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The Dos and Don’ts of Fillers

“Don’t make me look weird.”  That is such a common concern for patients because bad results with fillers are unfortunately seen all too often.  When used correctly, fillers are a fantastic tool to address the signs of aging.






Understand the Aging Process


Results using Juvederm Ultra XC and Juvederm Ultra Plus XC

Making the correct diagnosis is the first step in getting the best result.  Your face needs to be carefully analyzed by someone with experience who understands the anatomy and how various treatment options can improve the areas that give you concern.

Three things happen as we age:

  1. sagging of loose skin, fat, and muscle
  2. volume loss
  3. skin changes and wrinkles


Fillers primarily address volume loss, so you and your doctor need to carefully analyze the areas that bother you to make sure that fillers will provide the best improvement.

The goal is to provide a smooth transition between the subunits of the face.  You need to have an eye for highlights and shadows and understand the types of contours that the eye perceives as youthful.

In many cases a combination of treatment options is most appropriate.


Choosing the Right Filler

Understand what areas need to be corrected, and you will be able to choose the right filler.

The biggest difference is thickness.   Thicker fillers with more viscosity are great for building up volume in the deeper layers like enhancing high cheekbones.  For example, Voluma and Restylane Lyft were specifically designed for this exact purpose.  For superficial fine wrinkles and folds you’ll need a thinner filler that can be placed near the skin surface and spread out more evenly.  Fillers like Juvederm Ultra and Restylane with average thickness are very versatile in improving multiple areas of the face.

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Thick:  Voluma, Restylane Lyft, and Radiesse

Average:  Juvederm and Restylane

Thin:  Restylane Silk and Belotero

Most fillers are made of hyaluronic acid, a naturally occuring substance in the body.  There are some other materials available and even options like Sculptra, which will stimulate your body to grow more collagen.  Each type of filler has its own set of advantages.

Some hyaluronic acid fillers are more hydrophilic or “water-loving” than others.  For example, Juvederm injections in the lips have a tendency to draw in more fluid for an extra plumping effect in addition to the filler itself when compared to a different option such as Restylane Silk.  This is not necessarily a problem.  It can actually be an advantage, but you and your doctor need to keep in mind these subtle differences to choose the best one for you.

Longevity and cost are also important.  In general, the thicker fillers will last longer — sometimes up to 1 or 2 years.  Thin fillers that are wonderful for very fine superficial wrinkles may only last 4-6 months because they are reabsorbed faster.  Cost in the Charleston area typically ranges anywhere from around $500 – $900 per syringe (1 milliliter) of filler based on the specific product.  Only you and your doctor can determine how many syringes will be needed to fully correct the areas that bother you.

And remember:  Conservative results are the goal.  You can ALWAYS add more filler if needed.




Results using Juvederm Ultra XC and Juvederm Ultra Plus XC

You should never dread a trip to the doctor for fillers.  There is some mild discomfort, but in the right hands this really should be tolerable.

We use a combination of topical numbing cream and cold gel packs to make the whole process easier.  Also, lidocaine (a numbing medication) is mixed into the filler for additional comfort.

In some patients we also choose to perform what is called a local block where a tiny amount of lidocaine is placed into a certain spot to numb a wide area such as the entire cheek and lip before the filler is placed.  This is rarely needed though.

Slow and precise injection technique is another secret to minimizing discomfort.


Combine with Other Treatments as Needed

Facial aging is a combination of many factors.  Don’t get suckered into thinking that fillers are a magic wand to erase all of your problems.  They are a great option but often need to be combined with other treatments to get the best results and are not always the best answer to the specific problems that bother you most.

Ask your doctor how Botox, Dysport, skin treatments, lasers, or surgery could be used to augment the great results you are already seeing with fillers.


Dr. David Rodwell specializes in facial cosmetic surgery and minimally invasive procedures such as filler injections with Restylane and Juvederm.  To learn more about your options and what to expect after fillers call our office at (843) 628-1415 to schedule a private consultation.