Sophisticated facial rejuvenation procedures done using dermal fillers is about rebalancing the entire face and not just about lifting and tightening. Viva Eve’s expert skincare specialists modern and highly calibrated approach to dermal filler treatments ensures that our patients leave our practice looking like themselves, only better.  

Our providers are not interested in altering their patients’ appearance and making them look unrecognizable, instead they help their patients highlight their favorite features, refine their appearance, and define their own sense of beauty and confidence. 

What is a dermal filler injection?

Dermal filler injection is a minimally invasive nonsurgical rejuvenation treatment. Dermal fillers comprise a family of injectable medications that restore volume in areas of the skin where it has been lost and are injected just under the skin to restore and plump up volume, reduce the appearance of lines and wrinkles, or give lips and cheeks a naturally fuller look.  

Are dermal fillers safe?

Dermal fillers are perfectly safe if your injections are performed by a reputable highly trained provider. Every practitioner has different philosophies, techniques, and levels of experience. You and your provider should communicate about realistic expectations and results before your dermal filler appointment. Dermal filler injection is a medical procedure that involves risks for infection, discoloration, and lumps if injections are not performed correctly.

What are the main ingredients in a dermal filler?

Some of the more popular fillers on the market are composed of Hyaluronic Acid (HA), a naturally occurring sugar that is found throughout the body in human connective tissue. It is the substance that helps make the joints move smoothly and gives the skin its plumpness. Once this gel-like substance is injected below the skin, it combines with water and swells, which leads to a ‘smoothing’ or ‘filling’ effect.

Which Dermal Filler product should I choose?

There are quite a few FDA-approved dermal fillers with cosmetic indications on the market. They have slightly different formulations, but the same core ingredient is responsible for their therapeutic action. Viva Eve offers a suite of Juvederm and Restylane fillers, including but not limited to:

  • Juvederm Ultra Plus XC®
  • Juvederm Ultra XC®
  • Juvederm Vollure XC®
  • Juvederm Volbella XC®
  • Juvederm Voluma XC®
  • Restylane®
  • Restylane Lyft®
  • Restylane Silk®
  • Restylane Kysse®
  • Restylane Defyne®
  • Restylane Refyne®
  • Radiesse®
  • Sculptra®
  • Belotero Balance®
  • Revance RHA Fillers 
  • Others: Qwo®, Kybella®

In general, thicker, more viscous fillers can provide more dramatic results in areas with deeper lines and hollows in the skin. Dermal fillers that are lighter and thinner are more appropriate for finer lines and wrinkles.

Viva Eve’s clinicians will be happy to discuss their preferences and provide recommendations during your complimentary consultation. Our expert providers will work with you to create a customized treatment plan that achieves your desired look.

How long do the results last?

Unlike other cosmetic treatments that bring gradual results, the benefits of fillers appear immediately and last from four months to well over a year.

Will the wrinkles get worse after the filler wears off?

The dermal fillers are not permanent and break down in the skin over time. The pre-treatment wrinkles do reappear gradually after the effects of the fillers wear off. Patients who have gotten accustomed to smoother skin may see their baseline wrinkles reappear and feel as though they’ve worsened. But in fact, dermal fillers cannot in any way make wrinkles worse.

Which Dermal Filler product should I choose?

There are quite a few FDA-approved dermal fillers with cosmetic indications on the market. They have slightly different formulations, but the same core ingredient is responsible for their therapeutic action.

In general, thicker, more viscous fillers can provide more dramatic results in areas with deeper lines and hollows in the skin. Dermal fillers that are lighter and thinner are more appropriate for finer lines and wrinkles.

Viva Eve’s clinicians will be happy to discuss their preferences and provide recommendations during your complimentary consultation. Our expert providers will work with you to create a customized treatment plan that achieves your desired look.

Which areas can be treated with dermal fillers?

Dermal fillers are usually used in these common areas:

Add volume to lips

This is one of the most well known uses for dermal fillers. Even though there are some people (and a few well-known celebrities) who tend to overdo it, an expert clinician can easily customize the treatment to achieve a subtle enhancement to the natural shape of the lips and to even out the texture by filling in lines and creating symmetry.

Add volume to cheeks

Expertly injected fillers can restore volume and the youthful appearance to the cheeks without the “face freezing” effects that are sometimes associated with treatment. A younger looking face can be achieved without face lift surgery, which is invasive and requires long recovery.

Profile Balancing

Any non-surgical cosmetic dermatology procedure changes to the patient’s facial balance, proportions, and facial characteristics. Profile balancing uses several different procedures in combination to balance the features by slightly reshaping the chin or nose and reduce the appearance of a sagging neck.   Many patients choose this minimally invasive treatment instead of surgery.

Under Eye (Tear Trough) Treatment 

A tear trough is a deep crease between the lower eyelid and upper cheek.  Tear trough dermal filler is used to make the trough less pronounced, which can make the face look more “awake”. The product most often used in this area is one typically made of hyaluronic acid, although other ingredients may be used. 

Eliminate marionette lines and nasolabial folds

Marionette lines are the lines below each corner of the mouth that resemble those of a marionette doll. Fillers can very easily fill in these lines and instantly make a patient look years younger. Often referred to as smile lines, nasolabial folds are the lines that lead from the sides of the nose to the corners of the mouth. This area is also easily corrected with dermal fillers to create a softer and more youthful look.

Reduce Appearance of Scars

Dermal fillers can be used to temporarily improve the appearance of depressed scars and even out the surrounding skin texture. Using dermal fillers is not appropriate for scars that are raised above the surface of the skin, but there is a wide range of other techniques that are available to patients with this type of scarring, such as corticosteroid injections or laser resurfacing.

Hand rejuvenation

Our hands lose a lot of their collagen and elastin — just like the face does — and the skin becomes much thinner. This makes the bones, tendons, and veins more visible, which many people associate with age. Dermal fillers can make the veins, bones, and tendons less visible by providing volume and plumpness to the backs of the hands.

Can dermal fillers prevent future wrinkles?

The injection of non-animal-derived, stabilized hyaluronic acid stimulates collagen production. As a result, it can possibly delay or even prevent future fine lines and wrinkles. 

What happens during my initial consultation?

Your cosmetic dermatology journey at Viva Eve starts with a complimentary consultation that will allow Viva Eve’s provider to understand your skin goals and discuss the treatment plan that is right for you. We will discuss your reasons for the procedure and your areas of concern. We will also make sure that you have realistic expectations for what the procedure can achieve.

Some patients wish to go ahead with treatment on the same day and some need time to plan further in advance. You have the option to receive treatment the same day as your consultation.

What happens during pre-procedure consultation?

During this pre-procedure consultation the Viva Eve injector will discuss the following:

  • Your medical history, including a tendency for excessive scarring because the dermal filler treatment may lead to the formation of additional scars
  • Any prescribed medication that you take that is designed to decrease the body’s immune response because it may result in an increased risk of infection.
  • Staying off blood thinners (Advil, Ibuprofen, etc.) before the procedure.
  • Avoiding alcohol at least 24 hours prior to treatment
  • Avoiding beverages containing caffeine at least 24 hours before the treatment
  • Staying away from topical products like Retinols, Glycolic Acid, and Alpha Hydroxy Acid for 3 days prior to your injection. These products may break your skin, making you susceptible to bruises and infections after the procedure.
  • Discussing with your doctor any other skin therapies such as laser, mechanical or chemical peeling, microneedling and hair removal that you plan on having after the procedure. The use of dermal fillers with these skin therapies may lead to inflammation.
  • Making sure that you don’t have any skin sores, pimples, rashes, hives, cysts, or infections on your skin. If any are present, the treatment should be postponed until they are healed.
  • Avoiding bleaching, waxing, using depilatory creams, or tweezing in the area to be treated for one or two days prior to your dermal filler injection.

All these measures will help to minimize the risk of bruising, scarring, or infection after the procedure.

Some of our patients like to use an over-the-counter topical numbing cream (like Lidocaine external analgesic) 30 minutes prior to their visit. You can also ice your treatment areas ahead of time to further prevent bruising – and we will have ice packs handy should you choose to use them before or after the procedure!

Are dermal filler Injections painful?

Dermal fillers are not painless, but are usually easily tolerated by most patients, especially when a topical numbing agent or a local anesthetic is used. Our injectors use HA fillers that are premixed with lidocaine, a numbing agent, to make sure that you experience as little discomfort as possible. 

What are the steps of the dermal filler procedure?

Step 1

Assessment and Mapping

Our clinician will once again evaluate all the areas of your face to be augmented. Strategic points on your face may be marked as the appropriate injection sites for the filler. Photographs may be taken of the areas to be treated.

Step 2

Cleansing & anesthetizing

The injection sites will be cleansed with an antibacterial agent. Pain at the injection site may be reduced by a use of a contact cooling device to chill the skin, anesthetic ointment to numb the skin or by an injection of a local anesthetic.

Step 3

The injection

Injection usually takes only a few moments per site. The clinician injects, massages the site, evaluates the result, and adds filler as needed. Depending on the number of areas to be treated, the whole process may be as short as 15 minutes, or as long as an hour.

Step 4

Clean up & recovery

Once your Viva Eve clinician is satisfied with the results, any markings will be cleaned off. You will be offered an ice pack to reduce swelling and discomfort. Although the area may feel a bit tender for a day or two, pain medication is usually not required.

What to expect after having a dermal filler? Is there a recovery period?

Recovery time varies for each patient, type of filler injected, and the number of injection sites. Viva Eve’s providers will discuss specific recovery plan with each patient prior to scheduling the injections.

You can resume most activities right away, but Viva Eve’s clinicians offer the following advice following the procedure:

  • If there is any swelling, applying an ice pack to the treatment areas can help.
  • Avoid intense physical activity for the first 24-48 hours
  • Avoid lying down completely flat for 4 hours after dermal injection. This prevents the treatment from migrating outside the targeted areas.
  • Minimize your exposure to the sun and avoid being in the heat and cold until any redness or swelling has disappeared. Exposure to any of these may cause temporary redness, swelling, and/or itching at the injection site.
  • Don’t rub or massage the treated areas because it can cause the filler to migrate to another areas of your face.

Consider using arnica, a natural remedy, to help reduce post-treatment pain and bruising. It is available at our practice upon request.

How will I feel right after the injection?

Here are some of the things you may experience right after the injection:

  • An “overfilled” appearance to treated areas
  • Swelling or bruising ranging from mild to severe
  • Temporary numbness or redness
  • Palpable lumps or hard areas at the injection sites
  • Hypersensitivity reaction that can seem like an allergic reaction with hives and swelling

Most conditions can be alleviated with topical icing and massage and will improve within a matter of hours or just a few days. Some reactions may require more aggressive treatment with medications or injections.

Although not common, visual disturbances may occur. When accompanied by pain or weakness on one side of your body, it is extremely important that you contact your provider and receive care immediately.

Can I combine dermal fillers with other cosmetic treatments?

Viva Eve offers a number of combination treatments, depending on the patient’s specific needs. There are two types of injectables made of substances that affect the body in different ways. When used at the same time, they complement each other. In some cases, it’s best to relax muscles first and then have dermal filler treatment about at a later date. Your clinician may recommend either doing both treatments at the same time or waiting a week or two after the injection. 

What happens if I don’t like the way I look with dermal fillers?

One of the main benefits of HA fillers, aside from their natural appearance when injected, is that they can be dissolved by a special solution in case of an adverse event, or if the person dislikes the appearance. 

Viva Eve’s expert injectors warn that short-term filler side effects can obscure your real results—and ask you to wait to tweak the filler two to three weeks after your initial appointment, allowing for any bruises to fade, swelling to subside, and filler to settle. If you are still unhappy, in most cases your injector can add or subtract filler to help solve your specific problem.

Can I get dermal fillers when I am pregnant, trying to get pregnant or breastfeeding?

There is not enough data on the safety of dermal fillers for pregnant women or nursing mothers, which is why Viva Eve’s clinicians recommend avoiding dermal filler injections while pregnant or breastfeeding. We think that it’s best to be on the safe side and not take the risk.

What are the risks of dermal fillers?

The decision to use fillers is extremely personal. Each patient needs to decide whether the benefits of this procedure outweigh the risks and potential complications. 

Your Viva Eve provider will discuss any potential risks and you will be asked to sign consent forms to ensure that you fully understand the procedure, as well as the risks and potential complications.

Serious complications from dermal fillers are very uncommon. Potential risks vary depending on the specific filler used and the relative permanence of the filler substance and include:

  • Acne-like skin eruptions
  • Asymmetry/ under- or over-correction of wrinkles
  • Bruising and/or bleeding from the injection site
  • Damage to the skin that results in a wound and possible scarring
  • Infection at the injection site
  • Lumps
  • Palpability of the filler under the surface of the skin
  • Skin necrosis (ulceration or loss of skin from disruption of blood flow)
  • Skin rash with itching
  • Skin redness and/or swelling.

Can I save money by buying a dermal filler product online and doing it myself?

The FDA has issued an official warning urging consumers to “never buy dermal fillers on the internet. They may be fake, contaminated, or harmful.

In the last month, there have been multiple reports in media outlets and in the medical literature of dangerous complications resulting from self-injection of fillers by non-health professionals.

Viva Eve’s expert skincare specialist will not just know which filler to use, how much, the perfect filler for each area, etc, but they also have the talent and experience to consider your treatment in context and make sure you look your best.

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