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Volume Replacement - Facial Fillers

Injectable Facial Fillers
Facial Volume Replacement

Adding facial volume is the first option in providing facial rejuvenation.  While Juvederm was one of the first facial fillers to be introduced, there have been many other forms of facial fillers to follow over the years.  Each of the fillers in the list are used commonly in our practice.  They all have different properties and purposes.  

After reading about facial fillers, forward to the next page to learn more about lifting tissue.  

Juvederm is one of the original hyaluronic acid gel injectable fillers.  It is a soft gel that can be used safely in almost any area of the face.  We use it mostly for the lips and in the under-eye hollows.  

How Long Does It Last?

Juvederm lasts between 9 months to a year         

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Voluma is the most common filler used in our practice with Juvederm second.  While it is still a soft gel like Juvederm, it is not as soft as Juvederm.  It is therefore not always appropriate for the lips or under-eye hollows.  Voluma is, however, used in almost every other area of the face including the temples, cheeks, chin, jowls, and some under-eye hollows


Voluma lasts between 1.5 to 2 years        

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Sculptra is an very useful injectable filler that is integral to the liquid facelift procedure.  It is useful when a patient needs a significant amount of volume.  It is injected as a liquid ( not a gel ) that can be dispersed through the tissue.  It adds more volume than the other fillers while also lasting longer than most other fillers.  

Sculptra is not a hyaluronic acid gel filler.  Instead, it is made of poly-L-lactic acid ( PLLA ), which is a synthetic substance that has the ability to create volume by stimulating your own collagen production.  


Sculptra lasts between 2-3 years        

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Fat transfer is the first product on the list that is not synthetic.  The fat is taken from your own body by liposuction ( yes, you also get to thin out your belly or thighs ).  The fat is then processed and placed in small syringes to be injected into the face, hands, breasts, or butt.  

Fat has the benefit of being natural and biocompatible, long lasting, and usually abundant.  It is also the most cost-effective if there is a large volume need as injectable fillers can get expensive you you need more than a few syringes.   


Fat will last forever fat cells are alive    

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Learn More About The Next Steps - Face Lifting and More
How Has Aging Affected You?
Targeted Areas of Aging

Each area of the face is affected by the volume loss that comes with aging.  Look in a mirror to see if you are affected in the same way as the majority of the population.  

A youthful face usually has a distinctive sweep of volume extending from the temples to the under-eye area to the cheeks.  This sweep can be seen in almost every magazine model.  Loss of volume in the temple give a skeletonized appearance.  The loss of turgor allows the tissues of the lateral brow and lateral upper eyelids to sag and become loose.  In addition, the loss of volume accentuates the action of the crow’s feet muscles and increases the appearance of the crow’s feet lines.


The temple is usually treated with Voluma or Sculptra  which will both last approximately 2 years.  The treatment will often extend to the under-eye hollow as well as the cheek to give a youthful malar sweep.


The under-eye hollow is often seen as dark circles under the eyes.  The loss of volume under the eyes exposes the orbital bone.  In addition, the loss of volume allows the mid-cheek tissue to sag, which in turn lengthens the appearance of the lower eyelid while also thinning out the eyelid skin… causing wrinkles. 


The under-eyelid hollows is usually treated with one of the thinner hyaluronic acids such as Juvederm, Vollure, or Volbella.  Vollure and Volbella are particularly useful if the eyelid skin is very thin an right on the bone.    The treatment ideally extends into the temple and cheek to give a more uniform appearance.

The appearance of jowls is due to loss of facial volume in the cheeks, loss of tissue collagen, and the stretching of skin with gravity.  The cheek tissue falls against the chin ligament where it causes the crease commonly known as the marionette lines.  


The appearance of the jowl is usually treated with Voluma or Sculptra  which will both last approximately 2 years.  Treatment will usually consist of conservatively placing Voluma or Sculptra under the marionette crease to elevate and camouflage the crease.  Treatment ideally also consists of adding volume to the cheek to fill out the skin excess.  If volume replacement is not enough ( and still look natural ), then a face lifting procedure is considered.

The nasolabial folds, also known as the facial parenthesis lines, are due to cheek and under-eye volume loss.  With the loss of volume, the tissue becomes deflated and falls against the nasolabial ligament.  It is important to note that everyone including children have a nasolabial fold.  It is appears abnormal if you or your injector try to remove it.  Direct and aggressive treatment of the fold appears as a bump or out of place.  


Expert treatment of the nasolabial fold requires the injection of filler into deflated cheek mound just to the side of the fold, but only to a volume where the appearance remains “natural”.  A small amount of filler is placed deep in the fold.  Voluma, Sculptra, and sometimes Juvederm are used for this purpose.  The first two last for up to 2 years.

Adding volume to the lip has nearly the highest patient satisfaction rate of any area treated.  Yet, it is the area that gives patients the most apprehension.  Patients generally have nightmares about leaving with huge out of proportion lips.  

Rest assured, the primary goal of lip augmentation is to RESTORE your lips to their natural volumes that you might have had in your twenties.  

Most patients don’t realize that they have lost volume in their lips and surrounding tissue above and below with age.  The loss of volume causes the skin to accordion with movement which eventually cause the vertical “smoker’s lines”.  Secondary goals include restoring a natural pout and recreating natural portions to the lip.


Treatment of the lip includes Voluma ( lasts 2 years ) above the lip.  The volume decreases the potential to develop vertical lines above the lip while producing a natural pout by turning the upper lip upwards and outwards.  Juvederm is usually used to plump up the pink portion of the lip.  Vollure or Volbella ( last 2 years ) are thin hyaluronidase fillers that are sometimes used to fill existing vertical lines.  

The cheeks are a focal point of youth.  High cheekbones are sought out by fashion magazines for example.  Loss of volume in the cheeks coincide with loss of volume in the temple and under-eye hollows.  These areas are ideally treated as a unit.  Not only will the cheek look better, but the volume replacement might lift the tissue to decrease the depth of the nasolabial fold, marionette fold, and the degree of jowling.  


The cheek is usually treated with Voluma or Sculptra  which will both last approximately 2 years.  The treatment will often extend to the under-eye hollow as well as the cheek to give a youthful malar sweep.


Our office can provide you will helpful information, schedule a free consultation, and walk you through the process of having the procedure covered by your insurance.