Fillers, Cosmetic Dermal Filler

Cosmetic Dermal Filler


Fillers are used to correct facial wrinkles and folds, augment lips, shape facial contours and improve depressed scars.

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Areas that are commonly treated by fillers are:

  • Lip Fullness
  • Lip Lines
  • Under Eye (Tear Trough)
  • Cheeks (Malar)
  • Nose Bridge
  • Smile Lines (Nasolabial Folds)
  • Marionette Lines
  • Chin Crease (Mental Crease)
  • Chin Augmentation
  • Scars (Acne & Chicken Pox)
  • Earlobes
  • Hands


There are many different types of cosmetic fillers. The traditional and oldest form on the market is derived from bovine (cow) collagen. There is also a form derived from human collagen. Given their short duration and greater chance of skin reactions, these fillers are rarely used anymore.

The newest generation of fillers is made from a substance, hyaluronic acid, which occurs naturally throughout the body and is found predominantly in the skin. This substance is what keeps our skin plump and young looking and is what we lose over time as we age.

Three of the most popular of these products are Restylane®, Juvederm®, and Voluma™. They are made from NASHA — non-animal stabilized hyaluronic acid — and last at least twice as long as traditional bovine and collagen fillers.

Another new filler, RADIESSE® is made of unique calcium-based microspheres suspended in a natural gel. These microspheres form a scaffold which serves to support and stimulate the growth of your own collagen. Over time, the microspheres gradually break down and are safely and naturally absorbed by your body.

For deeper lines or folds, we recommend Perlane (similar to Restylane, but a larger particle size), Juvederm Ultra Plus, or RADIESSE.


When used correctly and injected by a cosmetic dermatologist, cosmetic fillers are very safe. Because hyaluronic acid is a natural substance already found in skin, there is very low risk that a patient will have an allergic reaction to a treatment. No allergy skin testing is required.

All of these products are FDA approved.


With all of these fillers, most patients have very few, if any, adverse side effects and little downtime after treatments. The most common side effects are redness and/or swelling at the injection site which typically lasts for about two to three days. As with any injection, bruising is also a possibility. In addition, a very small percentage of patients may develop a hypersensitivity reaction resulting in prolonged red, tender or swollen areas. Other injection-related reactions such as mild irritation, itching and rarely infection may occur.


A dermatologist will inject the filler substance under the wrinkle or fold. The cosmetic filler helps to restore volume to the skin, thereby softening wrinkles and reducing the visual effects of damaged skin. They also can be used to fill in scars and to provide fullness to the lips. The results are immediate and readily visible after the treatment.

Hyaluronic acid fillers work by binding about 1,000 times their weight in water, and this helps to plump the skin. All of these fillers can help to stimulate your own body’s production of collagen over time.

In addition, many patients achieve quick, dramatic results by combining cosmetic filler treatments with Botox® Cosmetic injections.




The results from Restylane and Juvederm typically last six to twelve months. RADIESSE lasts an average of 12-18 months.


As we age, the ability of the skin to produce hyaluronic acid decreases. Because hyaluronic acid helps to bind water, the ability of the skin to retain water declines with age. As a result, the skin becomes drier, thinner and looser.

With Restylane or Juvederm, you can have a natural beauty lift with the body’s own natural material. The results are instantaneous, and it produces a natural enhancement that is gentle, safe and effective.


Please give us a call and a member of our staff will be happy to answer your questions. You can find more information about these products at the websites listed below:


Whatever your goals are in your dermatology care, the team at North Dallas Dermatology Associates can help you in your unique needs. To learn more, call (214) 761-8524 or contact us online today.



Q: How Many Vials Of Juvederm Are Typically Used For The Upper And Lower Rims Of The Lips, To Achieve A Nice Natural Look, But With Noticeable Difference?

A: Because each patient has a different amount of volume loss and desires different results, there isn’t a standard amount of Juvederm that is used for injecting the lips. In my experience, no more than 1 full syringe is enough to give the lips a plump, yet natural appearance.

Q: I Recently Had Juvederm For Cheek Enhancement, Done In An Effort To Correct The Undereye Hollowness And Nasolabial Folds. Unfortunately, The Filler Injected In The Area Under The Eye And Beside The Nose Has Caused Me To Not Be Able To Smile Properly. I Can Only Smile Half As Wide And An Asymmetrical Smile At That (Causing A Rather Tactless Nephew To Comment That I Look Like I Just Had A Stroke). I Need The Filler Removed, But Can’t Seem To Find Any Information. Any Advice On How To Get Rid Of It?

A: If the person who initially injected the Juvederm wasn’t a board certified dermatologist, you’ll want to make an appointment with one immediately! Fillers made from hyaluronic acid such as Juvederm can be injected with an enzyme called hyaluronidase which can dissolve the filler. However, this should be done be a professional who is very knowledgeable when it comes to fillers and in particular, how to treat any adverse effects from them.

Q: Can Juvederm Be Injected In The Area Surrounding The Eyes: Crow’s Feet Lines? A: The best treatment for dynamic wrinkles (those that occur from movement) such as the crows feet would typically be Botox or Dysport. Juvederm works better when injected into static deeper folds and wrinkles (wrinkles at rest).[answer-faq]
[question-faq] I am booked to get Juvederm filler in my lips. My doctor says she will use a topical freezing, then use Juvederm with lidocaine in it. She says that I will see the results of the filler instantly so can adjust as needed. Will my lips look red and swollen after the procedure? If so, for how long? Can I go to work that day or will people wonder what happened to me?[/question-faq]
[answer-faq] As with any injection of a hyaluronic acid based filler such as Juvederm, swelling is a potential side effect. Although it is usually minimal, the degree of the swelling varies with each patient. Your lips may be a bit red and swollen after the procedure, but that should subside within 3-5 days. You should be able to go back to work immediately, but may need to apply concealer to the lips & lipstick over it to conceal any bruises. Q: I Want To Get Juvederm Injections For The Laugh Lines Around My Mouth. Is Juvederm Safe? What Should I Know About The Safety Of Juvederm?

A:  Juvederm is very safe! Not only is it FDA approved, but it is made from hyaluronic acid, which is naturally occurring in the body. Do keep in mind that it’s imperative that you see a board certified dermatologist when you are ready to get the injections.

Q: How Long Does It Take To See Results From Juvederm? I Just Got Some In My Nasolabial Folds And Lips, And I Can’t Wait To See How It Really Is Going To Look.

A: With a filler like Juvederm, you will see immediate results after your treatment. However, most patients may experience some slight swelling which can hide the actual results. This should subside within two weeks, allowing your best results to be appreciated.

Q: My Expression And Laugh Lines Bother Me. Can Juvederm Injections Fill These In And Still Leave Me Looking Natural, Not Like Work Was Done?

A: Absolutely! But it’s first important that you find a board certified dermatologist who is experienced with cosmetic fillers. Juvederm will give you beautiful, instantaneous results and it produces a natural enhancement that is gentle, safe and effective.

Q: Does Latisse Work Better Than Revitalash? I Still Have A Lot Of Revitalash Left, And I’m Not Sure If It’s Worth It For Me To Switch To Latisse.

A: Both products give great results. The main difference is that Latisse is a prescription product and is FDA approved. Revitalash is an over-the-counter cosmeceutical and is therefore not FDA approved.

Q: Can Latisse Cause Any Side Effects I Should Be Aware Of? If So, What Are They And How Long Do Latisse Side Effects Last?

A: The most common side effects of Latisse are an allergic or irritant reaction that can cause redness, swelling, dryness, and/or itchiness around the eyes. It is important not to get the product in your eyes. As long as you follow the application guidelines, these risks are typically low.

Q: I’m Considering Getting Radiesse Under My Eyes To Help With The Bags. I’ve Been Reading A Lot Of Reviews That Don’t Suggest It Under The Eyes. I’m 27 So My Skin Should Not Be Too Thin. What Is Your Opinion?

A: First, your best move is to make an appointment with a board certified dermatologist. With that being said, Radiesse should not be used to fill the “tear trough” bag hollow under eyes as it can sometimes be visible through the skin. Fillers such as Restylane are best suited for under the eyes instead. Keep in mind, this is a very delicate area and should only be injected by an expert.

Q: How Many Days Of Recovery Time Can I Expect With Restylane? Can I Have It Done In The Morning And Go To Work Without Anyone Really Noticing?

A: After receiving Restylane, there is minimal to no downtime.  You should be able to apply makeup for coverage and go back to work immediately. While you may have some temporary redness or swelling around the injection site, it should go away within a few hours of your treatment. As with any injection-type treatment, there is the possibility of bruising which can take a while to heal. Bruising can be treated with Arnica (both topical and oral), apple cider vinegar and even laser to speed up the healing time.  In my office, it is not uncommon for a patient to return to work immediately after his or her appointment.

Q: I Am Planning On Having Restylane Done On The Lines That Lead From The Nose To The Jawline. Has Anyone Had Any Bad Side Effects From Restylane Or From The Anesthetic? What Should I Expect?

A: Generally, Restylane side effects are very minimal. Some patients may experience slight swelling, redness, bruising or tenderness around the injection site, but these symptoms clear up on their own within a few days. Final results can be appreciated immediately after, but the results tend to look even better about 7 -10 days following the injection.

Q: How Long Does Restylane Last?

A: Depending on where Restylane is injected, it can last between 6 to 12 months. In areas with a lot of movement, such as the lips, it can fade quicker and has an average duration of 6 months.  In areas of the face with less muscle movement, such as under the eyes, it can last longer. Studies show a duration even up to 5 years in the glabella (frown area). As with all fillers, the longevity is strongly dependent upon the skill level of the person injecting the product, which is why it is integral to visit a board certified dermatologist.

Q: I Like The Volume I’ve Gained With Three Sessions Of Sculptra But Now I’m Really Scared About The Long-Term Side Effects. How Long Has Sculptra Been Around And What Can Be Expected? Is It A Smart Choice? I’ve Heard Such A Mixed Review.

A: Sculptra Aesthetic has been FDA approved and on the market for the past 8 years. When injected by a skilled dermatologist, it can give fabulous, natural looking results.  It is probably the “safest” of all of the injectables because it is stimulating your own body’s production of collagen.  There is nothing artificial or foreign injected. The most common potential side effects can be related to the injection procedure itself and include: redness, bruising, swelling, infection and/or mild discomfort during the injection. A very rare potential delayed side effect that has been reported is the appearance of small bumps under the skin. These Sculptra nodules are small bumps that may or may not be visible and tend to happen several months after treatment. They may go away on their own or need to be treated. They were more common in the past with more concentrated solutions, but are now uncommon with the dilutions that are currently used.

Q: Can You Please Compare Radiesse And Sculptra?

A:  Radiesse and Sculptra are both used to correct volume loss on the face.  Sculptra is delayed gratification as it works slowly over time and involves a series of injections to stimulate your own body’s production of collagen whereas Radiesse is a filler that gives immediate results. Sculptra consists of an all natural sugar molecule, poly-L-lactic acid, which helps to stimulate your own collagen production.The effects of Sculptra will increase gradually over time and the duration is typically about two years where as Radiesse, made of hydroxyapatite, is a temporary filler and works immediately.  With Radiesse, touchups may be needed at three months and it typically lasts for one year or less. I personally like to use Sculptra because of its longevity in the patient and the natural results that can be achieved.

Q: How Is Dysport Different From Botox? Is It Cheaper? Is It Better?

A:  Overall Botox and Dysport are very similar. Both are a type of botulinum type used to relax the muscles that cause frown lines and other overactive muscles on the face, like forehead lines and crows feet and the lower face. Dysport is a smaller-sized molecule so its unit of measurement is different than Botox. However, both have been in used in medicine for years and have a high safety profile.  Both Dysport and Botox must be injected every 3-6 months to maintain the results.

Q: I’m Considering Getting Dysport But I Want To Know What The Typical Recovery Is Like. Is A Couple Of Hours Enough? Or Will There Be Bruising Or Swelling That Will Require A Longer Downtime?

A: There is no downtime and no “recovery time” is needed after Dysport injections. Usually, there is minimal redness that subsides within 5-10 minutes after the injections.  As with any needle injection procedure, there is a slight risk of bruising.

Q: I’ve Been Researching How Long Juvederm Lasts, But What People Say In Juvederm Reviews And What The FDA Says Don’t Really Match Up. Can Someone Tell Me, How Long Does Juvederm Last? Does Where You Have The Juvederm Injections In Your Face Make A Difference In How Long It Lasts?

A: That’s a great question and one that I get often. The longevity does vary, depending on the injection site. For example, Juvederm typically lasts up to 6 months in the lips/around the mouth and 9-12 months in other areas . However, it is important to remember that the timeframe can vary for each individual.

Q: What Is Juvederm Ultra Used For? How Is This Different From Other Types Of Juvederm, Like Ultra Plus – Do They Treat Different Things?

A: In essence, Juvederm Ultra and Juvederm Plus are both in the same family of all natural hyaluronic acid fillers and are used to treat wrinkles of the face. Juvederm Ultra is a smaller particle size and is used to treat mild to moderate lines and wrinkles whereas Juvederm Plus is a larger particle size and is used to treat deeper  folds and wrinkles. At your consultation, a dermatologist can determine which will be best for your unique treatment plan.

Q: I’m Thinking Of Having Juvederm For Deep Wrinkles Between Brows. Are There Any Side Effects?

A: When injected correctly, filler between the brow can have fabulous results.  However, if injected incorrectly, it can have potentially serious adverse effects.The most important thing to understand when it comes to having your face injected is to go to an experienced physician injector that not only understands how to treat the face, but also can treat the possible side effects. While the most common side effects are mild — redness, swelling and/or bruising at the injection site.  In addition, a very small percentage of patients may develop a hypersensitivity reaction resulting in prolonged red, tender or swollen areas. The most serious possible effect is skin necrosis (sloughing) and even very rarely, blindness.For deep wrinkles between the brow, one may also want to consider a combination treatment of a filler and a neuromodulator such as Botox for a synergistic effect to both fill and relax the area for a natural, youthful appearance.


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North Dallas Dermatology Associates8144 Walnut Hill Lane Suite 1300
Dallas Texas 75231
Fax: (214) 420-7380

Our Hours:

Mon-Thurs: 8:00AM – 4:00PM
Friday: 8:00AM – 1:00PM

Free parking is available on the ground level of the parking garage directly attached to the BB&T bank.


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