to five days of mild skin peeling, where the skin has a sand-paper texture.

While the Fraxel is an excellent resurfacing laser, it is not suited to treat all skin types. Patients with darker skin tones can turn to the eMatrix laser to improve texture, aging signs, and acne scars. The eMatrix laser utilizes radiofrequency energy to heat the inner layers of the dermis, increasing new collagen production to create smoother, tighter, younger-looking skin. Multiple treatments spaced one month apart are necessary to achieve optimal cosmetic results. Similarly to the Fraxel laser, patients can expect 48 hours of redness after eMatrix treatment.

Other Frequently Asked Questions

What is dermal filler?

A dermal filler is an injectable cosmetic procedure used to fill facial wrinkles, restore volume loss, reduce acne scars, contour and define specific facial features, and provide the skin with essential hydration and suppleness. A dermal filler, sometimes referred to as a soft tissue filler, is a general umbrella term for many different injectables, including hyaluronic acid fillers like Juvederm, Restylane, and Belotero and biostimulators like Sculptra and Restylane. There is typically no downtime with dermal filler treatment, and results are long-lasting depending on the exact filler used.

What is the difference between dermal fillers and Botox?

While Botox and dermal fillers are both non-invasive injectable treatments for rejuvenation, their uses are distinct and complementary. Dermal fillers are designed to correct age-related volume loss, reduce the appearance of fine lines and facial wrinkles, and enhance definition in the cheeks, jawlines, midface, and lips. Collagen is the most abundant skin protein, contributing to the skin’s structural support, firm foundation, and overall youthfulness. As we age, collagen production decreases while existing collagen is depleted, resulting in more prominent signs of aging. Most dermal filler injections boost natural collagen production in the skin, which can help improve hydration, suppleness, and elasticity.

Botox is the gold standard cosmetic procedure for treating and preventing dynamic fine lines and deep wrinkles. Dynamic fine lines and wrinkles form over time due to repeated facial expressions, most commonly affecting the forehead, crow’s feet, and glabella. Botox is an injectable neurotoxin that inhibits nerve signals to the muscles near the injection sites responsible for making facial expressions. By limiting muscle contraction, Botox essentially “freezes” the area. The result is a smoother skin texture and a more youthful appearance. In addition to the cosmetic benefits of Botox, it also has many medical applications, including treating hyperhidrosis, temporomandibular joint disorder, migraines, and cervical dystonia. Many patients combine dermal filler and Botox injections to target various signs of aging and achieve pan-facial rejuvenation. This complementary injectable treatment approach is so popular that it is nicknamed the “liquid facelift.”

Is Juvederm or Sculptra a dermal filler?

Juvederm and Sculptra are both dermal fillers that use different mechanisms to boost collagen production and smooth facial wrinkles and creases. Juvederm is a family of dermal filler products manufactured by the pharmaceutical company Allergan. Juvederm dermal fillers are made of hyaluronic acid and include fillers like Voluma, Volux, Ultra, Ultra Plus, and Vollure. Each Juvederm product has a unique gel consistency that makes it ideal for a specific anatomical location of the face. Results are immediately visible following treatment and can last anywhere between six and twelve months, depending on the exact filler used.

Sculptra is a unique dermal filler in that it is composed of a substance called poly-l-lactic acid. Poly-L-lactic acid is a biocompatible substance that stimulates natural collagen production in the treatment area. Sculptra’s most important aftercare advisement is adhering to the “rule of 5’s.” Patients must perform five massages for five minutes each, for five consecutive days, in the area where Sculptra was injected. As Sculptra is a liquid injection, the massaging protocol helps guarantee even distribution of the dermal filler and prevents the side effect of nodule formation. Sculptra nodules can form if too much collagen is generated in a small area, which massaging the treatment area prevents. After an initial series of three Sculptra treatment sessions, the facial rejuvenation results last up to two years.

Are autologous fillers the same as dermal fillers?

Yes, autologous fillers can be encapsulated under the umbrella term of dermal fillers. Autologous fillers are injectables that use substances from the patient’s own body to treat specific skin concerns. Platelet-rich plasma injections (PRP) are autologous wrinkle fillers that are extremely popular due to their holistic approach. First, a sample of the patient’s own blood is collected and placed in a special centrifuge to remove the PRP rich in growth factors and proteins necessary for tissue regeneration and growth. The PRP is then injected into the targeted areas of the face. In addition to treating wrinkles and aging skin, PRP injections are also used to combat hair loss and are commonly used in orthopedic offices to treat joint pain. The effects of Platelet-Rich Plasma (PRP) injections can last more than a year. Since the blood is taken from your body, this cosmetic procedure is a natural and holistic approach to injections and skin rejuvenation.

Another form of autologous wrinkle injections involves using your own fat. Autologous fat injections are the only invasive dermal filler procedure that requires fat to be surgically removed from an area of your body, such as your stomach or buttocks, and injected into the face. Since fat grafts require invasive liposuction to harvest the fat and a costly purification process, they have lost popularity in recent years. Unfortunately, there is no simple technique for correcting or reversing the effects of fat grafting if treatment has produced unsatisfactory results. Instead, many patients and providers turn to hyaluronic acid and biostimulator fillers due to their safety, efficacy, accessibility, lack of downtime, and long-lasting results.

Are collagen injectables the same as dermal fillers?

Collagen injectables were the first type of injectable filler used in the United States. The collagen for these fillers was derived from bovine collagen and was associated with a higher incidence of allergic reactions. Collagen injectables like Bellafill are great for providing and restoring immediate volume to the injected area. However, collagen fillers were associated with an increased risk of allergic reactions, as it is estimated that 2-4% of the population have some sensitivity to bovine collagen, and roughly 1% of the population may react to bovine collagen. Collagen injections were quickly replaced when hyaluronic acid fillers were developed for facial rejuvenation.

How much is dermal filler?

The total cost of dermal filler treatment ultimately depends on a combination of factors, including the type of dermal filler product being used and the number of syringes of dermal filler needed. These vary on a case-by-case basis since each individual differs regarding the type and severity of the skin concerns they’d like to address and their personal aesthetic goals. The cost of a dermal filler varies based. The experience level of the healthcare provider performing your injections and the geographic location of the office where you have dermal filler treatment will also influence the total cost. Never let price alone dictate who performs your dermal filler treatment. Dermal filler treatment with a board-certified dermatologist or plastic surgeon is generally more expensive than a nurse injector in a medical spa setting. However, to guarantee safety and ideal cosmetic results, an experienced and knowledgeable board-certified healthcare provider must perform dermal filler injections. When you consult Dr. Green at her private dermatology office in NYC, you will create a tailored dermal filler treatment plan that caters to your particular needs. The precise cost of your dermal filler treatment can be determined at this time.

Are dermal fillers permanent?

No, dermal fillers are not permanent. Dermal fillers are semi-permanent, with results lasting six months to several years. The duration of the dermal filler results depends mainly on the type of dermal filler used and the patient’s metabolism. Most patients choose to have dermal filler treatment sessions regularly, typically every six months to 1.5 years, to maintain the best results. One of the benefits of dermal filler treatment is that it can be customized throughout the years to meet evolving cosmetic needs and goals. When you consult with board-certified dermatologist Dr. Green, she will work with you to establish a timeline for your dermal filler treatments best suited to your particular needs.

Can dermal fillers cause cancer?

Dermal fillers do not cause cancer. There is no evidence that facial fillers are linked to cancer. The FDA approval demonstrates the safety and efficacy of dermal filler products. In addition, other cosmetic injectable treatments that are provided in the office of a board-certified dermatologist, including Botox and other neuromodulators, are safe and effective options for rejuvenation that are not connected with any long-term dangerous side effects.

Can you be allergic to dermal fillers?

An allergic reaction is a rare yet serious potential side effect of any injectable. An allergic reaction to a dermal filler may be characterized by developing symptoms such as itching, swelling, tenderness, redness, or small bumps or nodules at or near the injection sites. A patient who has been treated with hyaluronic acid dermal fillers and has developed nodules due to an allergic reaction can, typically, have the bumps dissolved with injections of Hyaluronidase. Hylenex and Vitrase are the brand names for the injectable enzyme called hyaluronidase, which dissolves the nodule and reverses the effects of hyaluronic acid filler injections. Should you notice the formation of any such nodules, it is important to alert your injector immediately so that it can be properly treated and reported to the dermal filler manufacturer. You should not have dermal filler injections if you have a known allergy to any of the injectable ingredients, including gram-positive bacterial proteins found in hyaluronic acid, lidocaine, or bovine collagen.

Which dermal fillers last the longest?

Dermal filler products can be a great alternative to cosmetic surgery, providing patients with low-maintenance, long-lasting facial rejuvenation results. Certain Restylane and Juvederm fillers, such as Restylane Lyft or Juvederm Volume, can last up to twelve months. Biostimulators like Sculptra and Radiesse can last for two years or more after an initial series of treatments. However, the length of time that results will last depends upon various factors, including the area of the face that is injected, the type of dermal filler used for treatment, and the patient’s metabolism. Most patients undergo an annual or biannual maintenance treatment session to maintain the best cosmetic results. When you work with Dr. Green in NYC for your dermal filler treatment, she will help you develop a treatment plan and timeline for your dermal filler injections that suits your needs and goals.

Before and after Restylane filler

Is dermal filler the same as lip filler?

Yes and no. Every lip filler is a dermal filler, but not all dermal fillers can be lip fillers. Lip fillers are noninvasive, injectable dermal fillers specially formulated to enhance, plump, and define the shape of lips. They are typically hyaluronic acid-based and consist of flexible, lightweight formulations that allow for movement in the lips. Not every dermal filler is suited to be injected into the lips, and it is essential to consult with an expert injector like Dr. Green for your lip filler to ensure that you are able to achieve a beautiful, natural-looking pout.

What is the best hyaluronic acid dermal filler for the lips?

Lip fillers work beautifully to add volume and enhance contour, creating a perfect pout. Hyaluronic acid fillers like Restylane Kysse, Restylane-L, Juvederm Ultra XC, and Juvederm Ultra Plus XC are excellent dermal fillers for lip augmentation. Hyaluronic acid, the active ingredient in Restylane and Juvederm dermal fillers, naturally attracts water. When injected into the lips, the filler provides immediate enhancement, promoting moisture retention for a plump, hydrated look. Lip augmentation is a customizable treatment with dermal filler injections, allowing patients to achieve a subtle enhancement or a more dramatic, fuller volume. When you consult with Dr. Green, she will work with you to select the dermal filler best suited to your particular lip augmentation goals.

Which dermal filler is best for under the eyes?

Dermal fillers can be injected into the tear trough to reduce the appearance of dark circles and puffiness under the eyes. The preferred dermal fillers for this treatment area are composed of hyaluronic acid gel and have a small particle size. Dr. Green often uses Belotero and Restylane hyaluronic acid fillers to improve the look of under-eye hollows and bags. Belotero is flexible, thin, and easily integrated into the skin, making it an excellent dermal filler for the under-eye area. The formulation of Belotero eliminates the risk of having the side effect known as the Tyndall effect. The Tyndall effect is the term for the appearance of a blue tint to the treatment area as a result of light reflecting off the particles suspended in the gel filler. It is impossible to encounter the Tyndall effect with Belotero injections, making it an excellent option for undereye rejuvenation. Restylane Eyelight was the first dermal filler to be FDA-approved in 2023 to treat under-eye hollows. Using cross-linking NASHA gel technology, Restylane Eyelight boosts volume when injected into the tear trough area, erasing under-eye bags and dark shadows created by a lack of volume or a natural hollow under the eye. The perfect dermal filler for treating your under-eye concerns depends on your facial anatomy and cosmetic goals. The best way to determine which product is most appropriate for your needs is to consult with Dr. Green.

How much dermal filler do I need?

The amount of dermal filler required for one’s treatment plan will ultimately depend on the type and severity of the skin concerns being addressed, the patient’s age, and the type of dermal filler used. For example, patients interested in lip augmentation or treating undereye hollows typically require a single syringe of hyaluronic acid filler to achieve long-lasting, natural-looking facial rejuvenation results. In contrast, patients undergoing non-surgical body contouring procedures, such as the Sculptra BBL, can require more than 30 total vials of Sculptra to get their ideal results.

How much dermal filler for cheeks?

It is hard to estimate how much dermal filler is needed for cheek augmentation. Various factors, including the severity of the skin concerns being addressed, the patient’s age, and the type of dermal filler, will affect the amount of dermal filler required for optimal results. For example, younger patients with mild volume loss or those looking for slight definition in the cheeks may only need one string or vial split between the two cheeks. In contrast, older patients experiencing more severe volume loss may require multiple syringes for full rejuvenation. The best way to determine how much dermal filler is needed to address your particular concerns and provide optimal results is by consulting Dr. Green at her private dermatology office in NYC. Dr. Green is an artful injector and prefers to embrace a “less is more” philosophy regarding cosmetic injections. After assessing your medical history, skin concerns, and aesthetic goals, she will be able to give an estimate of how many syringes or vials may be needed.

What is the best dermal filler?

Thanks to a myriad of amazing dermal filler products, rejuvenating injectable treatments are incredibly successful in addressing a host of skin concerns, including fine lines, deep wrinkles, facial volume loss, lack of definition or contour, and even acne scars. The best way to determine which dermal filler is best suited to your anatomy, specific concerns, and unique aesthetic goals is by consulting with an experienced and knowledgeable expert, such as internationally renowned board-certified dermatologist Dr. Michele Green in NYC. Dr. Green’s specialty is non-surgical cosmetic rejuvenation, with over two and a half decades of experience providing the best cosmetic injections. She takes on a less-is-more philosophy regarding dermal fillers, which always yields beautiful, natural-looking, and long-lasting results. When you consult with Dr. Green at her private dermatology office, she will work with you to create a customized treatment plan for your dermal filler procedure that best suits your needs.

Where to get dermal fillers?

The FDA considers dermal fillers medical device implants due to the knowledge, training, and expertise required to perform injections. No one should purchase dermal fillers or other cosmetic injectables online, and only board-certified medical professionals should provide dermal filler injections. Injections performed by an inexperienced or untrained injector can result in greater risks during treatment, such as a dermal filler being injected directly into a blood vessel. This could result in severe side effects, including vision impairment, stroke, and skin necrosis.

Additionally, all dermal filler treatments should be performed under sterile conditions in a medical office and not at a “party,” private home, or unlicensed spa. Dr. Michele Green is a member of the American Society of Dermatology, which closely regulates the best practices and safety of dermal fillers. It is crucial to consult a reputable board-certified dermatologist, like Dr. Michele Green, in a medical setting for your cosmetic injections. Having dermal filler injections with a highly experienced board-certified dermatologist guarantees that you encounter the least amount of risk and achieve the best possible cosmetic results.

How to get started with dermal filler treatment

Dermal fillers are an excellent non-invasive treatment option for replenishing volume loss, enhancing certain facial features and contours, and providing a youthful appearance. In addition to eliminating the appearance of fine lines and hollows, dermal fillers can be used for non-surgical body contouring, reducing acne scars and stretch marks, and stimulating new collagen production. Dermal fillers are a popular alternative to cosmetic surgery due to the lack of downtime, the ease of having a dermal filler procedure, and the consistently stunning rejuvenation results that can be achieved. There are many different types of dermal fillers with distinct properties and ideal uses. To guarantee the safety and efficacy of your dermal filler treatment, get optimal results, and avoid unwanted potential side effects, it is critical to have injections with an experienced board-certified dermatologist. When you have cosmetic injections with an expert like Dr. Green, you can expect smooth, youthful, natural-looking results that last.

Dr. Michele Green is an internationally renowned expert in cosmetic dermatology with over 25 years of experience providing some of the world’s most discerning individuals with the best non-invasive cosmetic procedures, including dermal filler and Botox injections. Dr. Green takes a holistic approach and embraces a less-is-more philosophy regarding facial rejuvenation and body augmentation, customizing each patient’s treatment protocol to cater best to their particular skin concerns and overall aesthetic goals. She is consistently identified as one of New York’s best dermatologists by New York Magazine, Super Doctors, Castle Connolly, and the New York Times for her dedication to her patients and expertise. Dr. Green’s artistry makes her one of the most highly sought cosmetic injectors in New York. To schedule a consultation with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood and learn more about dermal fillers, please contact us online or call 212-535-3088.