Dermal Fillers

Dermal fillers are injectables for the enhancement of facial contours, the augmentation of certain features, the replenishment of volume loss, and the provision of a more youthful appearance. Dermal fillers are a non-invasive cosmetic procedure and a popular alternative to plastic surgery due to the consistently stunning facial rejuvenation results, lack of downtime, and ease of injections. When an expert injector, such as Dr. Michele Green in NYC, performs your dermal filler treatment, the results are long-lasting, natural-looking revitalization.

Dermal filler procedures are straightforward, require little preparation, and have few, if any, side effects. Some of the most common dermal filler products are composed of hyaluronic acid, calcium hydroxylapatite, poly-l-lactic acid, and polymethyl methacrylate. Each injectable has its own distinct properties and ideal applications. For example, hyaluronic acid fillers like Juvederm and Restylane are great options for enhancing facial features and eliminating wrinkles and creases. Sculptra, a collagen stimulator made of poly-l-lactic acid, is perfect for replenishing facial fat and volume loss, diminishing textural acne scars, and augmenting the hips and buttocks. Due to the variation in injectables and the expertise required for properly administering them, seeking dermal filler treatment from an experienced board-certified dermatologist is crucial for achieving optimal results.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing some of the world’s most discerning individuals with the best non-invasive cosmetic procedures, including dermal filler treatments. Regarding facial rejuvenation, Dr. Green takes a holistic approach and embraces a less-is-more philosophy, customizing each patient’s treatment plan to cater best to their particular skin concerns and personal aesthetic goals. She is consistently identified as one of NYC’s best dermatologists by Castle Connolly, New York Magazine, Super Doctors, and the New York Times for her dedication to her patients and expertise.

Before & After photos: Juvederm Voluma 2 weeks

What are dermal fillers?

Dermal fillers are a cosmetic injectable treatment for facial rejuvenation and body contouring. Dermal fillers are injected beneath the skin’s surface to eliminate fine lines and deep wrinkles, restore volume loss, and enhance certain features. Dermal fillers are composed of various substances, each with its own distinct properties and ideal applications. Some of the most common dermal filler products are composed of hyaluronic acid, calcium hydroxylapatite, poly-l-lactic acid, and polymethyl methacrylate. The cosmetic effects of dermal filler injections are semi-permanent, lasting between six months to five years. The longevity of one’s cosmetic results depends on their metabolism and the amount and type of dermal filler used. Most patients choose to have dermal filler treatment sessions regularly, adjusted to their specific needs, to maintain the best results. Dr. Green uses a variety of FDA-approved dermal fillers for facial rejuvenation and body augmentation.

What are dermal fillers used for?

Dermal fillers are versatile injectable treatments with many distinct applications:

• Nasolabial folds/ “smile lines”
• Deep wrinkles and skin folds
• Oral commissures and marionette lines
• Lip augmentation
• Peri-oral lines/ “smoker’s lines”, fine lines around the lips
• Under eye hollows (tear troughs)
• Horizontal neck creases
• Jawline enhancement
• Chin augmentation
• Replenishing facial volume in the cheeks, temples, and midface
• Improving the appearance of loose skin and jowls
• Hand rejuvenation
• Rejuvenating the décolletage, upper arms, thighs, hips, and knees
• Non-surgical buttocks augmentation (BBL)
• Reducing the appearance of depressed acne scars, stretch marks, and surgical scars

Dermal fillers are used to restore lost facial volume, enhance facial contour, and smooth out fine lines and deep wrinkles. Part of the aging process involves the loss of collagen and subcutaneous fat from the face, which provide us with a youthful, supple appearance. Dermal fillers can replenish some of this volume loss and create a rejuvenated, refreshed appearance. Dermal fillers can also be used to reduce the appearance of hollow under eyes that are caused by tear troughs, improve the look of acne scars, and naturally enhance facial features such as the jawline or the lips. Regardless of your cosmetic concern, Dr. Green can customize your dermal filler treatment to provide optimal, natural-looking, long-lasting results.

Before & After Photo: Aquagold, Dermal fillers and VBeam

Types of dermal fillers

Hyaluronic acid dermal fillers

Hyaluronic acid injectable fillers are an incredibly common type of dermal filler for enhancing facial contours and features, replenishing volume loss, and reducing the appearance of fine lines and deep wrinkles. Hyaluronic acid is a substance that naturally occurs in the skin and supplies it with essential hydration and youthful suppleness. Hyaluronic acid fillers are gel-like substances that, when injected, bind with the water that is present in the skin. The result is a lifting, plumping effect and a smoother skin texture. In 2010, the FDA approved hyaluronic acid fillers compounded with lidocaine to enhance the comfortability of dermal filler procedures.

Recent clinical studies have demonstrated that, over time, dermal filler treatments with hyaluronic acid injections stimulate the production of new collagen in the skin. Collagen is a protein in the skin that supports its underlying structure, providing a firm foundation and contributing to a youthful appearance. Patients who regularly have dermal filler treatments may need a smaller amount of dermal filler product in subsequent sessions to achieve their ideal cosmetic effects.

Juvederm hyaluronic acid fillers

Dr. Green was one of the first dermatologists in New York City to incorporate Juvederm dermal filler treatments into her practice. Juvederm’s advanced hyaluronic acid (HA) formulation can be used for deep wrinkles, and the cosmetic results can last up to 12 months. Several types of hyaluronic acid dermal filler products exist within the Juvederm family. Each Juvederm dermal filler product has a unique composition and ideal application. An expert injector, such as board-certified dermatologist Dr. Michele Green in NYC, understands the properties of each dermal filler and can recommend the appropriate combination of injectables for addressing your specific needs and achieving your goals. Juvederm dermal fillers are among the most popular hyaluronic acid fillers in the United States and are described in detail below.

1 treatment of Botox to Masseter area

Juvederm Ultra Plus XC & Juvederm Ultra Plus

Juvederm Ultra Plus and Juvederm Ultra Plus XC are ideal for injection into the mid and lower face. The formulas are relatively thick compared to other hyaluronic acid fillers, which is beneficial when treating deep wrinkles, such as the nasolabial folds and marionette lines. Juvederm Ultra Plus XC is also an excellent injectable for lip augmentation. Juvederm Ultra Plus XC is compounded with lidocaine, a local anesthetic that helps reduce discomfort associated with injections.

Juvederm Voluma

Juvederm Voluma is one of the most popular dermal fillers.  Juvederm Voluma was designed to enhance contour and replace volume loss in the cheekbones and malar area. Voluma is designed to help restore youthful contours by plumping up the cheeks and chin where the aging process has caused volume loss. This advanced formulation of hyaluronic acid can produce natural-looking cosmetic results that last up to 12 months.

Juvederm Volbella

Juvederm Volbella is designed to treat fine lines, particularly those around the lips, and for “smoker’s lines.” Juvederm Volbella lasts approximately 12 months, depending on the amount of product and the area injected.

Juvederm Vollure

Juvederm Vollure was designed to treat the smile lines or nasolabial folds. Juvederm Vollure has a longevity of 18 months, which is very appealing due to the decreased need for constant re-injection.

Juvederm Volux

Juvederm Volux is the first ever dermal filler designed and FDA-approved specifically for jawline enhancement. Made with patented Vycross technology for long-lasting, natural-looking results, Juvederm Volux can be used to enhance jawline definition, erase lower facial creases, reduce the appearance of jowls, and provide the ideal facial contour. Juvederm Volux is a relatively thicker hyaluronic acid gel offering rejuvenation results lasting 6-18 months.

Restylane hyaluronic acid fillers

The Restylane family of hyaluronic acid dermal fillers, manufactured by Galderma, are a popular option for reducing fine lines and wrinkles and enhancing contour. Dr. Green is consistently voted one of New York City’s best dermatologists. She has offered Restylane injections to her patients in Manhattan’s Upper East Side since it was first introduced as a dermal filler. The complete Restylane line of dermal filler products includes Restylane-L, Restylane Silk, Restylane Lyft, Restylane Defyne, RestylaneRefyne, Restylane Kysse, Restylane Contour, Restylane SkinBoosters, Restylane Eyelight, and Dysport. These injectables produce overall skin rejuvenation and a more youthful appearance, described further in the sections below.

Restylane-L

Restylane-L® is a hyaluronic acid filler designed for correcting moderate facial wrinkles around the corners of the mouth, marionette lines, laugh lines, and the tear trough area (under the eye area). Restylane-L is also a favorite dermal filler product for providing natural, soft lip augmentation. The cosmetic effects of injection with Restylane-L last approximately 6 to 9 months. Restylane-L is compounded with lidocaine to minimize any potential discomfort associated with injections.

Restylane Lyft

Restylane Lyft, originally marketed under the name Perlane, is a hyaluronic acid filler with a relatively large particle size and the highest G prime of any dermal filler. Restylane Lyft is an ideal injectable for treating deep wrinkles and volume loss correction in the face and hands. Restylane Lyft is also FDA-approved for cheek augmentation and is commonly injected into oral commissures. The cosmetic effects of injections with Restylane Lyft typically last 9 to 12 months in duration.

Restylane Silk 

Restylane Silk is a dermal filler that was FDA-approved for use in 2014 for fine lines in the perioral area and lips due to its smaller size molecule.

Restylane Refyne & Restylane Defyne

Restylane Refyne and Restylane Defyne are the newest Restylane products, which are designed with XpresHAn Technology™, which allows easy movement of the face in the areas it has been injected. Restylane Refyne treats moderate lines and wrinkles, whereas Restylane Defyne treats moderate to deep wrinkles.

Restylane Eyelight

Restylane Eyelight is the first dermal filler to be FDA-approved specifically for treating under-eye hollows. The hyaluronic acid filler is made with NASHA technology, specially designed to fill in tear troughs, erasing the appearance of dark circles under the eyes caused by volume loss or a natural hollow. Restylane Eyelight filler can provide results lasting up to 18 months.

Restylane Kysse

Restylane Kysse is a hyaluronic acid filler designed for lip augmentation, perfect for providing pillowy, luscious lip enhancement. Restylane Kysse is FDA-approved for patients 21 years and older and relies on innovative XpresHAn Technology™ to provide volume and hydration to the lips while maintaining a natural look. Additionally, the ability of Restylane Kysse’s formulation to mold to your natural tissues means that less product is required for optimal results. Results are incredibly long-lasting, with volumizing and rejuvenating effects for up to twelve months.

Belotero Balance 

Belotero is a thin, smooth, flexible hyaluronic acid filler manufactured by Merz that treats fine lines. Made with the proprietary Cohesive Polydensified Matrix (CPM) process, this hyaluronic acid filler easily integrates into the skin, making it an exceptional option for filling fine lines. Its unique properties offer a soft, even correction to those delicate areas of the face, such as lip lines and the tear trough area under the eyes. One of the benefits of Belotero is that it is much less likely than other hyaluronic dermal fillers to cause the Tyndall effect- a side effect of undereye fillers that causes a blue hue to the treatment area.

Bellafill 

Bellafill was originally FDA-approved in 2007 as Artefill. Bellafill comprises non-resorbable polymethylmethacrylate (PMMA) microspheres suspended in a water-based gel compounded with bovine collagen and lidocaine. This synthetic injectable was originally approved for reducing the appearance of smile lines. It can also be used to diminish the appearance of acne scars. Since this product contains bovine collagen, skin tests are required to ensure the patient is not allergic to the dermal filler. Bellafill has been reported to last for more than five years in duration.

Radiesse

Radiesse is an injectable filler made of calcium hydroxylapatite, which replenishes the lost collagen under your skin and promotes an increase in your natural collagen production. Radiesse is ideal for treating deep wrinkles, volume loss, and creases, and it is also FDA-approved for hand rejuvenation. The results from Radiesse dermal filler injections are long-lasting, typically lasting a year and sometimes up to two years.

Sculptra

Sculptra is a cosmetic injectable that is composed of a substance called poly-L-lactic acid. Once injected, Sculptra stimulates the production of new collagen in the skin. Collagen is a protein in the skin that provides structural support and a firm skin texture. As part of the natural aging process, collagen in the skin is broken down over time, leading to the signs of aging. By restoring collagen to the treatment area, Sculptra injections can replenish lost volume and create a youthful appearance. The cosmetic effects are long-lasting, with results remaining up to two years after completing an initial short series of injections with Sculptra. Due to Sculptra’s ability to be used in multiple anatomic locations in the face, it is an ideal product for pan-facial rejuvenation. Sculptra can also be used to treat other areas of the body, including the neck, décolletage, and buttocks.

Botox, Juvederm Voluma and Vollure – 2 weeks before / after

Autologous Fillers

Platelet-rich plasma Injections (PRP) are an autologous wrinkle filler that is extremely popular due to its holistic approach. First, a sample of the patient’s own blood is collected and placed in a special centrifuge. The platelet-rich plasma is then removed and injected into your face. Some patients choose to have microneedling with PRP simultaneously to help with fine lines, texture, and tone. The effects of Platelet-Rich Plasma (PRP) injections can last more than a year. Since the blood is taken from your body, this cosmetic procedure is a natural and holistic approach to injections and skin rejuvenation.

Another form of autologous wrinkle injections entails using your own fat. Fat grafting is a cosmetic procedure where your fat is surgically removed from an area of your body, such as your stomach or buttocks, and injected into your face. Since fat grafts require invasive liposuction to harvest the fat and a costly purification process, it has lost popularity in recent years. Unfortunately, there is no simple technique for correcting or reversing the effects of fat grafting if treatment has produced unsatisfactory results.

Collagen injectables

Collagen injectables were the first injectable filler used in the United States. The collagen for these fillers was derived from bovine collagen and was associated with a higher incidence of allergic reactions. Collagen injections were manufactured in two forms, Zyderm and Zyplast. Cosmoderm and Cosmoplast were also very popular collagen-based dermal fillers. However, The effects of these collagen injections tended to fade relatively quickly after three months, and constant maintenance was required. Due to the increased risk of allergic reactions and lack of longevity, Collagen injections were quickly replaced when hyaluronic acid fillers were developed for facial rejuvenation.

How long do dermal fillers last?

Dermal filler treatments produce semi-permanent results lasting anywhere between six months to five years. The longevity of one’s dermal filler results depends on their metabolism and the amount and type of dermal filler product used.

Is dermal filler permanent?

No, dermal filler is not permanent. Dermal filler is semi-permanent, with results lasting six months to several years. The duration of the dermal filler results depends mainly on the type of dermal filler used and the patient’s metabolism. Most patients choose to have dermal filler treatment sessions regularly, typically every six months to 1.5 years, to maintain the best results. One of the benefits of dermal filler treatment is that it can be customized throughout the years to meet evolving cosmetic needs and goals. When you consult with board-certified dermatologist Dr. Green, she will work with you to establish a timeline for your dermal filler treatments best suited to your particular needs.

Which dermal fillers last the longest?

Several long-lasting dermal filler products can be a great alternative to cosmetic surgery, providing patients with low-maintenance facial rejuvenation results. Restylane, Juvederm, and Sculptra are durable dermal filler products that can be used to create natural-looking, long-lasting facial rejuvenation results. These products typically last 1-2 years, although the precise amount of time your treatment’s cosmetic effects will last depends upon multiple factors. The area of the face that is injected, the type of dermal filler used for treatment, and the patient’s metabolism can all influence the duration of the results. Most patients undergo an annual maintenance treatment session to maintain the best cosmetic results. When you work with Dr. Green in NYC for your dermal filler treatment, she will help you develop a treatment plan and timeline for your dermal filler injections that suits your needs and goals.

Does dermal filler dissolve?

Hyaluronic acid fillers can be dissolved in the case of an adverse event or unsatisfactory cosmetic results. Remember, hyaluronic acid fillers can take up to two weeks to settle. If hyaluronic acid fillers need to be dissolved, hyaluronidase can do this. Hyaluronidase is an injectable enzyme that breaks apart hyaluronic acid, reversing the effects of injections. Different dermal fillers can not be dissolved, like Sculptra and Radiesse. These dermal fillers are composed of poly-l-lactic acid and calcium hydroxylapatite, respectively. To guarantee ideal results, it is essential that an experienced board-certified dermatologist, such as Dr. Michele Green in New York City, perform your dermal filler injections.

What is the difference between Botox and dermal fillers?

While Botox and dermal fillers are both non-invasive injectable treatments for rejuvenation, their uses are distinct and complementary.

Botox is the gold standard cosmetic procedure for treating and preventing dynamic fine lines and deep wrinkles. Dynamic fine lines and wrinkles form over time due to repeated facial expressions, most commonly affecting the forehead, crow’s feet, and glabella. Botox is an injectable neurotoxin that inhibits nerve signals to the muscles near the injection sites responsible for making facial expressions. By limiting muscle contraction, Botox essentially “freezes” the area. The result is a smoother skin texture and a more youthful appearance. Botox can take up to two weeks to take effect, after which the results last about four months. In addition to the cosmetic benefits of Botox, it also has many medical applications, including treating hyperhidrosis, temporomandibular joint disorder, migraines, and cervical dystonia.

Dermal fillers are better suited to eliminating fine lines and wrinkles or replenishing volume loss due to collagen breakdown. Collagen is the most abundant skin protein, contributing to the skin’s structural support, firm foundation, and overall youthfulness. As we age, collagen production decreases while existing collagen is depleted, resulting in more prominent signs of aging. Dermal fillers are designed to correct age-related volume loss, reduce the appearance of fine lines and facial wrinkles, and enhance the cheeks, jawlines, and lips. Additionally, most dermal filler injections boost natural collagen production in the skin, which can help improve skin texture and elasticity.

Many patients combine dermal filler and Botox injections to target various signs of aging and achieve pan-facial rejuvenation. This complementary injectable treatment approach is so popular that it is nicknamed the “liquid facelift.”

Before and after Restylane filler

What is dermal filler made of?

Most of the dermal filler products used by Dr. Green are composed of hyaluronic acid. Hyaluronic acid is a naturally occurring substance within the connective tissue and an essential component of the skin’s foundation. y utilizing hyaluronic acid dermal fillers, Dr.
Green can replenish and add necessary volume, induce new collagen production, and provide youthful plumpness and firmness to the skin. This, in turn, results in a refreshed, smooth, and natural-looking complexion.

Dr. Green also frequently utilizes Sculptra, a dermal filler composed of poly-L-lactic acid. Poly-L-lactic acid is a biocompatible substance that stimulates new collagen production in the treatment area. Sculptra is designed to correct a sunken, hollow appearance and restore facial volume. After a short series of Sculptra injections, the cosmetic effects from treatment last up to two years. Dr. Green takes a holistic approach to dermal filler treatment for her patients, customizing each treatment plan according to the patient’s facial anatomy, skin concerns, and desired cosmetic results. During your consultation with Dr. Green, you will have the time to discuss your particular cosmetic goals and determine with her an appropriate treatment plan and timeline that will provide you with the best results.

How much does dermal filler cost?

The total cost of dermal filler treatment ultimately depends on a combination of factors, including the type of dermal filler product being used and the number of syringes of dermal filler needed. These vary on a case-by-case basis since each individual differs regarding the type and severity of the skin concerns they’d like to address and their personal aesthetic goals. When you consult Dr. Green at her private dermatology office in NYC, you will create a tailored dermal filler treatment plan that caters to your particular needs. The precise cost of your dermal filler treatment can be determined at this time.

The experience level of the healthcare provider performing your injections and the geographic location of the office where you have dermal filler treatment will also influence the total cost. Never let price alone dictate who performs your dermal filler treatment. Dermal filler treatment with a board-certified dermatologist or plastic surgeon is generally more expensive than a nurse injector in a medical spa setting. However, to guarantee safety and ideal cosmetic results, it is critical that an experienced and knowledgeable board-certified healthcare provider performs dermal filler injections. All dermal filler treatments should be performed under sterile conditions, in a medical office, and not at a “party”, private home, or an unlicensed spa. Dr. Michele Green is a member of the American Society of Dermatology, and they closely regulate the best practices and safety of dermal fillers.

The FDA considers Dermal fillers a medical tool because they require extensive anatomical knowledge to administer safely. Improper injection technique or use of facial fillers can result in serious side effects. For example, if dermal filler is inadvertently injected into a blood vessel, potential side effects include vision impairment, necrosis of the skin, and stroke. Dr. Green is a board-certified dermatologist with special advanced training in dermal fillers and has been injecting soft tissue fillers for over 25 years.

Is dermal filler safe?

Yes! Dermal fillers are completely safe, provided that your treatment is done by an experienced and knowledgeable healthcare provider in a medical setting. Although it is often more expensive to have dermal filler treatment with a board-certified dermatologist like Dr. Green, it is imperative that you are selective when choosing your provider to avoid unnecessary complications and unwanted side effects. When you choose to work with Dr. Green, you can feel confident that you have an injector with both the expertise and experience to deliver dermal filler treatment in a safe, effective, and satisfactory manner. All dermal filler and injectable products Dr. Green uses at her private dermatology office are FDA-approved and proven safe and effective in clinical studies. One contraindication for treatment with dermal filler products is a history of an allergic reaction to cosmetic injectables. If you have had an adverse event related to dermal fillers in the past, discuss this with Dr. Green during your consultation.

Does dermal filler hurt?

No! Dermal filler injections are not usually painful. Still, a topical lidocaine cream can be prescribed and applied to the entire treatment area to reduce discomfort. The numbing cream should be applied thickly to freshly cleansed skin one hour before injections. Before the injections, the numbing cream will be cleaned off, and the skin will be sterilized. Most dermal filler products are also compounded with lidocaine, minimizing potential discomfort.

Who is a good candidate for dermal filler treatment?

Many patients interested in cosmetic injectables may initially be concerned with whether or not they are good candidates for the treatment. Thanks to a myriad of amazing dermal filler products, rejuvenating injectable treatments are incredibly successful when it comes to addressing a host of skin concerns, including fine lines, deep wrinkles, facial volume loss, lack of definition or contour, and even acne scars or stretch marks. Overall, healthy individuals in their mid-20s to late 70s are all good candidates for treatment with injectable dermal fillers. When it comes to choosing the “best” dermal filler products for meeting your needs and goals, it takes an experienced and knowledgeable expert. Dr. Green’s artistry and consistently stunning rejuvenation results are why she is regularly voted one of New York’s best dermatologists by Castle Connolly, New York Magazine, Super Doctors, and The New York Times. When you consult with Dr. Green, she will work with you to develop a custom treatment plan that will help you look and feel like your best self.

What is the process of having dermal filler treatment?

The first step is consulting an expert injector, such as board-certified dermatologist Dr. Michele Green. It is critical that dermal filler injections are performed by an experienced board-certified dermatologist like Dr. Green to guarantee the safety and efficacy of your treatment and ensure optimal results. Your consultation will be at Dr. Green’s private dermatology office in Manhattan’s Upper East Side neighborhood. During your consultation, Dr. Green will collect a thorough medical history, review any previous cosmetic procedures you may have undergone, and discuss your particular skin concerns and aesthetic goals with you. Photographs of the treatment area will be taken for your private medical record to enhance the discussion and track future progress. If you are a good candidate for dermal filler treatment, the injections may be performed on the same day as your consultation or scheduled later, depending on your preferred time allowance.

On the day of your dermal filler treatment, a topical lidocaine cream should be applied to the entire treatment area one hour before your injections. The numbing cream will desensitize the site to enhance your comfort during the dermal filler injections. Once you arrive at Dr. Green’s office, the numbing cream will be removed and the skin sterilized. Dr. Green will then masterfully inject the dermal fillers selected for your rejuvenation protocol. Ice packs are applied directly to the treatment area immediately after the injections to minimize bruising or swelling side effects. You will be provided all of the pertinent aftercare information required for achieving and maintaining ideal results, which can vary slightly depending on the type of dermal filler used. Dr. Green will invite you to return for a follow-up appointment approximately two weeks after your injections. At your follow-up appointment, Dr. Green will assess the cosmetic results of your dermal filler procedure to determine whether any touch-up is needed. Most patients have regular dermal filler treatments every six months to two years, depending on the type of dermal fillers used, their metabolism, and their overall aesthetic goals. When you consult with Dr. Green, she will work with you to establish a timeline for your dermal filler treatment sessions best suited to your needs.

What can I expect after dermal filler injections?

The most common side effect that patients experience after having treatment with dermal fillers is a mild amount of swelling, which should resolve within two weeks of injections. Some bruising may also occur, and Dr. Green advises patients with a high propensity for bruising to take an oral herbal supplement called Arnika Forte. Arnika can be taken for two days before your filler treatment and after your injections to prevent and heal any bruising. Dr. Green always recommends discontinuing any potential blood thinners, such as Aspirin, Aleve, Motrin, Multivitamins, Fish oil, or other herbal supplements, for two weeks before your treatment session to prevent bruising.

What are the side effects of dermal filler injections?

• Bruising
• Swelling
• Lumps
• Uneven results
• Discoloration
• Redness
• Pruritus
• Tyndall Effect

Lumps or nodules are a potential side effect of hyaluronic acid fillers that can be easily corrected. If lumps develop or if you are unhappy with your injection results, hyaluronic acid fillers like Juvederm and Restylane can easily be reversed with hyaluronidase injections.  Hyaluronidase is an enzyme that breaks down hyaluronic acid, reversing the effects of injections. Dr. Green has treated many patients who have had cosmetic injections with inexperienced injectors in medical spas and are unhappy with their cosmetic results. It is essential to carefully select an expert injector, like Dr. Michele Green, when having cosmetic injections to avoid poor cosmetic results. This is especially true for dermal fillers like Sculptra, which can not be dissolved with hyaluronidase.

Bruising at or near the injection site is another potential adverse event that can occur with any kind of cosmetic injection. To prevent and treat this side effect, Dr. Green always recommends that her patients discontinue any blood thinners 1 to 2 weeks before their appointment. This includes Aspirin, Aleve, Motrin, Multivitamins, Fish oil, and other herbal supplements. An herbal supplement called Arnika Forte can also be taken 1-2 days before your cosmetic injections and following your appointment to further protect against bruising.

Combining dermal filler treatment with other non-surgical cosmetic procedures

Dermal fillers work beautifully to smooth out age-related fine lines and deep wrinkles, provide facial contour, and restore lost facial volume. However, an alternative cosmetic injectable is ideal for diminishing dynamic wrinkles. Dynamic wrinkles are those which are caused by repeated movement, such as making facial expressions. The most commonly affected areas of the face are the forehead, the glabella (furrow between the eyebrows), and the lines around the eyes (crow’s feet).  Botox, Dysport, and Xeomin are injectable forms of botulinum toxin, a neuromodulator that relaxes the muscles responsible for facial expression. This ultimately softens the appearance of fine lines and prevents the formation of new dynamic wrinkles in the treatment area. During the same appointment, Dr. Green treats many of her patients with Botox injections and cosmetic dermal fillers to provide total facial rejuvenation and a refreshed, youthful, natural appearance.

Many patients choose injectable treatments right after their Thermage procedure for skin tightening. Thermage is a non-invasive skin tightening treatment that relies on radiofrequency energy to stimulate gradual new collagen production in the treatment area, improving skin texture and laxity. Results are attained in a single treatment session, and there is zero downtime with Thermage, meaning patients can easily schedule their treatment and resume normal daily activities afterward. The Thermage procedure can be used nearly anywhere on the face or body, including the neck, chest, décolletage, upper arms, abdomen, thighs, and buttocks, for a lifting and smoothing effect that firms and tightens loose skin. Thermage is complementary to injectable treatments, and many patients of Dr. Green’s take advantage of both cosmetic procedures for optimal facial rejuvenation.

What can go wrong with dermal fillers?

If dermal filler injections are improperly performed, serious side effects and poor cosmetic results can occur. For example, if dermal filler is inadvertently injected into a blood vessel, side effects can include blindness, stroke, and skin necrosis. It is critical that all dermal filler injections are performed by an experienced and knowledgeable healthcare provider with the expertise required to provide your ideal facial rejuvenation results safely.

Is Dysport a dermal filler?

Dysport is not a dermal filler but a different type of cosmetic injectable treatment. Dysport, like Botox, is a neurotoxin that treats dynamic fine lines and facial wrinkles. Botox and Dysport are essentially interchangeable.

Is Juvederm a dermal filler?

Juvederm is a family of dermal filler products manufactured by the pharmaceutical company Allergan. Juvederm dermal fillers are made of hyaluronic acid and include Voluma, Volux, Ultra, Ultra Plus, and Vollure. Each Juvederm product has a unique gel consistency that makes it ideal for a specific anatomical location of the face. Dr. Green was among the first dermatologists in NYC to offer Juvederm dermal fillers for facial rejuvenation. She is an Allergan platinum injector, often utilizing Botox and the Juvederm family of fillers to restore, rejuvenate, and enhance her patients.

Is Botox a dermal filler?

Botox is not a dermal filler. Botox is an injectable neurotoxin ideal for treating and preventing dynamic fine lines and deep wrinkles. Dynamic fine lines and wrinkles are those that form over time due to repeated facial expressions. Botox works by limiting the contractions of facial muscles near the injection sites, ultimately creating a smoother skin texture and a more youthful appearance. Botox and dermal fillers are different types of injectables that can be used in a complementary fashion in a “liquid facelift” to provide pan-facial rejuvenation.

Is Sculptra a dermal filler?

Sculptra is a unique dermal filler in that it is composed of a substance called poly-l-lactic acid. Poly-L-lactic acid is a biocompatible substance that stimulates natural collagen production in the treatment area. Collagen is the most abundant skin protein, contributing to the skin’s structural support and firm texture. There is zero downtime associated with Sculptra injections, and the most common side effects include mild swelling, bruising, and redness at or near the injection sites. Sculptra’s most important aftercare advisement is adhering to the “rule of 5’s.” Patients must perform five massages for five minutes each, for five consecutive days, in the area where Sculptra was injected. As Sculptra is a liquid injection, the massaging protocol helps guarantee even distribution of the dermal filler and prevents the side effect of nodule formation. Sculptra nodules can form if too much collagen is generated in a small area, which massaging the treatment area prevents. After an initial series of three Sculptra treatment sessions, the facial rejuvenation results last up to two years.

What is Radiesse dermal filler?

Radiesse is an FDA-approved injectable dermal filler made of calcium hydroxyapatite (CaHA). Using patented microsphere technology, each injection of Radiesses starts a process called collagenases. This process stimulates new collagen production, replenishing collagen around the injection site. Additionally, the CaHA gel microspheres themselves provide immediate volume to fill in visible deep lines and wrinkles. Radiesse typically lasts a year and, in some cases, up to two years. Radiesse is FDA-approved for use on the hands and reduces the appearance of deep wrinkles and creases on the face.

What is the best dermal filler?

There are many types of dermal fillers, each with its own formulation and ideal applications. The best way to determine which dermal fillers are best suited to your anatomy, specific concerns, and unique aesthetic goals is by consulting with an expert injector in the field of cosmetic dermatology, such as internationally renowned board-certified dermatologist Dr. Michele Green in NYC. Dr. Green’s specialty is non-surgical cosmetic rejuvenation, with over two and a half decades of experience providing the best cosmetic injections. She takes on a less-is-more philosophy regarding dermal fillers, which always yields beautiful, natural-looking, and long-lasting results. When you consult with Dr. Green at her private dermatology office, she will work with you to create a customized treatment plan for your dermal filler procedure that best suits your needs.

How much dermal filler do I need?

The amount of dermal filler required for one’s treatment plan will ultimately depend on the type and severity of the skin concerns being addressed, the patient’s age, and the type of dermal filler used. For example, patients interested in lip augmentation or treating undereye hollows typically require a single syringe of hyaluronic acid filler to achieve long-lasting, natural-looking facial rejuvenation results. In contrast, patients undergoing non-surgical body contouring procedures, such as the Sculptra BBL, can require more than 30 total vials of Sculptra to get their ideal results. The best way to determine how much dermal filler is needed to address your particular concerns and provide optimal results is by consulting Dr. Green at her private dermatology office in NYC.

How far does 1 ml of dermal filler go?

It may be hard to imagine the degree of facial rejuvenation just 1 ml of dermal filler can achieve. One ml is the same as one teaspoon of product. For many patients, 1 ml of dermal filler is enough to produce subtle, natural, yet beautiful cosmetic results. Younger patients typically only need 1-2 ml of product to achieve their desired results. Patients with more evidence of fine lines and wrinkles, facial folds, volume loss, and skin laxity can inject several ml of product in one treatment session without risking looking “overdone”. r. Green is an artful injector and prefers to embrace a “less is more” philosophy regarding cosmetic injections. Many patients are satisfied with the phenomenal results Dr. Green can provide them with just a single syringe of dermal filler.

How long does it take for dermal filler to settle

One of the greatest benefits of dermal fillers is how quickly the results are apparent. Many patients observe some improvement immediately following their dermal filler procedure. Some types of dermal filler take longer to produce observable results. For example, Sculptra, a collagen stimulator made of poly-L-lactic acid, takes several months to show results. Patients can expect to observe the final results of their hyaluronic acid dermal filler procedure two weeks after the injections after the swelling reduces. Swelling is a common side effect of dermal filler injections lasting up to two weeks after the treatment. Though the amount of time it takes for dermal fillers to settle will vary from filler to filler, most dermal filler products settle within the first two weeks of treatment.

Does exercise dissolve dermal fillers?

No! Currently, no evidence indicates exercise influences the longevity of dermal filler treatment. Refraining from strenuous exercise for at least 48 hours following dermal filler injections is still recommended to prevent excessive swelling or bruising. On average, the cosmetic effects of most dermal fillers last 6-12 months. The absorption rate of your dermal filler will ultimately depend on the speed of your metabolism, the area of the face that was injected, and the type and amount of dermal filler used. In your consultation with Dr. Green, you will have the opportunity to learn more about the ideal timeline for treatment with dermal fillers and how to achieve and maintain your desired results.

What is the best dermal filler for the undereye area?

Dermal fillers can be injected into the tear trough to reduce the appearance of dark circles and puffiness under the eyes. The best candidate for injectable fillers in the tear trough is a healthy individual with volume loss or a natural hollow in the under-eye area. The preferred dermal fillers for this treatment area are composed of hyaluronic acid gel and have a small particle size. Dr. Green often uses Belotero and Restylane hyaluronic acid fillers to improve the look of under-eye hollows and bags.

Belotero Balance is a hyaluronic acid filler that is flexible, thin, and easily integrated into the skin, making it an excellent dermal filler for the under-eye area. The formulation of Belotero eliminates the risk of having the side effect known as the Tyndall effect. The Tyndall effect is the term for the appearance of a blue tint to the skin in a treatment area after having filler. The Tyndall effect occurs when light is reflected off the particles suspended in the gel filler. It is impossible to encounter the Tyndall effect with Belotero injections, making it an excellent option for undereye rejuvenation.

Restylane Eyelight was approved by the FDA in 2023. Restylane Eyelight is the first hyaluronic acid dermal filler approved specifically for treating under-eye hollows. Using cross-linking NASHA gel technology, Restylane Eyelight boosts volume when injected into the tear trough area, erasing under-eye bags and dark shadows created by a lack of volume or a natural hollow under the eye.

The perfect dermal filler for treating your under-eye concerns depends on your facial anatomy and cosmetic goals. The best way to determine which dermal filler product is most appropriate for your needs is by consulting with Dr. Green.

What is the best dermal filler for the nasolabial folds?

The nasolabial folds or smile lines are the creases extending from the mouth’s outer corners to the nose on both sides of the face. The most commonly used dermal filler products for improving the appearance of smile lines include Radiesse, Restylane, Juvederm, and Sculptra. An experienced injector, such as board-certified dermatologist Dr. Michele Green in NYC, can evaluate your specific situation and needs and determine which dermal filler best suits your goals.

What is the best dermal filler for the lips?

Lip fillers work beautifully to add volume and enhance contour, creating a perfect pout. Hyaluronic acid fillers like Restylane Kysse, Restylane-L, Juvederm Ultra XC, and Juvederm Ultra Plus are excellent dermal fillers for lip augmentation. Hyaluronic acid, the active ingredient in Restylane and Juvederm dermal fillers, naturally attracts water. When injected into the lips, the filler provides immediate enhancement, promoting moisture retention for a plump, hydrated look. Lip augmentation is a customizable treatment with dermal filler injections, allowing patients to achieve a subtle enhancement or a more dramatic, fuller volume. When you consult with Dr. Green, she will work with you to select the dermal filler best suited to your particular lip augmentation goals.

Can you be allergic to dermal fillers?

An allergic reaction is a rare yet serious potential side effect of any injectable. An allergic reaction to a dermal filler may be characterized by developing symptoms such as itching, swelling, tenderness, redness, or small bumps or nodules at or near the injection sites. A patient who has been treated with hyaluronic acid dermal fillers and has developed nodules due to an allergic reaction can, typically, have the bumps dissolved with injections of Hyaluronidase. Hylenex and Vitrase are the brand names for the injectable enzyme called hyaluronidase, which dissolves the nodule and reverses the effects of hyaluronic acid filler injections. Should you notice the formation of any such nodules, it is important to alert your injector immediately so that it can be properly treated and reported to the dermal filler manufacturer. You should not have dermal filler injections if you have a known allergy to any of the injectable ingredients.

Can you tell if someone has fillers?

The best dermal filler treatments should be virtually undetectable to someone passing by on a busy New York street. The goal of cosmetic treatment with dermal filler injections is to enhance the natural beauty of each individual patient while reducing the appearance of various signs of aging. Dr. Green embraces a less-is-more philosophy regarding facial rejuvenation with cosmetic injections to ensure that all her dermal filler treatments are artfully performed with long-lasting, natural-looking results.

What is hyaluronic acid dermal filler?

According to the American Society for Aesthetic Plastic Surgery, hyaluronic acid fillers are among the top five most popular non-surgical cosmetic procedures. Hyaluronic acid dermal fillers are composed of hyaluronic acid, a naturally occurring substance that provides the skin with essential hydration and youthful suppleness. HA fillers are used to fill facial wrinkles, restore volume loss, enhance the lips, reduce acne scars, and provide contouring and definition to the jawline and chin. Some of the most popular types of hyaluronic acid dermal fillers include Juvederm, Restylane, and Belotero, all of which Dr. Green offers at her private dermatology office in Manhattan’s Upper East Side neighborhood. The results achieved with hyaluronic acid fillers last 6-18 months, with most patients engaging in regular dermal filler treatment sessions to maintain the best effects.

How to sleep after dermal fillers

Patients enjoy the fact that, with dermal filler treatment, there is very little aftercare and essentially zero downtime involved. However, patients should avoid sleeping directly on top of the treatment area for 24-48 hours following injections. Instead, after having a facial filler procedure, patients should sleep on their back in a slightly elevated position to keep pressure off the area. When you have your dermal filler treatment with Dr. Michele Green in NYC, she will provide you with all the pertinent aftercare information for your procedure to achieve and maintain the best rejuvenation results.

Can I buy dermal fillers online?

No one should purchase dermal fillers or other cosmetic injectables online. In addition, no one should have dermal filler treatments with an unqualified injector or in a non-medical setting. Although used for cosmetic purposes, dermal fillers are classified by the FDA as medical device implants. Injectable fillers should only be used by board-certified dermatologists with experience and knowledge of their unique properties.

Dermal filler products that are available for purchase online are not guaranteed to be safe and effective for injection and should not be used. It is crucial to consult a reputable board-certified dermatologist, like Dr. Michele Green, for your cosmetic injections. Having dermal filler injections with a highly experienced board-certified dermatologist guarantees that you encounter the least amount of risk and achieve the best possible cosmetic results.

Do dermal fillers cause cancer?

Dermal fillers do not cause cancer. There is no evidence that facial fillers are linked to cancer. The FDA approval demonstrates the safety and efficacy of dermal filler products. In addition, other cosmetic injectable treatments that are provided in the office of a board-certified dermatologist, including Botox and other neuromodulators, are safe and effective options for rejuvenation that are not connected with any long-term dangerous side effects.

Who can inject dermal fillers?

Dermal fillers are considered medical device implants by the FDA due to the knowledge, training, and expertise required to perform injections. As such, only board-certified medical professionals should provide dermal filler injections. A board-certified dermatologist, such as Dr. Green in NYC, has sufficient training to safely and effectively administer dermal filler injections. It may be unsafe to rely on a beautician or injector in a medical spa setting to provide injectable treatments. Medical spas are supposed to operate under the supervision of a physician. However, most cosmetic procedures in a med spa setting are often delegated to non-physicians to perform while a physician may or may not be onsite. Suppose dermal filler treatments are administered by someone without adequate training or the required presence of a medical expert. In that case, it can lead to greater risks during treatment, such as a dermal filler being injected directly into a blood vessel. This could result in severe side effects, including vision impairment, stroke, and skin necrosis. Dr. Green is a world-renowned, board-certified cosmetic dermatologist and master of dermal injections, and the safety and satisfaction of her patients are her top priorities.

Currently, in the United States, dental practices can administer Botox or other dermal fillers, provided the injectable treatment is directly tied to a dental treatment. However, cosmetic injectable treatment is outside of the purview of dental professionals. Only a board-certified dermatologist should administer cosmetic injectables to avoid unwanted side effects and produce the best cosmetic results. Dr. Green has over two and a half decades of experience providing the best cosmetic injectables and the aesthetic expertise to provide a superior patient experience.

How to get started with dermal filler treatment

Dermal fillers are an excellent non-invasive treatment option for replenishing volume loss, enhancing certain facial features and contours, and providing a youthful appearance. In addition to eliminating the appearance of fine lines and hollows, dermal fillers can be used for non-surgical body contouring, reducing acne scars and stretch marks, and stimulating new collagen production. Dermal fillers are a popular alternative to cosmetic surgery due to the lack of downtime, the ease of having a dermal filler procedure, and the consistently stunning rejuvenation results that can be achieved. There are many different types of dermal fillers with distinct properties and ideal uses. To guarantee the safety and efficacy of your dermal filler treatment, get optimal results, and avoid unwanted potential side effects, it is critical to have injections with an experienced board-certified dermatologist. When you have cosmetic injections with an expert like Dr. Green, the result is long-lasting, natural-looking revitalization.

Dr. Michele Green is an internationally renowned expert in cosmetic dermatology with over 25 years of experience providing some of the world’s most discerning individuals with the best non-invasive cosmetic procedures, including dermal filler and Botox injections. Dr. Green takes a holistic approach and embraces a less-is-more philosophy regarding facial rejuvenation and body augmentation, customizing each patient’s treatment protocol to cater best to their particular skin concerns and overall aesthetic goals. She is consistently identified as one of New York’s best dermatologists by New York Magazine, Super Doctors, Castle Connolly, and the New York Times for her dedication to her patients and expertise. Dr. Green’s artistry makes her one of the most highly sought cosmetic injectors in New York. To schedule a consultation with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood and learn more about dermal fillers, please contact us online or call 212-535-3088.