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Dermal Filler Injections are nonsurgical medical procedures that use substances such as hyaluronic acid or calcium hydroxylapatite formulated to restore age-related volume loss, provide structural support and lift to facial tissues, enhance facial contours, balance and proportion while maintaining a natural appearance.
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About the Treatment
Dermal filler injections are nonsurgical medical procedures that work by placing specialized injectable products, such as hyaluronic acid and/or calcium hydroxylapatite, into various tissue planes to restore lost volume, provide structural support, improve facial contours, and create a lifting effect to areas affected by aging. Some fillers primarily replace lost volume or provide lift and contour, while other fillers, such as RADIESSE (+) (calcium hydroxylapatite) also stimulate collagen production over time, improving the structure and quality of the skin and underlying tissue.
At Refyne Medical Aesthetics and Wellness, treatment with dermal fillers begins with a comprehensive assessment of the entire face – not simply the area the patient wants treated. Advanced knowledge of facial anatomy is essential because changes in bone, fat, muscle and skin all contribute to how the face ages. Understanding how these structures interact allows the practitioner to address the underlying cause of volume loss and tissue descent, rather than simply adding volume or filling a line that is visible.
This anatomical approach also guides where filler should be placed, at what tissue depth, and with which technique. Product selection is based on an understanding of filler rheology, including how different fillers provide projection, structural support, flexibility or tissue integration, as well as which types of fillers are best used in specific areas, such as the lips versus the chin, cheek or undereye. Needle versus cannula placement is selected according to the treatment area, anatomy, product and intended result.
Refyne Medical Aesthetics and Wellness offers advanced dermal filler injection techniques, including treatment of the temples, undereyes, cheeks, chin, jawline, nose, hands and earlobes. Treatment is planned with an in-depth understanding of how each area contributes to overall facial balance, allowing lost volume and structural support to be restored while maintaining natural facial proportions and avoiding an “overdone” appearance. Your provider will select from the Restylane family of hyaluronic acid fillers or RADIESSE (+) based on the anatomy being treated and desired outcome.
What Does Dermal Filler Address?
Dermal fillers are used to restore age-related volume loss and provide structural support, which can create a subtle lifting effect throughout the face and improve facial contours. Strategic placement can also enhance facial proportions, soften folds and hollowing, and restore balance between facial features.
- Lip Filler: As we age, the distance between the nose and upper lip, known as the philtrum, can lengthen, while the lips gradually lose volume, definition and structural support. Natural hyaluronic acid also decreases with age, which can contribute to thinner, less hydrated or “shriveled” appearing lips and more visible peri oral lines around the mouth. Dermal filler can be strategically placed to restore definition along the lip border, replace lost volume and hydration, improve peri oral lines, correct asymmetries, and restore vertical height to the upper lip, which can improve the appearance of an elongated philtrum. Because hyaluronic acid is naturally present within the lips, hyaluronic acid fillers are commonly used for lip rejuvenation. Product selection is based on the patient’s anatomy, degree of volume loss, and desired outcome. Restylane Kysse formulated with XpresHAn technology, is formulated to integrate with dynamic facial movement and may be selected when soft, flexible correction within this highly mobile area is desired. Restylane L provides greater structural support and may be preferred for more mature lips with significant loss of border definition or structural support. Proper product selection, injection depth, and placement within the appropriate tissue planes are essential to maintaining natural lip proportions and minimizing filler migration, distortion or an overfilled “duck like” appearance.
- Undereye Filler: As we age, the bone around the eye gradually recedes, facial ligaments become more lax, fat compartments shift, and the skin becomes thinner. These changes can make the tear trough more visible, creating undereye hollowing and shadows that may contribute to the appearance of dark circles or a tired appearance. Undereye filler is strategically placed to restore volume within the tear trough and smooth the transition between the lower eyelid and cheek. By reducing the depth of the hollow, filler can also decrease shadowing and improve the appearance of dark circles caused by volume loss. Depending on the degree of hollowing, more than one treatment session may be recommended to achieve gradual, natural-looking correction. Undereye filler is an advanced injection technique where proper filler selection, injection depth, and precise placement are especially important. At Refyne Medical Aesthetics and Wellness, a cannula technique is used for undereye filler to minimize trauma and certain injection-related risks. Treatment is generally well tolerated with minimal discomfort. Because undereye hollowing is not always an isolated concern, the cheeks and other areas contributing to facial volume loss may also need to be addressed for optimal support and facial balance. In appropriately selected patients, a combination approach using dermal filler and aesthetic botox injections into specific muscles may be recommended to achieve the best overall result.
- Chin Filler: The chin plays an important role in overall facial balance and proportion. Some patients naturally have a recessed or shorter chin, which can make the lower face appear less defined and may contribute to the appearance of a “double chin.” The chin may also appear overly square, lack a smooth, rounded contour, or have visible contour irregularities. Dermal filler can be strategically placed to improve chin projection, length, shape and contour, creating better balance between the chin, lips, jawline and overall facial profile. Treatment can also be customized to soften a square appearance, create a more rounded or tapered chin when desired, smooth irregularities, and improve the appearance of a “double chin.” Injection depth and placement are especially important in the chin, as different concerns require treatment at different tissue levels to achieve appropriate projection, shape, or surface correction. Restylane Defyne may be recommended for chin augmentation because it provides structural support while allowing natural movement and is FDA approved for augmentation of the chin region in adults with mild to moderate chin retrusion.
- Jawline Filler: As we age, bone loss and remodeling along the jaw, including the gonial angle at the back of the jawline, can reduce structural support, contributing to a less defined jawline and the appearance of jowling. Some patients may also naturally have a softer jawline and desire a more defined transition between the jawline and neck. Jawline filler can be strategically placed to restore structural support, improve the appearance of jowling, enhance the angle of the jaw, and create a sharper, more defined jawline. In men, treatment can also enhance the width and angle of the lower face to create a stronger, more masculine facial contour. RADIESSE (+) may be recommended for this area because it provides immediate structural support while also stimulating collagen production over time. RADIESSE (+) is FDA approved to improve moderate to severe loss of jawline contour in adults over age 21, making it an excellent option when greater structure, definition, and support are desired.
- Cheek Filler: As we age, volume and structural support are gradually lost throughout the midface, causing the cheeks to flatten and lose their youthful, rounded “apple” shape. As the tissues of the midface descend, this can also contribute to more prominent nasolabial folds and undereye tear trough hollowing. Cheek filler can be strategically placed to restore age-related volume loss, recreate youthful cheek contours, and provide structural support and lift to the midface. Restoring support in the cheeks may also soften the appearance of the nasolabial folds and improve the transition between the lower eyelid and cheek. In younger patients, cheek filler can also be used to enhance cheekbone definition and facial contour. RADIESSE (+) may be recommended when significant structural support and lifting capacity are desired. It contains calcium hydroxylapatite (CaHA) microspheres suspended in a gel carrier and has a high G′ (elastic modulus), allowing it to provide strong structural support and projection to facial tissues. The CaHA microspheres also stimulate collagen production over time, making RADIESSE (+) an excellent option for supporting and lifting the midface while improving facial contour.
- Temple Filler: As we age, the fat compartments of the temples gradually lose volume, creating hollowing that can make the upper face appear sunken or more skeletal. Volume loss in this area can also affect the smooth transition between the forehead, temples, and cheeks and contribute to an overall aged appearance. The temporal region has important fascial connections with the surrounding face, and restoring volume and support in the temples can improve facial contour and may provide a subtle lifting effect to surrounding tissues. In appropriately selected patients, temple restoration can contribute to improved lower-face support and soften the appearance of jowling as part of a full-face rejuvenation approach. Temple filler is considered a highly advanced injection technique because of the complex anatomy and important blood vessels located within this region. Our advanced injectable training and detailed understanding of temporal anatomy allow us to safely treat this area using carefully selected injection planes and techniques. A cannula technique may be utilized when appropriate to precisely restore volume while minimizing tissue trauma. Product selection is customized based on the degree of volume loss, anatomy, and treatment goals. RADIESSE® may be selected for its ability to restore volume while stimulating the body’s natural collagen production over time. Restylane Contour may also be recommended and is an FDA-approved hyaluronic acid filler for the correction of temple hollowing in adults over age 21.
- Non Surgical Nose Job: A non-surgical nose job, also known as liquid rhinoplasty, uses strategically placed dermal filler to improve the shape and proportions of the nose without surgery. Filler can be used to camouflage a prominent dorsal hump or “bump” by creating a smoother profile and can improve contour and symmetry. Strategic placement can also create the visual appearance of a straighter, more refyned, and narrower-looking nose, even though filler is adding rather than removing volume. Because the nose typically requires very small, precise amounts of filler, the procedure is performed conservatively and may be completed gradually. A touch-up may be recommended after the filler has settled to further refyne the result. Non-surgical rhinoplasty is a highly advanced injection technique because of the complex vascular anatomy of the nose and the potential for serious complications with improper injection. Our advanced injectable training and detailed knowledge of facial anatomy allow us to offer this specialized treatment using precise product placement, injection depth, and conservative dosing. This advanced training allows Refyne Medical Aesthetics and wellness to offer treatment areas that extend beyond traditional dermal filler injections.
- Earlobe Filler: As we age, the earlobes can lose volume and structural support while the skin becomes thinner and more lax. Years of wearing earrings can further stretch the tissue, causing the earlobes to appear elongated or deflated and making it more difficult for earrings to sit securely or face forward. Dermal filler can be strategically placed within the earlobe to restore lost volume, plump and support the tissue, and improve the overall shape of the earlobe. Restoring this structural support can also help earrings sit more securely and in a more upright, flattering position.
- Hand Regeneration: As we age, the hands gradually lose volume and structural support while the skin becomes thinner, making veins, tendons, and underlying structures more visible and giving the hands a more skeletal or aged appearance. At Refyne Medical aesthetics and Wellness, RADIESSE (+) can be used as a biostimulatory filler to immediately restore age-related volume loss while stimulating the body’s natural production of collagen over time, helping create smoother, more youthful-looking hands. For more comprehensive hand rejuvenation, filler can be combined with BBL light-based treatments to target sun damage, brown spots, and uneven pigmentation, as well as MOXI fractional laser treatment to improve skin texture and overall skin quality. This combination approach addresses both the volume loss and visible skin changes associated with aging hands.
Who Is a Candidate?
Good candidates are healthy adults with volume loss, hollowing, loss of definition, or features they want to balance, and who want natural-looking, gradual improvement. Filler is not recommended during pregnancy or breastfeeding. It is also not recommended with an active infection or cold sore at the site, a history of severe allergic reactions to filler ingredients, or certain autoimmune or bleeding conditions without medical clearance. Significant skin laxity may respond better to SkinTyte or to a surgical consultation. Lines caused by muscle movement are better treated with Botox.
The Dermal Filler Consultation
Your provider reviews your medical history, medications and supplements, any past filler or cosmetic procedures, and your goals. The exam assesses the face as a whole, including bone structure, fat, skin quality, symmetry, and how your features relate to each other. Photos are usually taken to plan treatment and compare results. Your provider then recommends the areas to treat, the products, the technique, and whether staged sessions would give the most natural outcome.
What to Expect During Treatment
Treatment takes place in our office and usually takes 30 to 60 minutes, depending on how many areas are treated. Many fillers contain lidocaine for comfort, and topical numbing may be applied first. After the skin is cleansed, your provider places filler with a fine needle or a cannula and shapes it as needed. You may feel pressure or brief stinging.
Recovery and Aftercare
Most patients return to work the same day or the next day. Swelling, tenderness, and bruising are common, especially in the lips and under-eyes. They usually improve within a few days and settle over 1 to 2 weeks. Avoid strenuous exercise, alcohol, and pressure on the treated areas for about 24 hours. A follow-up about two weeks after treatment lets your provider assess the result and add small refinements if needed.
Results
Improvement shows right away and continues to refyne as swelling resolves, with final results at about 2 weeks. With collagen-stimulating fillers such as RADIESSE (+), improvement continues over the following months. Results typically last 6 to 18 months or longer, depending on the product, the area, your metabolism, and your lifestyle. Maintenance sessions help sustain results.
Why Choose Refyne for Dermal Filler?
Filler at Refyne is planned from a full-face assessment grounded in detailed knowledge of facial anatomy and filler rheology. Dr. Brooklyn Buras, DNP, APRN, FNP-BC offers advanced areas that require specialized training, including the temples, under-eyes, nose, jawline, hands, and earlobes. A cannula is used where it reduces trauma and risk, and FDA-approved products are matched to each area. The goal is a natural, balanced result, not a filled look.
FAQ
What is dermal filler?
Dermal filler is an injectable gel that restores volume, support, and contour. Refyne uses hyaluronic acid fillers from the Restylane family and calcium hydroxylapatite (RADIESSE).
How does filler work?
Hyaluronic acid fillers add volume and hydration right away. RADIESSE adds immediate support and also stimulates your own collagen over time.
Am I a candidate?
Most healthy adults with volume loss, hollowing, or a desire for better facial balance are candidates.
How long does treatment take?
Most appointments take 30 to 60 minutes.
Is filler painful?
Most fillers contain lidocaine, and most patients describe mild pressure or stinging.
How much downtime is required?
Minimal. Swelling and bruising usually improve within a few days.
How long do results last?
Results typically last 6 to 18 months or longer, depending on the product and the area.
Are there risks or side effects?
Common effects include swelling, bruising, and tenderness. Rare but serious risks include infection, lumps, and blockage of a blood vessel. This is why advanced anatomical training and careful technique matter. Hyaluronic acid fillers can be dissolved if needed.
Can filler be combined with other treatments?
Yes. Filler is often combined with Botox, MOXI, BBL HEROic, or SkinTyte for complete rejuvenation.