The aging face may contain fine lines, deep wrinkles or folds, and flat or hollow areas of the cheeks or temples. Some people may just have thin lips. Adding volume with injectable gels or body fat can restore youthful appearance without surgery. Gels containing hyaluronic acid, a naturally occurring component of human skin, are available in different formulations for different areas of the face depending on your needs. While temporary, they may last months to years before repeat treatment is required. If a more permanent solution is desired, it may be a better choice to use your own body fat.

Types of procedures

  • Juvederm HD: This is a good option for fine lines around the mouth, and lip augmentation.
  • Juvederm Vollure: This filler is used for deep nasolabial folds
  • Juvederm Volbella: This is the filler of choice for hollow areas under the eyes
  • Juvederm Voluma: This is used to fill flat cheekbones and hollow temples
  • Autologous fat grafting: Fat from your own body can be added to the cheek bones during a facelift

Procedure details

  • During a consultation, you and your plastic surgeon will use a mirror to focus on the areas of your concern and mark areas to be filled
  • Local anesthesia is not required, but a combination of topical anesthetic cream or local anesthesia may be helpful
  • The filler is injected into the skin lines or deeper soft tissues using a tiny needle
  • Aftercare with an small ice pack can minimize swelling and black and blue appearance
  • Arnica Montana capsules may also help if you are prone to bruising

Risks & Benefits

Pain is minimal and resolves in minutes. Bruising is usually resolved in two or three days. One concern can be small bumps or nodules at the site of injection. These are more often the result of the needle and not clumping of the filler material, and will resolve over a week. The filling effect on lines and wrinkles improves over a few weeks as the filler diffuses through the soft tissues.Occasionally, additional filler can be added after a few weeks of observation. It is unusual for overtreatment to result in unwanted fullness, or for the filler to disturb the blood supply of the skin, but this can be reversed with a medication that dissolves the filler. Even rarer is blindness related to over injection of filler near the eye. That is why your plastic surgeon will use experience and judgement to produce high quality results while minimizing associated risks.

Fillers produce a more youthful skin texture and facial contour without surgery. These changes can last for months to years. In the areas such as the cheekbone and temples, fillers may be more practical than permanent implants which were more popular in the past.

Frequently Asked Questions

There are so many choices; how do I know which filler to choose?

The choice of filler depends on the depth of the lines or hollows, the thickness and texture of your skin, and the goal of temporary or permanent fill. Your experienced plastic surgeon will guide you to the right product.

I’m not sure if I will like how I look with a filler. What if I want to return to my original appearance?

Most fillers are absorbed by the body over months. Temporary gel fillers give you the chance to decide if you like the look. For patients who like the results, the filler can be repeated a couple of times per year, or body fat can be injected instead to maintain the appearance and avoid repeat injections over the years.