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All you need to know about fillers

The face starts to lack volume and appears aged with deeper nasolabial folds, unaesthetic lines, a deeper fold, the lips start to thin, and turning down the corners of the lips. 

Hyaluronic acid fillers are injected right underneath these folds to replace the volume lost which creates a younger look in the face by replenishing your body's natural production of hyaluronic acid, which diminishes as you age.

What are fillers, also known as facial or dermal fillers?

As skin ages, it begins to lose collagen filled with hyaluronic acid, the natural filler substance in your body.

Collagen and HA add structure and volume to the face, therefore a lack of this causes the skin to sag and wrinkle – that’s where dermal fillers come into play.

Millions of people use dermal fillers to achieve a more relaxed and smooth facial appearance while still having the freedom of expression.

In fact, 2.1 million filler procedures were performed in 2018, just in the United States.

With age, skin becomes more susceptible to wrinkles and sagging. Exposure to damaging sun rays and years of muscle movement (squinting, chewing, smiling) contribute to the breakdown of tissue and loss of volume in the skin.

If you are looking for a non- surgical facelift, smooth out a few fine lines, or fill in deep-set wrinkles, fillers may be the ideal choice for you.

Fillers are a temporary to lasting solution administered through a few tiny facial injections on specific areas of your face.

The face starts to lack volume and appears aged with deeper nasolabial folds, unaesthetic lines, a deeper fold, the lips start to thin, and turning down the corners of the lips.

Thanks to its ability to store moisture, fillers containing hyaluronic acid are responsible for giving skin a plump, hydrated look while adding volume to weakened facial features and stimulating collagen growth.

Hyaluronic acid fillers such as Restylane or Juvederm are injected right underneath these folds to replace the volume lost which creates a younger look in the face by replenishing your body’s natural production of hyaluronic acid, which diminishes as you age.

Not to be mistaken, fillers aren’t the same as neurotoxins like Botox and Dysport.

The latter type “freezes” muscles to reduce wrinkles, while fillers smooth out skin by filling wrinkles.

What are the benefits of fillers?

While dermal fillers are casually known as “wrinkle fillers,” they can do much more than just smooth out wrinkles, although they are excellent at this too!


Here are a few of the common issues dermal fillers can help address:

  • Smooth out lines around nose and mouth (a.k.a. marionette lines, smile lines)

  • Enhance & restore volume to sunken cheeks or temples

  • Diminish vertical lip lines

  • Plump & enhance the lips

  • Smooth out a chin crease

  • Improve symmetry among facial features

Who is an ideal candidate for fillers?

Dermal fillers are used to treat deep wrinkles and expression lines, as well as recessed or pitted scars.

The best candidates for fillers are:

  • Non-smokers.

  • People with realistic expectations of the results.

  • Those with moderate to severe folds or wrinkles, or other problem areas that they do not want to correct with surgery (for example, under-eye circles, sunken cheeks, etc.)

  • Those without a history of extreme allergies.

  • Physically healthy.

  • Committed to good skin health.

  • Those unsatisfied with the appearance of your skin due to fine lines and wrinkles, sagging skin or dry skin.

Your aesthetic doctor will go over your medical history and allergen history to determine which injectable option won’t lead to a reaction.

What are the risks of fillers?

Some of the most common risks or side effects of fillers vary depending on the specific filler used and the relative permanence of the filler substance and include:

  • Acne-like skin eruptions

  • Asymmetry

  • Allergic reaction

  • Bruising at the injection site

  • Numbness

  • Temporary redness

  • Swelling

  • Pain/tenderness

  • Bruising

  • Bleeding at the injection site

Speak to your doctor before having fillers, to minimize risks or side effects.

Which types of fillers are available?

There are various types of fillers:

  • Hyaluronic acid

  • Hyaluronic acid is a naturally occurring substance that is already found in your skin.

  • It helps keep skin plump and hydrated.

  • HA fillers are typically soft and gel-like.

The results are temporary, lasting 6 to 12 months or longer before the body gradually and naturally absorbs the particles.


Most HA fillers are infused with lidocaine to help minimize discomfort during and after treatment.

FDA approved hyaluronic acid brand name fillers include:

  • Captique

  • Esthélis

  • Elevess

  • Hylaform

  • Juvederm

  • Perlane

  • Prevelle

  • Puragen

  • Restylane

As we covered, the most common type of facial filler is hyaluronic acid – the natural substance found in many areas of the body including joints and skin.

  • Calcium Hydroxylapatite (CaHA)

Calcium hydroxylapatite is also a naturally occurring substance, found primarily in our bones.

It is one of the most well-studied dermal fillers worldwide and has been extensively used for the correction of moderate-to-severe facial lines and folds and to replenish lost volume.

When used in a filler, the calcium particles are nearly microscopic and suspended in a smooth gel.

Calcium hydroxylapatite is also reported to help stimulate natural collagen production, and it is typically used for deeper lines and wrinkles.

FDA approved CaHA fillers include Radiesse.

  • Polymethylmethacrylate (PMMA)

PMMA is a synthetic, biocompatible substance that has been used in medicine for much of the last century.

PMMA fillers contain collagen, a naturally occurring substance in the skin that provides structure and firmness.

FDA approved PMMA fillers include Bellafill® (formerly known as Artefill).

  • Poly-L-lactic acid (PLLA)

Poly-L-lactic acid is a biocompatible, biodegradable synthetic substance.

Its products are technically classified as “collagen stimulators,” as their main mechanism to smooth fine lines is by helping your skin rebuild natural collagen—the filler gel itself dissipates a few days after treatment.

Poly-L-lactic acid is typically used to treat deeper facial wrinkles, and results can last more than 2 years.

FDA approved Poly-L-lactic acid fillers include Sculptra Aesthetic.

What are the steps of a fillers procedure?

The average length of filler injections is about 10 to 20 minutes per session, depending on the individual and the number of areas being treated.

Just before the actual treatment, the area will be cleaned, and you may be given a topical anesthetic to numb the area prior to injection.

Many filler products also contain lidocaine, a mild anesthetic, which is intended to help minimize discomfort during and after your treatment.

Your provider will then inject a precise amount of filler strategically beneath the skin.

A dermal fillers procedure includes the following steps:

  • Facial assessment & mapping

If you choose to utilize packaged soft tissue fillers, the provider will evaluate your facial appearance and skin tone and examine the areas of your face to be augmented.


Strategic points on your face may be marked as the appropriate injection sites for the filler.

  • Cleansing and anesthesia

The injection sites will be cleansed with an antibacterial agent.

Pain at the injection site may be decreased by using a cold instrument to chill the skin, anesthetic ointment to numb the skin or injection of local anesthesia.

While not painless, the injections are usually easily tolerated.

  • Injection

Injection usually takes only a few moments per site.

The process of injecting, massaging, and evaluating the result is performed, and additional filler added as needed.

Depending on the number of areas to be treated, the whole process may be as short as 15 minutes, or as long as an hour.

  • Clean up

Once the results are deemed satisfactory, any markings will be cleansed off.

You may be offered an ice pack to reduce swelling and alleviate discomfort.

Although the area may feel a bit tender for a day or two, it is usually not painful enough to require any medication.

Do dermal fillers hurt?

There may be a slight discomfort whilst the filler is being injected into the face

To provide further relief and alleviate as much pain as possible, our fillers contain a pre-mixed local anesthetic.

How long do dermal fillers last?

Dermal filler treatments typically take 20-40 minutes and the amount of dermal filler needed will depend on volume loss and the areas you would like to restore to its natural beauty. You will see results immediately after treatment.

The results from most injectable fillers are temporary; commonly lasting from a few months to about a year and depends on the type of filler used.

How long the effects of dermal fillers will last depends on the product, the area of treatment, and the patient.

To maintain your results, your cosmetic surgeon will simply repeat treatment, adjusting the amount and techniques as necessary to ensure optimal results.

Hyaluronic acid fillers tend to be the most temporary option, and therefore are often recommended for first-time filler patients.


These will typically last from 6 to 18 months. Injections to the lips will wear out a little faster than those to the nasolabial folds

Which dermal filler do I need?

Each filler product is uniquely formulated to have a certain texture, density, and injection depth.


While your provider will determine what product is best for you, the following diagram from the American Board of Cosmetic Surgery illustrates in general where cosmetic surgeons tend to apply certain products:

How long is the recovery of fillers?

Dermal filler injections require very minimal downtime, allowing patients to return to work and their normal activities directly following treatment.

In fact, a filler treatment is sometimes described as a “lunchtime facelift.”

Yet for the first 24 hours, individuals may be instructed to refrain from strenuous activities and excessive sun or heat exposure.

You should be able to go back to your normal activities right after treatment, but your cosmetic surgeon may ask you to take the day off from exercise or other strenuous activity.

One of the biggest benefits of using dermal fillers is that they provide immediate results.

Once you undergo a filler injection, you will notice your appearance transform soon thereafter.

On top of this, you don’t have to worry about recovery time like you would following plastic surgery.

In fact, you can complete the filler treatment in just 10 minutes depending on the number of areas needing treatment.

After you’re free to continue your daily errands or even go back to work

What should I expect after fillers?

The results of soft tissue treatment using dermal fillers are apparent immediately and will last from several months to almost two years depending on the filler used and the patient injected.

Maintaining good overall health and maintaining healthy and strong skin with appropriate products and skin treatments will improve the results and longevity.

Are dermal fillers covered by insurance?

Fillers are an optional, cosmetic treatment used for enhancing your appearance. Therefore, it is not covered by insurance.

What are fillers, also known as facial or dermal fillers?

Fillers work quickly to restore your skin’s youthful look and minimize the appearance of lines and wrinkles along your brow, around your lips and more.

The costs of dermal fillers depend on a variety of factors, which include:

  • The type of filler used

  • The location of the office

  • The expertise of the aesthetic provider

Hyaluronic acid fillers such as Restylane and Juvederm fillers cost anywhere between $500 and $1,300 per 1mL syringe depending on those factors.

In the Dominican Republic, however, the cost of fillers is $350 dollars per 1ml syringe. It is a single-day, one-hour treatment.

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