Facial Fillers - Overview

Facial fillers are what they sound like. They fill in! They replace soft tissue that has been lost as we age. If you look at a child’s lovely face, they don’t have lines or wrinkles because they have an abundance of fat in their face. As we age, we usually gain fat in the lower half of our body and lose fat in our face.

In addition, there can be loss of skin elasticity as we age. Think of our skin as the wrapping paper and the fat and muscles of our face as the package. If the package shrinks with ageing, then the skin will hang and sag. Fillers can take up much of that laxity and, in fact, people refer to the addition of several cc’s of fillers as a “liquid facelift”.

Lip Fillers - Overview

This is a very popular procedure these days. There seem to be two distinct groups of women (and occasionally men) that desire this procedure: women in their early 20’s, who have been heavily influenced by what they see on social media. And women in their 50’s and 60’s who have noticed that their lips are thinning as they age (not their imagination, it is happening!).

1What is a facial filler and how is it different than Botox?

Facial fillers are what they sound like. They fill in! They replace soft tissue that has been lost as we age. If you look at a child’s lovely face, they don’t have lines or wrinkles because they have an abundance of fat in their face.

As we age, we usually gain fat in the lower half of our body and lose fat in our face. In addition, there can be loss of skin elasticity as we age. Think of our skin as the wrapping paper and the fat and muscles of our face as the package.

If the package shrinks with ageing, then the skin will hang and sag. Fillers can take up much of that laxity and, in fact, people refer to the addition of several cc’s of fillers as a “liquid facelift”.

Botox is a drug which is injected which causes the muscles to stop contracting. Botox is largely used in the upper face: the crow’s feet, between the eyes and the forehead.

2What types of lip fillers are there?

There are a few fillers that Dr. Berman believe are better suited for use in the lips, over the plethora of fillers that are now on the market.

Dr. Berman personally prefer Volbella and occasionally, Juvaderm Ultra (not Ultra Plus). Dr. Berman prefer these because they are softer and you want a soft filler in your lips.

Generally speaking, the softer fillers last a shorter period of time, compared to the more cohesive fillers, such as Voluma, which are firmer.

Volbella, will last about one year and Voluma, which is better suited for deeper injection than the lip area (such as the nasolabial folds or over the cheek bones) will last about 2 years.

Juvaderm Ultra is somewhat firmer than Volbella and gives a somewhat elevated ridge at the top edge of the lip, which Dr. Berman personally do not like but Dr. Berman have noticed that some women in their 20s prefer (no doubt due to social media).

Dr. Berman is wary of using fat in the lips because it can be tougher to make sure it is perfectly smooth and it cannot be dissolved like the fillers above.

3Where are fillers commonly injected?

They are commonly and effectively injected along the infra-orbitial rim, zygomatic arch, into the cheeks themselves, into the tear trough, the nasolabial folds, the upper and lower lips and the areas above and below the lips, in the pre-jowl hallowing. into the cervical-mento line, into the temple hollowing, into a deep furrow in the glabellar line. Basically anywhere on the face where it can be helpful to add volume.

4Will I look unnatural?

None of our patients want to look like those movie stars who look way over-injected and who resemble Daffy Duck more than they do a person. The key is not to place too much filler.

Dr. Berman always explains to his patients that it is better to ERR on the side of caution and place a bit too little and come back in a week or two and buy some more filler, than overload an area.

5Will the injection hurt?

The injection should be almost painless. You are getting an injection but it is very manageable.We never use blocks etc. Most if not all of the fillers that we use,are already mixed with lidocaine. This will render the area numb.

6What should I avoid before my appointment to get fillers?

It is best to avoid Aspirin, Bufferin or any type of blood thinner for the week before. It is also better to avoid drugs like Motrin, Advil, Ibuprofen etc. Tylenol is fine since it does not interfere with blood clotting.

7Which fillers does our clinic commonly use?

Juvaderm, voluma, vollure, volbella, and  occasionally your own fat.

8What are the potential problems with lip injections?

It can be a bit uncomfortable during the injection. I think it is totally unnecessary to use nerve blocks. I have my patients apply an ice pack for about 30 seconds beforehand and with good injection technique are all that is required.

I have done a large number of lip fillers with no complaints of significant discomfort. In addition, the fillers already have lidocaine mixed in with them. There can be bruising, and although this is not common, it can happen.

There can be swelling. Everyone will have a little bit of swelling and I always tell my patients to give it 10-14 days to completely settle in place, before considering any changes or adjustments. I have had a very small number of patients, who have had a lot of swelling in the lips after the injection.

It was not clear why. It was not an allergic reaction. It settled down but took a few weeks to do so. This has only happened about 2 times in the very large number of patients, I have injected with fillers.

9After injection lip care

I don’t think you need to do anything. You certainly can go exercise or eat anything you want. If you have nothing else to do, then you could ice it for a few minutes to minimize any swelling. Definitely avoid taking aspirin or any blood thinners for a week before.

10How long do fillers last?

Different fillers last different lengths of time. Volbella lasts about a year, However, in some individuals when it is injected in the lips, it can last a shorter period of time. Voluma lasts about 2 years. Vollure lasts about 18 months.

11Will I bruise?

The vast majority of patients will not bruise. However, anytime you are stuck with a needle, you can get a bruise. If you get a bruise, it can last 2-3 weeks, so be aware of this.

You do not want to do this 2-3 weeks before an important social event, in case of bruising. Of course, you can cover any bruise with make-up.

12My best advice

Do not overdo it. I strive for a natural look. It is much better to undercorrect than to overcorrect. It is always better to put some in now and then in a few weeks (or months) later, to add more.

If you have extremely thin lips, you can only add a small amount at a time, to stretch the red part of the lip, so that you can add more at a later date. If you try to add too much at once, it just looks like you got punched in the lips, not an attractive look!

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Testimonials

  • I just had my upper lip filled and to my surprise, it was quick and painless. I'm 41 years young and i've noticed my upper lip was starting to look uneven and not as full as it use to be. Dr. Berman made my lips come to life again. I'm very pleased with the results. I highly recommend him and his staff.
  • I actually have great lips (to toot my own horn) but I wanted a little "mmfph"/ definition to my top lip for when I wear makeup, specifically lipstick. I decided to see Dr. Berman for this because he is known to make people look naturally fabulous. We decided on volbella because it would give me the natural look I desired since I already had full lips. I only got my top lip treated. The injections themselves weren't that bad and once Dr. Berman was done I loved the look. He did warn me however that for the next 2-5 days I may experience sensitivity to the injection sites, swelling, and even potential discomfort. I experienced all those post procedure symptoms. I actually freaked out a little bit because my top lip was so swollen I thought something was wrong. But the staff at the office reminded me that this was completely normal and the second day was going to be the worst. They were absolutely right. I got my treatment done on a Tuesday and by Friday evening I felt pretty again and it was back to exactly what I wanted. I love this office because the staff are honest and caring and Dr. Berman is such a skilled doctor and so calm and collected. If I decide to do this again, there is no question I would come back!! Thank you Dr. Berman and staff! You guys are amazing 🙂
  • I have been thinking about getting lip fillers for a little over a year now. I am 33 years old, and while everyone told me I had nice lips, I wanted more. Hesitant that the outcome would be the infamous “duck lip” look, I did a lot of research before making my decision to go with Dr. Berman. Not only did he take the time to explain the entire procedure to me beforehand, but he continued to talk through everything as he was injecting my lips. He made me feel comfortable every step of the way, and even explained what the healing process would be like over the next 2 weeks. I am so happy with my new look. My lips are the perfect shape & size, and very natural. I will be returning to Dr. Berman not only for lip fillers, but for all procedures going forward. I am one very happy new patient!
  • I went for lip fillers, only in my top lip, and my results were great, only slight swelling. The entire procedure was pretty much painless, getting the flu shot and tensing ur muscle hurts way more then this. It is like a one sec sting and then you cannot feel anything. I have a low pain tolerance. I loved how honest he was, I thought I needed filler under the eyes but he actually thought otherwise and informed me that the pigment under my eye will not go away with just fillers and made other suggestions for me. His staff was super kind and I will def be back, for many other services his office offers. I would recommend his office to family and friends.
  • Dr. Berman was very gentle and professional with his work detail. I felt very comfortable with him, he listened to exactly what I was looking for. I would recommend him to anyone who needs a great doctor for Lip fillers.
  • I am a 30 year old male. I never had any fillers done before other than some Botox. I recently visited Dr Berman to get a filler for my nasolabial folds (smile lines). The overall experience was great. Very friendly staff and the doctor did a very nice job. I am pleased with the result! I would highly recommend them.
  • I had visited another plastic surgery office that a friend suggested and was immediately told that I needed very expensive surgery... no discussion of any other options. I went to Dr. Berman because I had seen him several years ago for a dog bite and he was very up front and honest telling me that the ER doctor had done a fine job on the stitches and no further treatment would be necessary. After all these years, it was the same with my visit yesterday. He suggested the filler that would work best for my situation and went over all the pros and cons and made me feel very good about the treatment. I will definitely be going back to his office for future treatments. In addition, his staff is very helpful and makes you feel comfortable while you're there. Great doctor and great staff!
  • I've been going to Dr. Berman for years - he has kept me looking young through Botox, Juvederm, and other procedures. I have so much respect and appreciation for his efforts and my results. Dr. Berman (and his entire team) is professional, attentive, and dedicated to his clients. I am so very happy that I made the decision to make Dr. Berman my cosmetic surgeon.
  • Dr. Berman was very informative and helped me to decide on the best option for Juvederm. I required minimal fillers and it really took five years of my face. No bruising, and he was very gentle. Highly recommend. I also received my first treatment of Sculpture will add another review once I start to see results.
  • Dr. Berman does an amazing job of turning back the clock with the use of Botox and Fillers. As a wife and mom in my thirties, I rarely ever have time for myself. When I first started coming to Dr. Berman's office, he did an amazing job of thoroughly explaining to me what he would recommend for me regarding facial fillers. He also makes sure that I am comfortable during the entire visit. I am always happy with my final results and people constantly think that I am still in my twenties! I'll take that!! Thanks Dr. B!!

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