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The Problem

Most of us lose volume in our face as we age causing our temples, cheeks and eyes to hollow out, our lips to thin, our jaw lines, cheeks, and necks to sag, and wrinkles to appear. With time, we look gaunt, skeletonized, and well, just old. Volume in a face is a marker of youth—loss of volume, aging. None of us are immune.

The Solutions

The Surgical Approach

Facelifts, eyelifts, and brow lifts tighten and lift sagging eyelids, eyebrows, cheeks, necks and jowls but do not replace lost volume. Cheek and chin implants restore volume very effectively to these facial areas, but require surgery with an associated downtime. Fat transfer from the abdomen or thighs to the face is often used to restore volume, however, to date the durability of the beneficial effect is both unpredictable and unreliable. Repeated fat transfers are often required to sustain the improvement.

The Non-Surgical Approach

Dermal fillers such as Restylane, Restylane Lyft, and Voluma when injected under the skin have been used to restore facial volume with great success over the past many years. Complications are few, downtime nil, and results pleasing, While fillers don’t, in general last as long as a surgery, they can substantially make you look much better for quite a while. They can even be used to fill out a volume depleted face after a facelift.

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Reflating the Volume Depleted Face


After 4 syringes of Lyft

What are Dermal Fillers?

The dermal fillers we commonly use consist of hyaluronic acid— Restylane, Restylane Lyft, Restylane Defyne and Voluma.

Hyaluronic acid is a normal constituent of our skin, subcutaneous tissue, and connective tissue. When natural hyaluronic acid is specially treated and injected under the skin, this modified hyaluronic acid attracts and holds water, adding volume to the area injected, lasting until the body degrades it, anywhere from six to eighteen months after injection. The increase in volume that results from injection of one of these fillers under the skin improves overlying facial creases and wrinkles, and enlarges lips, making the face appear more youthful.

How Do We Use Dermal Fillers?

Our goal with filler is to add volume to your face, restoring your more youthful contours. We inject them to improve cheek volume, facial wrinkles and creases such as the nasolabial fold (the crease between the nostrils and the corner of the mouth), frown lines (especially in conjunction with neuromodulators such as Dyport), and wrinkles on the cheeks. These products are particularly useful to enhance and augment the cheeks, lips, temples, and fill vertical wrinkles above the upper lip. For many patients, the improvement after dermal filler injections is not only satisfying, but also quite dramatic.

What Dermal Fillers We Use?

Juvederm Voluma XC

Voluma refers to Juvederm Voluma XC, a specific dermal filler product within the Juvederm family. It is designed to address age-related volume loss in the midface and cheek area. Voluma is composed of hyaluronic acid (HA), a naturally occurring substance in the skin that helps to maintain volume and hydration.

This particular filler is known for its ability to add volume and lift to the cheeks, resulting in a more youthful and well-defined appearance. Voluma is often used to correct sagging or flattened cheeks, providing a non-surgical option for midface rejuvenation. The results from Voluma can be long-lasting, typically lasting up to two years or more, depending on individual factors.

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Restylane Defyne

Restylane Defyne is a specialized dermal filler product designed to address deep facial lines and wrinkles, particularly in areas of the face where dynamic expressions and movement occur, such as the nasolabial folds (smile lines) and marionette lines. It is composed of hyaluronic acid, a natural substance found in the skin, which helps to add volume and support to these specific areas.

Restylane Defyne is known for its flexibility and durability, allowing it to adapt to the natural movements of the face while maintaining its structural integrity. This feature makes it an ideal choice for individuals seeking to smooth out deep wrinkles and lines without sacrificing their ability to express emotions. Restylane Defyne typically provides long-lasting results, with effects lasting up to a year or more before a touch-up may be desired.

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Restylane Lyft

Restylane Lyft is a specialized dermal filler product designed to address volume loss and sagging in the midface, cheeks, and the back of the hands. It is composed of hyaluronic acid, a natural substance found in the skin, which helps to add volume and lift to the treated areas. Restylane Lyft is known for its ability to create a more youthful and rejuvenated appearance by restoring lost facial volume, enhancing cheek contours, and reducing the appearance of deep lines and wrinkles.

This product is often used to achieve a subtle and natural-looking lift, making it a popular choice for individuals seeking non-surgical facial rejuvenation. Restylane Lyft provides long-lasting results, with effects typically lasting up to a year or more before a touch-up may be desired.

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Restylane Kysse

Restylane Kysse is a dermal filler product formulated specifically for enhancing and volumizing the lips. It is composed of hyaluronic acid, a naturally occurring substance in the body that helps to hydrate and plump the skin. Restylane Kysse is known for its versatility, providing natural-looking results by adding volume to the lips, defining the lip border, and smoothing out fine lines and wrinkles around the mouth.

This product is designed to create soft and natural lip augmentation, allowing individuals to achieve their desired lip shape and fullness. It is a popular choice for those seeking non-surgical lip enhancement with minimal downtime, offering results that can last up to a year before requiring a touch-up.

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Frequently asked questions

How Are Dermal Fillers Implanted? How Long Does The Procedure Take? Is it Painful?

Dermal fillers come in pre filled syringes and are injected just underneath the skin using very fine needles or cannulas into the area to be improved. Prior to injecting a dermal filler, we often numb the area to be filled with topical anesthetic cream. As we inject the area, we can also chill the overlying skin with an iced roller resulting in additional anesthesia.

This combination of topical anesthesia and cold reduces any pain from the injections to a minimum. Additionally, all the fillers we use contain local anesthetic, so that after a few passes the area to be enhanced becomes more numb. The injection of a dermal filler takes between 20 and 45 minutes depending on how many syringes are used.

A young Mick Jagger

Mick today, markedly volume depleted

When Will I See Improvement From Dermal Fillers And How Long Will It Last?

You will see improvement from a dermal filler immediately after it is injected. On average with hyaluronic acid filler, this improvement will last about 6 to 18 months. After the first two or three injections, most patients find they can go increasingly longer intervals without reinjection.

Is There Any Downtime Following Dermal Filler Injection?

There is minimal to no downtime after a dermal filler treatment. Dr. Gal recommends not to workout on the day of injection after your treatment. You can return to your normal activities without restriction the following day after the dermal filler injection procedure. The area injected, particularly the lips, may be swollen and numb similar to a visit to the dentist. The numbness will disappear in one or two hours. The next day you will have increased swelling and bruising to the area of the face treated. Bruising may last up to 7 days. Swelling usually improves within 24-48 hours.

Are Dermal Fillers Safe? Are There Any Side Effects?

All of the dermal fillers are extremely safe when used in the matter described above. All the dermal fillers we use are either FDA approved for filling facial wrinkles, for augmenting volume, or both. Many have been used for almost a decade here and much longer in Europe. They are exceedingly safe products with few side effects. Occasional bruising, swelling, lumpiness, and/or tenderness at the implantation site can happen but all disappear within a few days.

Allergies to these products are very rare. As for any cosmetic procedures done around the mouth and particularly to the lips, we customarily provide a prescription for an antiviral agent to prevent any outbreak of cold sores (oral herpes virus).

How and Where are the Different Fillers Used?

Restylane Lyft

Restylane Lyft is our “go to” filler. We use it in most every area of the face: to plump up lips, to augment the cheeks, to fill in the nasolabial folds (folds from the nose to the corner of the mouth), the marionette lines (the folds from the corner of the mouth down to the jawline), to elevate the jowls, to restore a youthful jawline, and fill in hollow temples.


Voluma is approved for use to elevate the cheeks restoring youthful volume there. It is a wonderful product when used as indicated and lasts about 12-18 months.

What to Do and What to Expect After a Filler Treatment

It is helpful to apply ice packs to the treated area(s) for several hours to reduce any potential swelling and bruising, both of which can occur. It is typical for swelling to be at its peak the following day after injection. If you like the way you look the next day, you should consider getting additional filler injection as this swelling will resolve. Should any swelling or bruising appear over the first few days after a treatment, rest assured that it will resolve quickly over the next few days. Expect some achiness in the areas treated, especially a low grade headache if the temples are filled. This can easily be remedied by over-the-counter analgesics such as extra strength acetominophen (Tylenol) or ibuprofen (Motrin). Make-up can be applied in an hour or two after a treatment.

Small palpable lumps can occur in the injection area and to avoid these, we ask you to gently massage the treated areas 5 minutes in the morning and evening for about a week after the treatments. Persistent lumps, while possible, are very infrequent.

How Much Do Dermal Fillers Cost?

We price all our fillers by the syringe and prices vary between various products. Some smaller areas such the lips, nasolabial folds, etc. may require only one or two syringes. However, to adequately rejuvenate a volume-depleted face, multiple syringes are usually needed to make a noticeable difference.

At the time of consultation, we will go over in detail where and how much filler we should use to give you the result you desire. If you have to, it is always best to wait until you can afford enough filler to do the job rather than try to get by with too little and end up disappointed.

If you want to see if fillers are right for you, please fill in the form below.

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