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As we age, production of the structural proteins, collagen and elastin, begins to decrease. Collagen and elastin are responsible for giving the skin structure and support, and as collagen production decreases, fine lines and wrinkles become etched into the skin, volume loss occurs in the mid-face, the skin starts to sag, and the lips begin to thin. Taken altogether, these signs of the natural aging process can be distressing, causing patients to feel self-conscious and seek an alternative. Many people falsely believe that in order to fully reverse these signs of aging, you must seek surgical treatment from a plastic surgeon, however, there are a wide variety of non-surgical options available to combat wrinkles, volume loss, and sagging skin. One such non-surgical treatment available at Dr. Michele Green’s New York City Dermatology office that works wonders to combat signs of aging is hyaluronic acid dermal fillers.

Hyaluronic acid (HA) dermal fillers are composed of the naturally occurring hyaluronic acid and are used to fill in facial wrinkles, restore lost volume, enhance the lips, fill in acne scars, and provide contouring and definition to the jawline. According to the American Society for Aesthetic Plastic Surgery, HA fillers are in the top five most popular non-surgical treatments available on the market. With the hydrophilic hyaluronic acid, HA fillers are able to plump and hydrate the skin, filling in nasolabial folds, marionette lines, glabellar lines, under eye hollows, and provide volume to thinning lips and a receding chin. The naturally occurring hyaluronic acid means there is a very low risk for allergic reactions or adverse events, and the long-lasting treatment can be performed with no downtime.

Board-certified dermatologist, Dr. Green, has been expertly treating patients in her Upper East Side New York City office for more than 25 years. A highly skilled injector known for her less-is-more approach to dermal fillers, Dr. Green has years of experience treating patients with many different types of dermal fillers, including Juvederm, Restylane, Belotero, and Sculptra. In addition to soft tissue fillers, Dr. Green’s office offers a wide range of medical and cosmetic treatments, including Botox, chemical peels, microneedling, laser treatments, CoolSculpting, and more. Praised for her high patient satisfaction, Dr. Green has been voted one of the best healthcare providers in New York City by such publications as Castle Connolly, Super Doctors, and New York Magazine.

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What is hyaluronic acid fillers

Hyaluronic acid fillers (HA fillers) are a type of dermal filler with the key ingredient within the filler itself being hyaluronic acid. Hyaluronic acid is a naturally occurring substance in the body that is extremely hydrophilic, meaning that it attracts water, which helps to keep the skin hydrated and plump. However, as we age, production of hyaluronic acid decreases along with production of collagen, which contributes to the formation of dry, wrinkled, loose skin. Hyaluronic acid fillers can be used as a way to reverse these signs of the natural aging process. Depending on the thickness and formulation of the filler itself, HA fillers can be used on many areas of the hands and face, including the lips, nasolabial folds, marionette lines, glabellar lines, chin, jawline, under eye hollows, and midface. The effects of the treatment can be seen immediately and can last for between one to two years for a full facial enhancement.

How do hyaluronic acid fillers work?

Hyaluronic acid fillers are used to add volume, contour, hydrate, and rejuvenate the treatment area. While each type of hyaluronic acid filler is slightly different in composition and formulation, each contains cross-linking technology to provide structure to the treatment area . Hyaluronic acid filler is also unique in that the HA contained in the filler helps to attract water, which hydrates the skin and leads to a plumper, more youthful appearance.

What is the procedure for receiving hyaluronic acid filler treatment?

The process of receiving hyaluronic acid fillers is quick, simple, and safe, and the treatment can easily be performed in Dr. Green’s office in 15-30 minutes, making it a true “lunch-time” procedure. In the week before coming into the office for the treatment, Dr. Green recommends refraining from blood thinners, such as ibuprofen and aspirin, in order to limit the risk of bruising. Once Dr. Green has determined the type of hyaluronic acid filler that will work best for you, she will begin by marking the injection site. Typically, no topical anesthetic is needed as most HA fillers are formulated with the anesthetic lidocaine to improve patient comfort during the procedure. The filler is injected using an ultra-thin needle for maximum precision. Following the treatment, Dr. Green recommends icing the treatment area, staying hydrated, and refraining from the consumption of alcohol and blood thinners for several days. Any mild side effects, including bruising and swelling, should abate within 3-5 days following the procedure.

What are the different types of dermal fillers?

Dermal fillers can be composed of various ingredients in order to provide volume and fill in wrinkles and creases on the face. There are several main types of dermal fillers that are used for cosmetic procedures that are available at Dr. Green’s office. When you have your initial consultation with Dr. Green, you will discuss your treatment goals, and she will determine the treatment option that is best for you.

Calcium Hydroxylapatite Fillers

One type of dermal filler is calcium hydroxylapatite fillers (CaHA fillers), that are composed of a substance found in your bones. The treatment can be used to treat deeper wrinkles and helps to boost the body’s natural collagen production for effects that last for up to a year. The most common brand of CaHA filler is Radiesse, which is frequently used to replace volume loss that occurs in the mid-face. In addition to immediately restoring lost volume with patented microsphere technology, Radiesse promotes collagenases, which is the production of collagen, for improved results over time.

Polymethylmethacrylate Fillers

Polymethylmethacrylate fillers are formulated with collagen and tiny spheres that remain under the skin following the injection. These small spheres work to immediately provide volume to the skin, and give the skin a firm feeling and look. The most common brand of Polymethylmethacrylate filler is called Bellafill.

Poly-L-lactic Acid Fillers

Poly-L-lactic acid fillers are a synthetic form of injectable filler that immediately provides volume to the skin and promotes the production of collagen in the treatment area over time. The treatment is best used to address deep wrinkles and combat volume loss and deep hollows in the midface and under the eyes. The most common form of Poly-L-lactic acid filler is Sculptra, which can last for two years or more, and was first FDA-approved in 2009.

Hyaluronic Acid Fillers

Hyaluronic acid fillers are composed of the naturally occurring substance, hyaluronic acid, which is important in keeping the skin hydrated and plump. As we age, the body begins to produce less hyaluronic acid and collagen, which results in the formation of wrinkles, sagging skin, and volume loss over time. Hyaluronic acid fillers, such as Restylane, Juvederm, and Belotero, help to restore lost volume, fill in creases and wrinkles, and contour the jawline. Hyaluronic acid fillers are advantageous in that there is a low risk of allergic reaction, as the composition of the filler is naturally occurring in the body. Most hyaluronic acid fillers last for up to one year.

ER 45 yo female before after Juvederm Ultra Plus 1 syringe lips and nasolabial and Voluma 2 and a half syringes in cheeks 2 months apart LEFT MGWatermark

What are the different families of hyaluronic acid dermal fillers?

There are many different hyaluronic acid fillers available at Dr. Green’s dermatology office that can be used to specifically address a variety of areas on the face and body. With many options available, deciding which is best for you can be a challenge, which is why it is important to consult with an expert dermatologist, such as Dr. Green, who can recommend either Juvederm, Restylane, or Belotero.


One of the most popular families of soft tissue fillers with a portfolio of different options to treat many areas of the face and body is the Juvederm family of dermal fillers. Produced by Allergan Aesthetics, Juvederm facial fillers are long-lasting and effective at restoring lost facial volume, correcting creases and wrinkles, and lip enhancement. The FDA-approved members of the Juvederm portfolio are as follows:

Juvederm Ultra Plus – Juvederm Ultra Plus was one of the first Juvederm filler products to be FDA-approved and is used to address moderate to severe wrinkles or creases, such as the marionette lines and nasolabial folds. The treatment can last for up to a year.

Juvederm Voluma – Juvederm Voluma is FDA-approved to specifically address age-related volume loss in the midface, and can be used for cheek augmentation and volume restoration. When injected into the subcutaneous layer – or deep dermal layer – Juvederm Voluma provides patients with a contoured, hydrated, youthful-looking midface shape. Juvederm Voluma lasts for up to a year in the midface.

Juvederm Vollure – Designed and FDA-approved to treat moderate to severe facial wrinkles and folds, Juvederm Vollure is an excellent option as a part of full facial rejuvenation. Juvederm Vollure works best to address wrinkles such as the nasolabial folds and marionette lines – also known as smile lines, – and can last for up to a year.

Juvederm Volbella – Juvederm Volbella is the member of the Juvederm family specifically designed for lip augmentation, and to eliminate the appearance of fine lines surrounding the lips, including the perioral lines. Perioral lines, which are also known as vertical lip lips or lipstick lines, are often most apparent when puckering the lips and extend vertically upward and downward from the lips. Juvederm Volbella works to erase these lines and plump the lips. The treatment lasts for up to a year.

Juvederm Volux – The newest member of the Juvederm portfolio to receive US FDA-approval, Juvederm Volux is designed specifically for chin and jawline enhancement. The treatment works to contour the jawline and provide patients with their ideal chin and facial proportions. Juvederm Volux lasts in the treatment area for up to a year.


The Restylane family of injectable fillers is also very popular among patients at Dr. Green’s NYC dermatology office. The line of HA fillers, produced by the company Galderma, is created using the proprietary XPresHan technology formulation to improve cross-linking for long-lasting support. Restylane products are designed to address a variety of concerns, including the elimination of moderate to severe facial wrinkles, lip enhancement, and correcting tear trough deformities. The FDA-approved members of the Restylane family include:

Restylane Silk – Composed of a smaller particle size than other fillers in the Restylane family, Restylane Silk was the first filler treatment that was designed specifically for the lips. The filler can be effectively used to create a well-defined cupid’s bow, for soft, full lips, and to smooth away fine lines surrounding the mouth.

Restylane Lyft – Where Restylane Silk has the smallest particle size of the Restylane fillers, Restylane Lyft has the largest. The filler is used specifically to address volume loss in the midface, and can be injected on the cheekbones to add volume. Restylane Lyft can last for up to a year in the treatment area.

Restylane Defyne – Restylane Defyne is and HA filler that can be used to eliminate moderate to severe facial folds, including the nasolabial folds and marionette lines. Restylane Defyne can also work for chin enhancement to address concerns regarding chin recursion and provide patients with the ideal lower face contour.

Restylane Refyne – Similarly to Restylane Defyne, Restylane Defyne can be used to address the nasolabial folds that form along the side of the nose and run along the mouth, and marionette lines. Restylane Defyne and Refyne differ in that Restylane Refyne has a more flexible formulation and is not as thick as Defyne, meaning that Restylane is best for mild to moderate facial wrinkles.

Restylane Kysse – Like Restylane Silk, Restylane Kysse has also been specifically designed for lip augmentation and to smooth away perioral lines. Restylane Kysse is used to add fullness and color enhancement to the lips, for smoother, more hydrated, plumper lips.


Created by the company Merz, Belotero is another hyaluronic acid dermal filler that is often used in the mid-face and under the eye. Formulated with the proprietary Cohesive Polydensified Matrix (CPM) process, Belotero works to integrate into the skin efficiently with a smooth and flexible gel. When it comes to injection technique, Belotero is injected using a very thin needle into the mid-dermal layer for soft tissue augmentation. The treatment lasts for up to a year and can be repeated annually for continued results.

How long do hyaluronic acid fillers last?

Hyaluronic acid fillers are a long-lasting, non-surgical solution to address deep wrinkles, volume loss, and contour and enhance the face. While the treatment is not permanent, results of the procedure can last for between one and two years, depending on the type of HA filler being used and the treatment area. Typically, Dr. Green recommends receiving an annual touch-up treatment in order to maintain the results of the procedure.

How long do hyaluronic acid lip fillers last?

There are several forms of hyaluronic acid fillers available specifically to treat perioral lines and enhance the lips, including Restylane Kysse, Restylane Silk, and Juvederm Volbella. These fillers typically have slightly smaller particle sizes compared to those that are designed for the midface and deep wrinkles, in order to provide augmentation to the lips while maintaining flexibility for facial expression. Most patients will be able to see the results of these fillers for up to a year, after which they should return to Dr. Green for a touch up appointment.

Are hyaluronic acid fillers safe?

Many clinical studies have been performed to determine the safety and effectiveness of hyaluronic acid dermal fillers, and researchers have shown that the treatment is safe and effective at reversing signs of the natural aging process. According to a study published in the National Library of Medicine (Dermatol surg; DOI: 10.1111/j.1524-4725.1998.tb00007.x), 78.5% of patients receiving hyaluronic acid dermal fillers showed improvements eight months after receiving treatment. Further, the study demonstrated that there were no major adverse events associated with the treatment, meaning no serious side effects, and any mild effects resolved on their own within several days. As such, not only is the treatment highly effective, it has been demonstrated to be very safe as well.

What are the side effects of hyaluronic acid filler treatment?

Much like any injectable treatment, there are mild side effects associated with hyaluronic acid filler treatment, including swelling, bruising, redness, bleeding, and lumps at or near the injection site in the several days following the procedure. These mild side effects will resolve themselves on their own and are typically no cause for concern. The risk of developing any more serious side effects is greatly decreased when you seek treatment from an experienced injector, however, if you receive treatment from a less experienced practitioner, you may be at risk for infection, migration of filler, scarring, blisters, numbness, scarring, and blindness. Injecting the filler into a blood vessel is also possible for less experienced injector and can lead to further adverse events, such as necrosis, which is the death of the tissue. That is why it is always best to have dermal filler treatment performed by an expert dermatologist, such as Dr. Green.

Can you have hyaluronic acid fillers when pregnant?

Dr. Green does not recommend receiving hyaluronic acid filler when pregnant or breastfeeding. If you are pregnant or breast feeding and looking for treatment for wrinkles, volume loss, or lip augmentation, it is best to consult with a board-certified dermatologist, such as Dr. Green, to determine a treatment that will be safe for you and for your baby. It may be best to wait until after the birth of your child to seek injectable treatment.

Can I use hyaluronic acid after fillers?

Not only is hyaluronic acid found in fillers, but it can also be found in skincare products that are meant to help hydrate the skin. At Dr. Green’s proprietary MGSKINLABs, she offer skincare products to help combat the natural aging process at home. Her Hydra Repair Hyaluronic Acid Serum helps to moisturize the skin and smooth the appearance of fine lines and wrinkles, which can be used at home after receiving hyaluronic acid fillers.

How much are hyaluronic acid fillers?

When patients ask, how much do hyaluronic acid filler cost, the answer is: it depends. The cost of treatment depends on many factors, including the patient’s geographic location, the type of institution at which you receive treatment, the type of filler being used, and the size and scope of the treatment area. For example, patients receiving only lip filler will pay less than patients who are receiving midface filler, as more syringes of filler will be necessary to fully address the treatment area. Typically, a single syringe of hyaluronic acid filler costs between $500-$1,000. Patients who receive treatment at the office of a board-certified dermatologist, may find treatment more expensive than at a MedSpa. However, the risk of severe side effects greatly decreases when you seek treatment from an expert, experienced injector, such as dermatologist Dr. Green.

Do hyaluronic acid fillers dissolve?

Over time, hyaluronic acid filler dissolves as it is metabolized by the body at the injection site, which is why the results of HA filler treatment are not permanent. However, if patients are unhappy with the filler treatment, hyaluronic acid-based fillers can also be dissolved, meaning the results of the treatment can be reversed at any time. That is why hyaluronic acid fillers can be a good option for patients who are new to fillers and are unsure if dermal fillers are the right option for them, as the filler can be dissolved at any time.

How to get started with hyaluronic acid fillers today

The natural aging process can wreak havoc on the face and body. As collagen production decreases, the skin begins to lose elasticity and structure, contributing to the development of deep wrinkles, fine lines, and creases, as well as a loss of volume in the midface, hollows under the eyes, and a receding chin. Luckily, hyaluronic acid filler, such as Restylane, Juvederm, and Belotero, are the ideal solution to combat these signs of aging. Perfect for filling in wrinkles and creases, augmenting the lips and chin, and filling in hollows or restoring lost volume, hyaluronic acid dermal fillers are also long-lasting and very safe when receiving treatment from an experienced injector, such as Dr. Green. To find out if hyaluronic dermal fillers are right for you, contact us online at our NYC based office or call 212 535 3088.

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