model blonde smile

The headlines are full of “Filler” news these days. On the ‘Red Carpet’ (“who got what” “What did they have lifted, injected, added/subtracted, or tightened?”)

And away from the splashy celebrity world, the subject is all over your own neighborhood or workplace. Plastic Surgery procedures have become mainstream, largely due to the fact that we want to present our best faces (and figures) to the world.

The adoption of regular cosmetic maintenance is especially strong in areas like ours (Silicon Valley) where projecting vitality and relevance is VERY important. It’s all good news for patients, because of the ‘Bonuses’ available with many treatments.


As we’re discussing here- Fillers do more than Fill.

In addition to replacing lost volume, injectable fillers can Lift, Contour, Correct, and Define. And, they do so without surgery.

We’ll detail a few examples for you:


Voluma– made by Allergan (the same company that manufactures Botox and Juvederm). It’s a newer entry in the filler market, and is regarded as the longest-lasting. (up to 2 years)

Voluma before             Voluma After

Voluma is FDA-approved for the restoration of volume in the cheek area.  You know what happens when we age; Gravity helps along the process of skin and tissue laxity (the skin ’relaxes,’ stretches, and droops or sags). The underlying muscles do the same. Fat distribution changes, and lines become more visible. The contours of the face may change, with the drooping skin and tissue ‘collecting’ at or below the jawline. Jowls may become prominent at a formerly firm jaw and chin.

Voluma is a filler made of hyaluronic acid (a substance found in our own skin), and can be completely reversed with an injection of an enzyme (hyaluronidase).

  • Filling- It’s a thick gel, that’s injected into the face- the injection usually made deeply, at the bone. It’s FDA-approved purpose, as mentioned- filling the cheek area. The results are immediately visible, and do what they claim. But, what else is happening?
  • Skin-Tightening- The hollowed cheek area is plumper, but along with that, comes the added effect of tighter skin. Some of those visible lines have disappeared, or diminished.
  • Lifting- Now that some lost volume has been replaced, and the overlying skin and tissue tightened, something else occurs. With the new, firm support provided by the filler over the bone, the skin and tissue has also been ‘lifted.’ The degree of lift will depend on a few things, like the amount of product used, and the patient’s own tissue situation and facial structure..


Voluma and other injectables are often used successfully in ways that may not yet have the designation of “FDA Approval.”  This is usually described as an “off-label” use. It does not automatically mean that using the substance in another way is unsafe.  An important note here: this is where the patient needs to be extra-vigilant in doing homework. No ethical doctor will use a substance on a patient in a way that they feel could endanger the patient.

(There are many unethical people in our world, who may have no qualifications, or some qualifications, and who may be less cautious. The message here: make sure your doctor is board-certified, and experienced.)

How does all of this fit into our discussion today?  Many of the current, successful uses of these materials are technically considered ‘off label.’


Patients, young or older, who feel that their facial features are unbalanced, have been seeing great results from the use of products like Voluma, Radiesse, Juvederm, Restylane, Botox, and Sculptra.  Cheekbones can be emphasized or built up, definition added to the jawline and chin, the nasal bridge built up, and in the case of Botox, reduction of prominent jaw muscles.

Voluma Before-photo by Dr. Lepore

Voluma Before-photo by Dr. Lepore

Voluma After-photo by Dr. Lepore

Voluma After-photo by Dr. Lepore

The thicker fillers; Voluma, Radiesse, and Sculptra, are used mainly for the ‘building’ purposes- while Juvederm and Restylane, are more commonly used to fill and soften areas like the nasolabial folds, and to enhance the lips and other areas.

Radiesse Before-photo by Dr. Lepore

Radiesse Before-photo by Dr. Lepore

Radiesse After-photo by Dr. Lepore

Radiesse After-photo by Dr. Lepore


  • Using fillers to reshape or lift the face will produce a subtle but definite result.
  • They’re certainly not as long-lasting as a surgical lift would be, and are generally less costly than surgery. (But keep in mind- the cost of injectable treatments is usually calculated by the number of syringes containing the product that are used).
  • Recovery time may be minimal, or last for several days for some. (With any injection, there is the possibility of bruising. Patients who experience bruising usually use makeup or a concealer, and return to their regular schedules immediately.)

Again, we encourage you to seek out experience and skill for these procedures. For subtle rejuvenation or refreshment, defining, lifting, or reshaping, today’s fillers have proved to be a real bonus for the consumer and patient. Patients tell us the experience is a real lift in other ways as well. Most are very happy with the experience and the results, and return to repeat the process.

[Dr. Vincent Lepore is a Board Certified Plastic Surgeon, providing plastic and reconstructive surgery for San Jose and Silicon Valley for over 20 years. Please see our website for details, and our Before and After Gallery. Cosmetic Consultations are free of charge. We invite you to schedule by calling (408) 356-4241.]

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