FAQs Fillers


Restylane, Perlane, Juvederm Ultra, Juvederm Ultra Plus, Voluma and Belotero are injectable products made of hyaluronic acid chaine by different manufacturers. Hyaluronic acid is a molecule that binds water and is normally found in the deeper layers of the skin. These fillers do not contain any animal products. They are unlikely to cause an allergic reaction. Hyaluronic acids have been used in this country for medical treatments in the eye and joints for many years and have been used for cosmetic purposes in the U.S., Europe and Canada for over a decade with an excellent safety profile. The thicker variants of these products, Perlane and Juvederm Ultra Plus, are generally used for deeper folds and cheek volume. The newer filler Belotero is used for finer lines and is injected higher up in the skin. Voluma is only used for cheek volume and is injected more deeply.


Results are generally noted immediately, although mild swelling, bruising and redness generally can take at least 48 hours to resolve. Maximum results may take 1-2 weeks to fully appreciate. Makeup may be applied the day after treatment. If more correction is desired, additional treatments can be performed at least 1 week after an earlier visit leading to further improvement.


Benefits initially last about 6 to 12 months for most hyaluronic acid fillers, though Voluma studies demonstrated most patients maintained results at 2 years. Voluma us used only for cheek and mid face volume, and is more expensive than the other fillers. Longevity will vary depending on the area treated and the individual patient. Lip enhancement may resolve more quickly because of the mobility of the area.


The recent introduction of fillers containing lidocaine anesthetic has made the procedure much more comfortable. Numbing cream applied by the patient before the appointment or by us in the office can also improve the experience. We also use ice packs which help with discomfort as well as swelling. Our use of the cannula technique can also minimize discomfort in the cheek, marionette (chin) area and lips.


Transient bruising at injection sites can occur, particularly if you have had aspirin or ibuprofen (Advil) within 1 week, or alcohol within 48 hours of treatment. Puffiness, tenderness and/or redness may result for 1-4 days, and rarely longer. Small areas of firmness may be palpable, and rarely visible, but blend in with time. If necessary, any visible bumps from the filler can be removed using a tiny injection of a medication that dissolves the filler (hyaluronidase). Very rarely prolonged swelling, redness, itching, firmness or bluish bumps may last weeks or longer. Other rare side effects include dizziness, headache, rash, visual disturbances, infection, or reactivation of cold sores. Extremely rare side effects include compression/occlusion of blood vessels leading to formation of a scab which can result in a scar. Exceedingly rarely this can lead to blindness.


You may not be treated with filler injections if:

  • You are pregnant or nursing.
  • You have multiple severe allergies or history of anaphylaxis.
  • You are taking a blood thinner such as Coumadin (Warfarin) or aspirin.
  • You have a bleeding disorder.
  • You have had a previous allergic or severe swelling reaction with any hyaluronic acid filler.

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