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“Fillers” is a broad family term that includes any material designed for injection into or below the skin to treat facial lines and/or volume deficiencies. Most fillers are made from Hyaluronic Acid (HA), and the most popular ones are Restylane® and JUVÉDERM®.

Lines that benefit the most are static (or standing) lines as opposed to dynamic lines which result from underlying muscle activity such as smiling. Dynamic lines are best treated with BOTOX® Cosmetic to soften muscle contraction. With time, untreated dynamic lines become engraved as static lines.  Once that occurs, fillers with or without BOTOX® Cosmetic will help. When they are no longer sufficient, skin resurfacing might be considered. Lines most often treated include the nasolabial folds (smile lines), lines around the mouth (perioral marionette lines) and lines around the eyes and forehead.

Fillers are also used for facial volume replacement. As some individuals age, fat, i.e., volume, is gradually lost from the face. By replacing some of this volume loss with a filler, a more rejuvenated appearance can be restored in patients in whom volume atrophy is a significant component of aging (“non-surgical facelift”).

Of course, aging is more complicated than just loss of fat so filling does not equate to being 25 years old again and overfilling can result in an abnormal appearance. Still the use of facial fillers and BOTOX® Cosmetic can help to delay a facelift until the loss of facial skin elasticity becomes excessive. Their use after surgery can also continue to maintain or enhance a facelift. The drawback, and advantage, of HA fillers is that they are not permanent and that the material will be metabolized by the body in less than six months.


Choices for lip enlargement include various temporary fillers such as Restylane® or JUVÉDERM®. A temporary filler is the safest and most flexible option, but the drawback is that it needs to be repeated about every six months.

After application of a numbing cream, the filler is injected with a very small needle along the skin/lip junction and also into the lip. It should always be done very precisely and in great moderation to avoid a “duck lip” appearance which is very noticeable and not desirable.

Do avoid permanent filler options as they can end up appearing unnatural, irregular or create even worse problems, plus ‘fashions’ change.