The Rising Popularity of Dermal Fillers

One of the primary reasons for their popularity is the immediate and natural-looking results they provide. Unlike surgical facelifts, dermal fillers offer a minimally invasive solution with little to no downtime, making them perfect for individuals with busy lifestyles. Moreover, the versatility of fillers allows them to address various concerns, such as smoothing wrinkles, enhancing lips, contouring the jawline, and restoring lost volume in areas like the cheeks and under-eye region. 

The advancements in filler technology, particularly the development of products like the resilient hyaluronic acid (RHA) line, have played a significant role. These newer fillers are designed to move naturally with facial expressions, providing a more natural and realistic look and feel. Additionally, the growing social acceptance and desire to maintain a youthful appearance have motivated more people to seek out dermal filler treatments. The openness of celebrities and influencers in discussing their cosmetic enhancements has also helped to destigmatize the use of fillers, encouraging a wider demographic to explore these non-surgical options.

Overall, the increase in the use of dermal fillers reflects a growing trend towards minimally invasive procedures that provide effective, immediate, and aesthetically pleasing results.

Why Dallas Is A Premier Destination For Dermal Filler Treatments?

Cosmetic procedures are concentrated in several “hot spots” across the US.  While most major cities have an abundance of qualified dermatologists and plastic surgeons:  Los Angeles, New York, Miami, and Dallas are nationally known for cosmetic procedures.  Dallas has a vibrant and growing economy, warm weather, a younger population, and an abundance of highly qualified plastic surgeons, dermatologists, and physician extenders.  

The Importance Of Selecting An Advanced Nurse Injector For Dermal Filler Treatment

It is important not to forget that dermal fillers are a medical procedure and should be treated as such.  A highly qualified injector requires advanced training well beyond what could be taught in limited exposure courses.  While some aestheticians may dabble in injectable procedures, a physician or nurse practitioner have the highest level of training.  Nurse practitioners in particular have devoted many extra years to advanced training and function autonomously.  

At Dr. John Burns' plastic surgery practice in Dallas, Texas, he is pleased to offer dermal filler treatments by Advanced Practice Nurse Injector, Laura Stelk, DNP.

What Are The Different Types of Dermal Fillers?

There are several types of dermal fillers, each formulated with different substances to address specific aesthetic concerns. Here are the main categories:

Hyaluronic Acid (HA) Dermal Fillers

Hyaluronic acid is a naturally occurring substance in the skin that helps maintain hydration and volume. HA fillers are versatile and widely used due to their natural-looking results and reversibility (they can be dissolved with hyaluronidase if needed).

Most Common Brands

Juvederm, Restylane, Belotero

Effectively Treats

Lip enhancement, smoothing nasolabial folds, filling under-eye hollows, and contouring cheeks and jawline.

Autologous Fat Injections (Fat Grafting)

This procedure involves harvesting fat from another part of the patient’s body (typically the abdomen or thighs) and injecting it into areas needing volume enhancement.

Uses

Filling in hollow areas such as the cheeks and under-eye region, lip enhancement, and hand rejuvenation.

Benefits

Since the filler material is the patient’s own fat, there’s no risk of allergic reactions, and the results can be long-lasting.

Collagen Fillers

Once popular, collagen fillers have largely been replaced by newer HA fillers. However, they are still used in some cases for their ability to smooth out fine lines and wrinkles.

Most Common Brands

Cosmoderm, Cosmoplast (though less commonly used today).

Effectively Treats

Treating fine lines, crow’s feet, and lip enhancement.

What Does Dermal Filler Treat?

Dermal fillers have become a cornerstone of non-surgical cosmetic enhancements due to their versatility and effectiveness in addressing various aesthetic concerns. One of the most common uses of dermal fillers is to smooth fine lines and wrinkles, particularly those around the mouth (nasolabial folds), eyes (crow's feet), and forehead. By injecting fillers into these areas, patients can achieve a more youthful and refreshed appearance.

Dermal fillers are also frequently used for volumizing and contouring the face. This includes augmenting the cheeks, chin, and jawline to restore lost volume and enhance facial symmetry, which naturally diminishes with age. Lip enhancement is another popular application, where fillers are used to add volume, define the lip borders, and correct asymmetries, resulting in fuller, more attractive lips. Under-eye hollows, which can give a tired appearance, are also effectively treated with fillers to create a smoother, more rested look. Beyond facial rejuvenation, dermal fillers can improve the appearance of scars, particularly acne scars, by elevating the depressed areas to be more level with the surrounding skin. Overall, the widespread use of dermal fillers is attributed to their ability to provide immediate, natural-looking results with minimal downtime, making them an appealing option for individuals seeking non-invasive aesthetic improvements.

Lip Enhancement

As we age, the lips become volume deficient and with thinning also wrinkle.  Full lips are a sign of youth and fillers give a more youthful appearance. Dermal fillers are commonly used for lip enhancement.  Juvederm, Juvederm Volbella, and Restylane Kysse are FDA approved to volumize the lips and last about a year in most cases.  These are hyaluronic acid fillers that are hydrophilic which mean they absorb water giving the lips a plump and full appearance.  In addition to hyaluronic acid fillers, autologous fat is also a very popular option.  Fat is usually filtered into either a micro- or nano- fat to allow for smoother and easier injection for lip enhancement. 

Volume Loss & Recontouring To Aging Lips

Adding volume to thinning lips gives a full and youthful look to the lips.  In most cases, volume is added uniformly at the junction of the dry and wet parts of the lips.  In addition to simply adding volume, filler can be used to sculpt or mold the lips.  Adding fillers at the edges of the lips, white roll outlines the lips and rolls the lips outward.  Filler can also be selectively added to deficient areas like the central upper lip called Cupid’s bow.  This give a more refined and artistic lip enhancement.

Additional Volume And Lip Definition To A Youthful Lip

Traditionally, lip volume was added so that the ratio of the upper and lower lip was 1:2.  Most modern studies have trended toward a 1:1 ratio giving less attention to the lower lip pout and more upper lip enhancement.  It is important to ask each patient what they prefer so that volume can be added in the desired amount to the upper and lower lips.

Read More: The Perfect lip Ratio

Jawline Contouring & Strengthening

Fillers are commonly used to augment the facial skeleton.  One popular area is the jawline to help with a weak jawline.  This is particularly helpful for men who desire a stronger and more masculine jawline.  For these indications, a more robust or viscous filler is necessary as it is injected deeply, close to the bone.  Juvederm Volux, Restylane Lyft, or Radiesse are commonly used for jawline enhancement.  Typically several syringes are necessary to achieve full correction.  

Read More: Three Options For A More Masculine Jawline
Read More: Radiesse + Jawline Filler That Lasts

Profile & Chin Projection

A weak chin is a common indication of deep filling.  Like jawline contour, Juvederm Volux, Restylane Lyft, or Radiesse are commonly used for chin augmentation or enhancement.  In the chin, fillers can achieve adequate projection to give a stronger chin and profile.  Like jawline contour, chin fillers are popular with men who desire a stronger chin and profile.

Menjections: Masculinizing Facial Injections For Men

Read More: Volux XC: The Powerful New Filler for Chin & Jawline Augmentation

Cheek Contouring

Adding volume to the cheeks is usually done over the facial bones of the upper face:  Zygomatic arch, Maxilla, and infraorbital rim.  Adding filler to this area volumizes the midface helping to combat gravitational aging of soft tissue and restoring a youthful appearance to the face.  These fillers are injected deeply.  Popular options are Juvederm Voluma, Restylane Lyft, or Radiesse.  By adding volume to the midface, gravitational aging is reversed and a more youthful volumizing effect is achieved.

Strengthening & Defining Flat Cheeks

Just below the mid-face bones are the cheeks which can become deflated giving a gaunt and aged appearance to the face.  Adding volume to the cheeks is delicate and should be done incrementally.  Unlike augmenting the bony skeleton, cheek augmentation is done more superficially with less viscous fillers.  Sculptra and Radiesse are popular options in the area as these fillers stimulate needed collagen and smooth fine lines and wrinkles over a wider area.  Sculptra is typically injected in a series where collagen is stimulated periodically and builds upon itself.

Restoring Volume To The Midface

Restoring volume to the aging midface is achieved with more robust hyaluronic acid fillers like Juvederm Voluma or Restylane Lyft which last up to 24 months.  Several syringes are typically necessary to achieve full correction.  Autologous fat is also a popular option as fat is natural, and readily available so that full correction is easily achieved.  Fat is popular in combination with a facelift in a procedure known as the “Lift and Fill Facelift.”

Nonsurgical Nose Job

A non-surgical nose job or rhinoplasty is a way to alter the appearance of the nose without surgery.  Dermal fillers are used to shape the nose and Botox can also help with relaxing muscles that distort the nose.  The most common application is to camouflage a dorsal hump by building up the nasal skin on either side of the dorsal hump.  A filler can also be placed to raise the nasal tip or treat asymmetries or build up a deficient part of the nose. 

Hyaluronic acid/HA fillers are used most commonly as these are easily molded and can be reversed if necessary.  There are many features of a nose that cannot be treated with facial fillers so realistic expectations are necessary.  It is important to remember that adding volume to the nose won’t make it smaller if size is an issue.  Nonsurgical rhinoplasty is temporary and lasts about a year in most cases.

Advantage of Getting A Non-surigcal Nose Job

The advantage of a nonsurgical rhinoplasty is that surgery is avoided and results are achieved in a simple office procedure.  Results can also be maintained with subsequent injectable appointments.

Disadvantage of Getting A Non-surigcal Nose Job

The disadvantages are that only certain features of the nose can be treated so it is very limited in application.  By adding volume to the nose it will by definition make the nose bigger which is not desirable in most cases.  This is a temporary procedure that must be routinely repeated to maintain the results.

Softening A Dimpled Chin

A dimpled chin is caused by an overactive mentalis muscle.  The skin puckers similar to an orange peel which is why chin dimpling is called, “peau-de-orange.”  This is treated with Botox to relax the muscle and sometimes with filler to fill out the chin thus smoothing the skin.  To treat this area patients are asked to pucker which causes the skin of the chin to dimple.  In significant cases, this can happen by simply closing the lips or at rest. 

Perioral Volume Loss- Volume Loss Around The Mouth

The area around the mouth is one of the first places to show gravitational age and is often highlighted as a first sign of facial aging.  The mouth is framed with “parenthesis” which involves the nasolabial fold and marionette lines.  The nasolabial folds run from the side of the nose to the corner of the mouth, and the marionette lines run downward from the corners of the mouth.  In mild cases, filling the mid-face, zygomatic arch, and central maxilla can lift the soft tissue thus improving these areas. 

In more severe cases a combination of mid-face cheek filling and direct filling of the nasolabial fold and marionette lines are necessary.  In most cases, a combination of hyaluronic acid fillers is used.  Mid-face filling is done with thick, more viscous fillers like Juvederm Voluma or Restylane Lyft while nasolabial folds and marionette lines are treated with medium viscous fillers like Juvederm Ultra or Restylane.  Treating these areas can dramatically reduce these age-defining lines and have a profound effect on facial rejuvenation.

Let's Review The Liquid Facelift

Booking Your Dermal Filler In Dallas, Texas

We recommend seeking the care of an experienced injector affiliated with a dermatology or plastic surgery medical practice and not a medical spa where the physician is not readily available. 

Make sure when booking that you know who will be doing your treatments.  You’ll want to spend some time before your treatment in consultation with your injector to make sure that you are getting exactly what you want.  Most Botox is billed by the unit and your injector should be able to show you exactly where you’ll be injected and how many units you’ll need.  In the same way, you should know how many syringes and what type of filler you are getting to each specific area you want filled.  Make sure you understand the cost before the treatment.  After treatment, you should have a way to contact your injector in case you have anything you might need.  Most injectors will follow up with you after treatment either by phone or with a brief follow-up appointment.

The Importance of Selecting a Board-Certified Advanced Injector

Your injector should be supervised by a board-certified plastic surgeon or dermatologist specializing in facial rejuvenation.  Your injector should be well qualified and trained with experience and plenty of before and after photos.  Dr. Burns is partnered with Laura Stelk, C-NP, a nurse practitioner with a doctorate from Baylor University.  She has advanced training from Allergan, Galderma, Merz, and Revance and was personally trained by Dr. Burns. 

What You Can Expect At Your Dermal Filler Appointment
with Laura Stelk, DNP

Laura Stelk, NP-C is an advanced practice nurse practitioner and aesthetic injector with a doctorate from Baylor University.  At your initial consultation, Laura does a complete and comprehensive facial analysis and discusses your goals and long-term planning.  After a plan is formulated, she will perform the treatments that are recommended.  You’ll receive after-care instructions and a blueprint for future planned treatments.

Complimentary Consult

Pre-Treatment

Laura Stelk, NP-C will meet with you and go over your proposed treatment and for returning patients summarize any prior treatments to optimize your planned treatment.  She will numb the area with numbing cream, clean the areas, and make sure you are comfortable with the planned treatment.

Post-Treatment

After your treatment, you’ll receive written instructions on how to care for the areas and a list of do’s and don'ts.  Our office will make sure your treatments are well documented and that you receive any “loyalty points” in our programs:  Alle or Aspire.  You’ll receive some topical skin therapy and a cold pack to help with swelling.

Temporary Side-effects

Botox and fillers can have some mild swelling and transient bruising that can typically be concealed with makeup.

Aftercare & Maintenance

You’ll receive instructions after your treatment: apply ice or cool compresses, avoid sun and saunas, avoid workouts the first day, and elevate your head for several hours.  Fillers have an immediate effect while botox may take 3 - 5 days for full effect. 

How Much Is Dermal Filler Treatment in Dallas, Texas?

While Botox is priced by the unit, fillers are priced by the syringe.  The average cost for fillers is between $750 to $950 per syringe depending on the type of filler.  Most treatments take between 2 and 4 syringes although this number will vary depending on the treatment desired and needed.

Frequently Asked Questions

How long do dermal fillers last?

Fillers last between 12-24 months depending on the type of filler.

Are there any risks with getting dermal filler injections

No procedure is without risk, but dermal fillers are extremely safe in the hands of an experienced injector. Bruising and swelling are common,  transient side-effects and vary from patient to patient. 

It is extremely rare to have an allergic reaction to a dermal filler. Injection of a filler into an artery can cause necrosis of the skin (which is also extremely rare).

Can I get dermal filler treatment while I'm pregnant or breastfeeding?

At our practice, we prefer not to inject pregnant or breastfeeding patients.

What happens if I don't like my dermal filler results?

Before and After photos are taken to evaluate your results. Hyaluronic acid fillers can be reversed with an injectable called hyaluronidase that will dissolve the filler. Touch-up procedures can also be done to improve your results. Dr. Burns has a touch-up policy which is reviewed with you at your consultation.

How can I tell which injectable filler is right for me?

Each filler has a specific indication and area that is best for use. The FDA approves fillers for use in specific areas. Dense fillers are typically used closer to the bone and are useful for augmenting the facial skeleton. Finer fillers are better used for delicate areas such as the lips, lower eyelids and superficial fine lines and wrinkles. 

Your injector will recommend the appropriate filler for your concerns.

What is the difference between Botox and filler?

Botox is a neuromodulator which means it blocks a muscle from contracting. Neuromodulators are used to relax muscles associated with facial expression thereby reducing wrinkles caused by muscle contraction. Areas commonly treated with Botox are: the eyebrows, the 11's, forhead wrinkles, and crows feet. 

Fillers are gelatinous substances that by definition fill. They are placed to restore volume in volume-deficient areas. They are also used to augment or enhance a feature of the face. Fillers have an immediate effect lasting between 12-24 months while Botox takes 10-14 days to take full effect and around lasts 3-4 months.

Book Your Complimentary Dermal Filler Consult With Us