Non-surgical facial rejuvenation procedures are becoming increasingly popular among facial cosmetic patients. This is not surprising – the chance to reverse some signs of aging with a short procedure, involving almost no down time and a very easy recovery, is very appealing. Filler injections fit this description, and are among the most popular procedures performed at the Donath Facial Plastic Surgery. Below, you will find a complete introduction to the facial fillers we use.

How Fillers Work
As we age, there are two general processes that contribute to changes in appearance. First, soft tissue is lost, so the youthful character of skin gradually disappears. Second, skin becomes looser and less elastic, leading to sagging and wrinkle formation. Fillers work by reducing both of these trends. Like the name implies, fillers simply “fill” areas of soft tissue to stretch the overlying skin, flatten wrinkles, and create a full, youthful contour.
Types of Fillers
At our clinic, we use a full range of products to give our patients the best results. These fillers differ in their components, texture, and duration of effect. A summary of our available fillers is below.
- Restylane: made of hyaluronic acid; has a very soft, granular texture so is very effective in the lips and below the lower eyelids; lasts up to eight months.
- Juvederm: made of hyaluronic acid; has a soft and smooth texture which is effective in the lips, and can be used as an all-purpose filler; lasts up to one year.
- Radiesse: made of hydroxylapatite; has a relatively firm texture so is effective when injected into nasolabial folds, along the jawline, by the corners of the mouth, and in the chin; lasts up to two years but often needs a touch-up injection at one month.
- Captique: made of collagen derived from cows, so a skin test is required to test for allergic sensitivity; good all-purpose material for many areas; lasts up to six months.
- Artefill: made of polymethylmethacrolite and collagen from cows, so a skin test is required to test for allergic sensitivity; has a relatively firm texture so is effective when injected into nasolabial folds, along the jawline, by the corners of the mouth, and in the chin; is permanent.
Suitable Patients for Fillers
In general, any prominent wrinkle and skin crease can be improved with filler injection. The most common facial regions for treatment are the smile lines from the nose to the corners of the mouth (“nasolabial folds”), the lips, the circles under the lower eyelids, the cheeks, and the jawline in front of jowls. Fillers can also be used to reduce scars from acne or trauma. If you have any of these complaints, fillers may help. Ideal patients should also be using no blood thinning medications around the time of the injection, to reduce the chance of bruising
Non-surgical Rhinoplasty
In certain cases, fillers can be injected in the nose to improve its contour. It is therefore possible for some patients to avoid surgical nasal correction (rhinoplasty).
The Injection Process
Filler injections at the Donath Facial Plastic Surgery are performed by Dr. Donath, or by our nurse aesthetician. After a thorough discussion of your goals, and a complete exam of your facial features, you will be give an ice pack to hold against the areas to be injected. Rubbing alcohol will then clean these areas, and a local anesthetic will be used to numb the injection sites. The appropriate amount of filler will then be injected carefully, and molded to achieve the desired result. You will be able to follow the progress, so you are happy with the final amount of product used. Further application of ice will reduce any minimal soreness from the injections.
Anesthesia
Injecting in certain areas, such as the lips, nasolabial folds, and nose, can be very painful without anesthesia. Therefore, local anesthetic will be used whenever possible. Patients at our clinic are very surprised at the comfort they experience during the filler injection.
Recovery
Patients should avoid manipulating the injected substance. Other than this, there are no specific precautions or recommendations.
*Each patient is unique and individual results may vary.
Facial Filler FAQs
Fillers are best suited for patients who do not want surgery, but desire reduction or flattening of wrinkles or replacement of lost volume in certain areas. These include the lips, nasolabial folds, circles under the lower eyelids, cheeks, and the jawline in front of jowls. Some patients with complaints about their nasal appearance may also benefit from filler injections. If collagen is to be used, patients must show that they are not allergic to is by having a simple skin test performed four weeks before the injection. There are no medical contraindications to filler injections, but patients should not use blood thinning medications around the time of the injection to reduce potential bruising.
Fillers increase the volume of soft tissue, to create a more youthful contour and to flatten any overlying wrinkles.
The effects of a filler are seen immediately, so the process can be stopped when you are happy with the result.
Most fillers are temporary, and the duration of effect varies. The list of our fillers above gives their components and expected durations.
You will be able to feel the filler under your skin, but the only visible effects should be the cosmetic improvements created by the filler.
There is no limit to the number of injections a patient can have over time.
Since fillers simply add volume, they always have a consistent effect. However, as your face ages you may need different types or amounts of fillers.
Since the effects of most fillers are temporary, patients may eventually want to consider surgical procedures that can have a longer effect on wrinkle reduction and soft tissue enhancement. Also, fillers are not capable of lifting tissue.
What are the risks of filler injection?
Fillers are extremely safe. One risk of the injection process is bruising, which is rare and resolves quickly. Patients may also develop sensitivity to a particular filler, but this is very rare. Another potential risk is irregularity under the skin, which can be treated with massage or with removal of a small amount of filler.