Facial Fillers and Injectables

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Almost everyone has skin imperfections of some kind. But for some people, wrinkles, acne scars, chickenpox marks, or other imperfections are uncomfortably noticeable. In the past, there was no practical option for removing or reducing such surface imperfections. However, today's dermatologiest can employ a number of different methods – including injections – to produce smooth, clear skin and attractive facial contours.

If you're considering an injection procedure to smooth your skin, the following information will provide you with a good introduction to the available options. For more detailed information about how these procedures may help you, we recommend that you consult a facial surgeon who is board certified or has completed a residency program that includes instruction in these procedures.


*The national average cost for injectables is between $398 to $897.

*Botox has been the most commonly used cosmetic nonsurgical injectable procedure since 2000. In 2010, more than 2.4 million individuals in the U.S. received neurotoxin injections.

Fillers and injectables are not procedures with permanent results.








  1. What are some of the most common benefits of these procedures?
  2. How are these procedures performed?
  3. Where will the procedure be performed?
  4. How much pain is there?
  5. What is the recovery period like?
  6. Ideal candidate:
  7. What is the long-term outcome like for most people?
  8. Alternatives
  9. Risks
  10. How do I finance this procedure?
  11. How long do these procedures take?
  12. What can I expect after the procedure?


What are some of the most common benefits of these procedures?

The most common benefit of injectable treatments is the elimination of unwanted wrinkles on the surface of the skin. In addition, injections can give patients a more youthful appearance by re-establishing pleasing contours with added volume.

Injectables work best on two kinds of wrinkles: those caused by movement of the muscle (such as those that appear around the mouth and eyes when smiling or frowning) and those caused by gravity (i.e., sagging skin). There are a number of different kinds of injectables, each with its own risks and benefits.

Alloderm is a frequently used material prepared from human skin. It is inserted in small sheets through tiny incisions. Cymetra is a form of Alloderm that has been frozen and fractured into tiny particles so it can be injected through a needle. Cymetra is more easily injected than Alloderm, but it doesn't last as long. The benefits of both Alloderm and Cymetra can be quite impressive. Allergic reactions are rare.

Botox is unique in that it prevents wrinkles from forming by paralyzing some of the very small muscles in the face. As a result, it stops the repetitive muscle contractions that lead to the appearance of wrinkles. Botox is extracted from the bacteria that cause botulism -- Botulinum Toxin A. It is most commonly injected into wrinkles in the forehead and around the eyes, but is also used on the lips, nose, chin, and neck.

Collagen is one of the most frequently used injectable materials. This substance is found in the connective tissues of the human body. Patients can therefore choose to donate collagen from parts of their own body (this is known as Autologen) for use in the injection treatment. This requires removal of some of the patient's own skin.

If you were undergoing a face lift, breast reduction, or removal of a scar, you would probably have extra tissue available for collagen injections. If not, you'd have to have an incision made (with a resulting scar) in order to remove skin tissue for collagen. Injected human collagen can last a year or longer. However, you don't have to donate your own skin to have collagen injections. Cowhide collagen is widely available as well.

One benefit of collagen is that it stays in place quite well, and no incision is required. (Some injectables such as silicone tend to move around in the injected site.) With collagen injections, you can continue your daily routine without interruption. Collagen usually lasts three to five months, and complications are quite rare.

Fat injections use material gathered from the patient's own body. This reduces the chance of adverse reactions. However, fat injections don't last as long as other materials. The amount of re-absorption by the body is variable.

Silicone is a rarely used injectable. It does present an advantage in that it is not absorbed by the body. Drawbacks of silicone injections include infection and rejection of the material by the body.

Restylane is a non-animal gel based on a substance found in our own bodies, hyaluronic acid, which creates volume in the skin. By being non-animal based, this reduces the risk of any allergic reaction or contracting a disease. Results last longer than other injections, generally remaining for six to 12 months. Plus, once the gel breaks down, it turns into water and carbon dioxide, which leaves Restylane untraceable in the body.

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How are these procedures performed?

Injections are most commonly made between the surface layers of the skin and the underlying fat. The material that you and your doctor decide upon is placed into a syringe. A needle is placed under the skin at the site of correction, and the material is injected along the lines of the wrinkle, scar, or other recessed area. The injectable material plumps and tightens the skin, thereby decreasing (and in some cases eliminating) wrinkles and lines from sagging skin and scars.

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Where will the procedure be performed?

Injectable procedures are performed on an outpatient basis. You should be able to leave the same day. In more extensive procedures such as Alloderm insertion, or fat in the lips, cheeks or naso-labial folds, sedation may be required. Collagen and Cymetra can almost always be injected without anything other than a topical or cream anesthetic plus (in addition to the anesthetic included in the syringe).

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How much pain is there?

The amount of pain during any cosmetic surgery varies from patient to patient. However, the discomfort associated with injectables is relatively mild. In many cases, injectables are given without anesthesia.

Patients may experience some discomfort during and immediately following the procedure. Injections done on the cheek, chin, and close to the eyes are usually less painful than those around the lips, but this varies from patient to patient. If you are particularly concerned about pain, be sure to discuss this with your doctor before the day of the procedure.

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What is the recovery period like?

The recovery period for injection treatments is relatively short. Bruising is usually minimal, and swelling depends on the extent of the procedure.

Patients should stay away from activities that can aggravate the injection site. Heavy exercise and alcohol consumption should be avoided for the first few days following the procedure. Recovery times will depend on the site and the extent of the procedure.

An extended period of pain, discomfort, itching, and burning may be a sign of infection. If you experience in of these symptoms, you should call your doctor.

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Ideal candidate:

In general, the best candidates are:

  • Individuals with scarring, sagging, or wrinkling on the face
  • Individuals with loss of fat, plumpness, or high contours of the soft tissues in the face
  • In good physical health
  • Psychologically stable
  • Wanting to improve their appearance
  • Realistic in their expectations
  • Aware of the options and the limitations

This is only a partial list of the criteria that your surgeon will consider in determining whether or not this procedure is appropriate for you. Be sure to ask your surgeon if he/she considers you an ideal candidate for injectable treatments.

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What is the long-term outcome like for most people?

Most patients who have had an injectable procedure are pleased with the results. The treatments can, in many cases, significantly reduce facial wrinkling and sagging skin. However, most injection treatments have a relatively short life span. Autologen, fat and collagen are quickly absorbed by the body, and most of the filler from these injections disappears within a year. Other injectable materials are associated with more frequent side effects. Be sure to discuss all of the various options with your doctor, who will help you to decide which is the best option for you.

Alloderm - A portion of the sheet alloderm may remain permanently, or it may eventually be completely absorbed. In any case, it lasts longer than most injectables, including collagen. There is not enough long-term information on Cymetra to know if a portion of it will last permanently, but early reports suggest that it probably will not.

Botox – The effects of Botox wear off in three to five months, but patients are often extremely satisfied with the results it produces. They may require only two treatments per year with almost no swelling at the time of injection. Except for the fact that a healthy muscle is plump and contracts, Botox is an excellent way to achieve a youthful, smooth face. Its popularity is due to its effectiveness.

Collagen -Standard collagen will be completely reabsorbed within a few months. Autologen lasts somewhat longer. Some lucky patients may have collagen last five to six months, but most will find that three to four months is typical. Occasionally, it lasts only two to three months. While they like the results, some people are frustrated by the need for frequent injections.

Fat - A portion of the injected fat will remain in place permanently, but a second procedure may be needed to completely correct sagging or wrinkling. Fat is perhaps the only injectable material available for recreating a youthful look in those patients requiring large volumes for a fuller, more youthful-looking facial structure.

Silicone – Silicone remains permanently. However, it can cause scarring hardening and lumpiness in the face years after the procedure is performed. Correction may require surgery to cut out the areas of silicone and scars, leaving the face permanently scarred. While a small percentage of patients have had an excellent result, it is risky; many others have had significant problems.

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Recently, a new method of fat injection has gained popularity. This procedure is called lipostructure. Like fat injections, this treatment calls for a removal of fat from the patient's own body. However, lipostructure is significantly different from traditional fat injections because it attempts to keep these fat cells alive. The idea behind lipostructure is that by keeping the fat cells alive, they will not be reabsorbed into the body, and the results will last longer.

This procedure is quite new, is more extensive, and requires very specific training on the part of the physician. Consult your doctor to see if lipostructure is an option for you.

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One of the greatest risks associated with injectable procedures is the risk of infection. However, under most circumstances, properly trained doctors can minimize the chance of such complications. Depending on the filler material that you and your doctor choose, there may also be a risk of an allergic reaction or rejection of the material by your body. It is always a good idea to discuss the different options and risks with your doctor before you decide on a particular injectable material.

Consult your doctor for more detailed information on the availability and safety of new injectables.

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How do I finance this procedure?

Did you know that 29 percent of all Americans have considered having an elective procedure? Of those, 60 percent would schedule a procedure immediately if financing was available. With iEnchance's patient financing options, money no longer has to be the barrier between you and your new image. By filling out our on-line application you can qualify for a loan in as little as 30 seconds.

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How long do these procedures take?

Most injection treatments will take less than an hour to finish. Time, of course, depends on the extent of the procedure, which normally takes between 15 and 60 minutes.

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What can I expect after the procedure?

For the first 24 to 48 hours following the procedure, most people experience some swelling and redness at the site of injection. Itching and very mild discomfort is not uncommon. However, most of these symptoms fade away within a day or two.

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The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. The best method of determining your options is to consult qualified surgeons who are able to answer specific questions related to your situation.

*Disclaimer: Costs source: According to the American Society for Aesthetic Plastic Surgeons (ASAPS), nationally in 2010. Most surgeons offer convenient payments plans for this procedure. Cost does not include anesthesia, operating room facility, hospital stay, and other related expenses. Costs may vary depending the extensiveness of the procedure, location, and other factors. Costs are provided solely for research purposes. For specific estimates, please contact a qualified plastic surgeon.

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