Dermal Fillers

Dermal Fillers


Many changes occur in our appearance as we age, which usually begin in the internal dermal structure and make their way to the surface to become noticeable to us and others. One of those changes involves the natural displacement and loss of subcutaneous fat and in the face, which leads to a hollow appearance and the formation of wrinkles. As fat is depleted and skin begins to thin, muscles start to work closer to the skin’s surface, making smile lines, crow’s feet and other signs of aging more apparent.

Another issue you might see when you look in the mirror is skin that has lost its youthful elasticity and firmness. This change can be attributed to a depletion of collagen and elastin, two essential proteins that support the healthy vitality of our skin during our youth and young adult years. Over time, our bodies create less of both substances, so the dermal structure loses the support necessary to maintain youthfully supple skin and begins to thin. The stretching and loosening of the dermis exacerbate the loss of facial volume, resulting in the formation of wrinkles around the nose and mouth and jowls along the jawline.

From Dr. Barrett

“Dermal fillers have revolutionized minimally invasive rejuvenation. They are an important part of my practice because not everyone can afford the downtime associated with surgical procedures. The key with fillers is not to overdo it. We see so many people that have had overdone fillers because their provider was either inexperienced or did not want to say no. We don’t always recognize what we look like to the rest of the world and can easily become hyper focused on a particular area and infatuated with the immediate improvement every time we get filler done. Many times we say “no” to patients who want too much filler, or to patients who think that filler will make a difference in a certain area when in reality it will not help. Keeping things natural is the way to go.”

What are Dermal Fillers?

Dermal fillers tend to be one of the most requested anti-aging treatments today, due to their ease of use and their ability to create a variety of quick improvements. Dermal fillers help to smooth away facial lines and replenish lost volume and fullness in the face. They can also correct nagging imperfections that aren’t necessarily associated with aging, such as shallow scarring and facial asymmetries. Dermal fillers can be integral for those with early signs of aging when used alone, or as a component in facial rejuvenation surgery to enhance results further.

Are Dermal Fillers Right for You?

Dermal fillers are a good option for men and women looking to turn back the clock or camouflage imperfections without incisions or downtime. These formulas work on all skin tones and types, and an array of products allow for them to be used safely and successfully on nearly any area of the face. Most fillers contain synthetic ingredients that mimic natural ingredients in the body, so the risk of irritation or an allergic reaction are extremely low. They are not derived from animals.

Dermal fillers are not the best choice for individuals with significant aging symptoms. These products are not effective in reversing severe skin laxity – only surgical procedures can deliver desired results in these instances. However, dermal fillers can be used with facial surgery to boost the benefits and enhance the overall outcome.

Who Should Administer Your Dermal Filler?

Dermal fillers are frequently performed by a variety of providers, including plastic surgeons, nurse practitioners and med spa employees that have been certified in the procedure. However, the fact that many people offer this procedure does not mean you will receive the same standard of care or superior results from every provider. Dr. Barrett and his nurse injector not only has the training and qualifications to administer your dermal fillers, but they will also take the necessary time to ensure they understand your concerns and the goals you would like to achieve. You can have confidence in knowing Dr. Barrett is committed to ensuring your experience at Barrett Plastic Surgery is a positive one, whether you come in for a quick injectable treatment or schedule breast enhancement surgery.

Benefits of Dermal Fillers

Dermal fillers offer a host of benefits to the right patients. In just a few minutes of treatment time, dermal fillers can be used to accomplish the following enhancements:

  • Add volume to the lips
  • Fill in shallow contours
  • Soften facial creases and wrinkles
  • Elevate recessed scars
  • Correct minor asymmetries
  • Reverse hollowing in the midface
  • Minimize early jowl formation on the jawline

With an array of formulations to choose from, Dr. Barrett will tailor your procedure to your precise needs. The goal of dermal fillers is to produce a natural, aesthetically-pleasing change to the face that refreshes your appearance and reduces nagging imperfections that make you self-conscious about your looks. Depending on the filler used and the areas treated, you can expect to enjoy your enhancements for many months before another session is required.

Options in Dermal Fillers

With many products and formulations to choose from, you can rest assured there will be a dermal filler appropriate for you. Some of the options offered at Barrett Plastic Surgery include:


The Juvederm family features a line of hyaluronic acid fillers with a smooth consistency that can address different concerns. Hyaluronic acid is a substance in the body that supports the dermal structure and keeps skin hydrated. The synthetic HA found in the fillers is biocompatible, with minimal risk of irritation or an allergic reaction. The XC listed after the name of each product refers to an anesthetic in the formula that increases the comfort level of the patient during the procedure. Specific products include:

Juvederm XC

The first formula created for the Juvederm family continues to be a popular option for smoothing away wrinkles around the nose and mouth. It is frequently used to treat parentheses lines that appear in the corners of the mouth and nasolabial folds that extend from the mouth to the chin.

Juvederm Vollure XC

This newer addition to the Juvederm line contains innovative crosslinking technology that utilizes different molecular weights of hyaluronic acid particles. Known as Vycross technology, the different weights serve to produce a slightly different consistency that tends to work better for some patients. In addition, the results from Vollure tend to last a bit longer overall.

Juvederm Voluma XC

Lines and wrinkles aren’t the only aging symptom our patients want to reverse today. Volume loss, due to collagen depletion in the midface, can also make you look older than you feel. Voluma is a thicker formulation that fills out the midface to eliminate hollowing and redefine cheekbones for a more youthful facial profile. It is also the only filler in the Juvederm line that offers results for up to two years at a time.

Juvederm Volbella XC

The midface is not the only area that loses fullness over time. The lips can also begin to thin, making you look perpetually angry or worried. In addition, fine lines can start to feather upward from the upper lip, which are often called smokers lines or lipstick lines. Volbella is another formula that uses Vycross technology to add subtle volume to the lips and reduce the appearance of lipstick lines.


Restylane also features an extensive line of products containing hyaluronic acid. There are subtle differences between the Restylane and Juvederm formulations, and Dr. Barrett will advise you as to which product he believes will work best for you. The Restylane group of dermal fillers includes the following:


The original Restylane formula is still an excellent choice for smoothing away wrinkles and creases around the nose, under eye and mouth. The solution is often recommended for parentheses lines, nasolabial folds, tear trough and marionette lines that run from the mouth to the chin, resembling a marionette doll. Restylane is also FDA-approved for adding volume to the lips.

Restylane Silk

While Restylane can be used to plump up the lips, Restylane Silk is designed explicitly for this purpose. The formulation is silky smooth, with smaller particles that provide a natural boost to your lip definition. Restylane Silk also works to smooth away the lipstick lines that appear above the upper lip.

Restylane Lyft

Restylane Lyft is an excellent option for those who wish to add subtle lift and volume to the midface. The formulation can also be used to reduce the appearance of moderate to severe facial lines. Restylane Lyft was formerly known as Perlane-L and offers the same natural fullness. The product is also recommended for treatment of the backs of the hands, to minimize the appearance of protruding veins.

Restylane Refyne

Restylane Refyne was more recently added to the Restylane line and features revolutionary XpresHAn technology that creates a smooth formulation that produces the most natural results. This product works on wrinkles around the nose and mouth without compromising your ability to make normal facial expressions. Refyne also boasts long-lasting effects for many patients that can extend up to 12 months. Restylane Defyne Restylane Defyne offers a similar makeup to Refyne, except the links are more tightly bound to allow for treatment of deeper facial lines. Like Refyne, the product is primarily used on creases around the nose and mouth, and results can last up to one year or even longer for some patients.


Radiesse differs from the other dermal fillers Dr. Barrett offers, both in its formulation and in how it works. This product contains calcium hydroxylapatite microspheres, which work with the natural processes of the body to produce natural, long-lasting benefits. The microspheres offer immediate volume at the time of injection, so you enjoy positive results within days after your procedure. In addition, the substance stimulates the body to create more collagen, a protein that supports the dermal structure to give skin a smooth, supple appearance. Results from a Radiesse treatment often last a year or more. Radiesse is Dr. Barrett’s filler of choice for midface, chin, or jaw line filling. Radiesse works in the following areas:

  • Nasolabial folds
  • Parentheses (smile) lines
  • Marionette lines
  • Chin wrinkles
  • Early jowl formation
  • Temporal Hollowing

In addition to these areas of the face, Radiesse can also be used to minimize the appearance of protruding veins on the backs of the hands, turning back the clock in this area as well.


Sculptra is also a different filler in terms of what it contains and how it improves your appearance. It is a purely stimulatory filler. This filler is crafted of poly-L-lactic acid, a substance that has been used in a variety of medical devices for decades. When injected into the dermal structure, the absorption of the microparticles stimulates the body to produce more collagen. In the months following treatment, the additional collagen will go to work reversing signs of aging like nasolabial folds, chin wrinkles and marionette lines. The result of a Sculptra treatment, which consists of three sessions within three to four months, can last for up to two years or longer.

Preparing for Your Treatment

Dermal filler injections are considered safe and comfortable for the majority of patients today. However, there are steps you can take to minimize potential side effects like bruising and swelling after your treatment. Dr. Barrett may advise you to follow these steps in the days preceding your session:

  • Do not take any non-steroidal pain medications the week before your procedure
  • Avoid supplements like vitamin E, fish oil and St. John’s wort for one week
  • Do not drink alcohol or caffeine for a day or two before your procedure
  • Remain well hydrated and eat plenty of leafy greens to boost your vitamin K storehouse
  • Consider taking Arnica supplements before and after your injections

Dr. Barrett may provide you with additional instructions, depending on your specific situation. The closer you follow all directions, the better your odds of a safe and successful procedure.

Procedure Overview

Dermal filler injections are performed in our office at Barrett Plastic Surgery in just a few minutes of time in most cases. We provide topical numbing before injections are administered even though the needles used are relatively fine and do not cause much discomfort. For sensitive areas like the lips, icing or additional medication may be applied to ensure your comfort during treatment. Nitrous oxide is also available for patients with severe anxiety. Dr. Barrett will take care to place your injections in strategic locations to produce an even, natural result.

After Your Treatment

You will be able to return to your schedule as soon as your injections are completed. While mild bruising and swelling are not uncommon, they are not usually noticeable to others – especially if you apply makeup after your procedure. There is no significant pain after the treatment to keep you from performing your usual tasks.

Quick Procedure, Quick Results

Dermal fillers usually take just a few minutes to complete, with results that can last for many months in most cases. You can also schedule regular treatment sessions to ensure your effects last indefinitely. Fillers are an ideal treatment for men and women that want to refresh or enhance their appearance without incisions, anesthesia or a recovery process. To find out which dermal filler is the right fit for you, contact Barrett Plastic Surgery today at 310-598-2648.

The information about dermal fillers was reviewed by Dr. Daniel Barrett. If you have any questions, please don’t hesitate to contact us using our contact form below.

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