Injectable Dermal Fillers

When we are young our skin is smooth and elastic with a healthy glow. As we age, our body’s natural collagen and hyaluronic acid levels decrease. Our skin loses volume and becomes lax. This leads to skin wrinkling and an aging appearance.  Fortunately there are some nice, fairly simple non-surgical ways to help restore facial volume and shape.

Hyaluronic Acid

Hyaluronic acid (HA) is a water-loving molecule found naturally throughout the body.  It binds to water and has different functions in different tissues.  In joints like the knee it provides lubrication and helps maintain a smooth gliding surface.  In the eye it serves as a sort of shock-absorber and helps maintain the volume and shape of the eye.  The greatest concentration of hyaluronic acid, however, is in the skin tissues.   HA binds up to 1000 times its weight in water, providing volume in the skin and the tissues under the skin.  Our skin contains large amounts of HA, helping the skin look and feel full and healthy.   As we age, the skin’s ability to produce HA decreases. With decreasing levels of HA, the skin loses its ability to maintain water.   The skin becomes drier and loses volume.

Several companies have created great hyaluronic acid products to help with this problem.  Typically these products are injected either into certain levels of the skin or sometimes just beneath the skin to add fullness and volume. There’s an art to this, however.  If you want a great result, you need to have this done by a professional injectable artist.  Fortunately, we just happen to have one of those in our office!  Krista, a registered nurse, has been doing this for 14 years.  People travel from all over the state of Texas and beyond to have Krista do their treatments.  Sometimes people drift away to receive treatment somewhere else because they found a “deal”, but it seems like they always come back.  She’s just that good.

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Krista, R.N


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Restylane was the first HA dermal filler approved by the FDA for cosmetic use.  The clear gel formulation of hyaluronic acid is packaged in single-use syringes.  From its beginnings of having a single product, Restylane has evolved into a family of injectable HA’s.  These include Restylane, Restylane-L, Restylane Lyft, Restylane Silk, Restylane Defyne, Restylane Refyne, and Restylane Kysse. 

Each of these has its own unique formulation of hyaluronic acid, each potentially having a slightly better effect in a specific area compared to the others.  Restylane Lyft, for instance, is FDA-approved for adding volume to the cheeks and the back of the hands,  and for the correction of age-related midface contour deficiencies.  Restylane Silk, on the other hand, is composed of gel that has smaller and smoother particles of HA than the other Restylane products.  It is the first FDA-approved product specifically designed for subtle lip augmentation and the smoothing of wrinkles around the mouth.  It takes someone with experience to determine which product may work best for you.  Krista has that experience.


Juvéderm was approved for cosmetic use a few years after Restylane.  Like Restylane, Juvéderm now has a full product line of specific hyaluronic acid preparations.  These include Juvéderm Ultra XC, Juvéderm Ultra Plus XC, Juvéderm Voluma XC, Juvéderm Vollure XC, and Juvéderm Volbella XC.  Juvéderm Voluma XC is typically used in the cheek, adding shape and volume.  Juvéderm Volbella XC is usually used for lip augmentation and to treat fine lip lines.

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There are similarities and differences between Juvéderm and Restylane products.  Make sure that the person doing your injections has experience, knowledge, judgement, and an artistic eye.  Krista has all of these.

Injectable Filler Frequently Asked Questions

How do I know which filler to use?

An experienced injector can help determine which filler, or combination of fillers, may work best for you.  A filler that adds significant volume to the cheeks may not be the best filler to improve subtle lip lines, for instance.  Visit with Krista in our office.  She has years of thoughtful experience and can help guide you in this process.  Click  here  to see a video of Krista discussing her choice of an injectable HA for a client’s cheek.

Do the injections hurt?

In most cases a topical anesthetic is placed on the areas that will be treated.  Some of the HA formulations have lidocaine, a local anesthetic, in them.  In select cases a local nerve block may be applied; while this is not usually required, some people prefer to have this.  Click here  to see a video of Krista doing an injection of  Juvéderm Voluma XC into the cheek of a client.  Watch the client’s facial expressions; she doesn’t flinch at all.

How long does a treatment take?

That depends on the number of areas being treated.   We typically ask clients to expect to spend about 1.5 hours in the office when they receive HA injections.  This allows time for the topical anesthetic to work and time for the actual injection treatments.

How long does it last?

Products injected into the cheeks might last up to two years.  Products added to increase lip volume don’t last as long, perhaps for about 6 or 9 months.  It’s not possible to tell a person exactly how long the results of a treatment will be visible.  This will vary depending on which product is injected into which area, as well as a person’s own metabolism.

Are there risks?

Being treated with hyaluronic acid fillers is an artistic medical treatment.  You wouldn’t (we hope), for instance, go to the grocery store or the post office and expect someone there to be able to do this.  As with any medical treatment, there are some risks.  One of the biggest ‘risks’, perhaps, is that a person may require a little more filler than initially thought.  The HA may not last as long as hoped.  A person may not have as much symmetry as she/he wanted and could require additional filler to help with that.  These are some of the more common risks.  There are others, however, and these are discussed thoroughly during an office consultation.

Office Information


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