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Juvederm & Fillers

Injectable fillers restore lost volume, smooth wrinkles, enhance facial shape, and restore a more youthful appearance to the face.

Should You Consider Juvederm & Fillers?

Injectable fillers have acquired a bad reputation for creating the duck lips popularized by plastic surgery junkies in Beverly Hills. Though there are still patients, plastic surgeons, and medical spas using fillers for this purpose, when in the right hands fillers can achieve subtle results that reverse the initial signs of aging.

Are You A Candidate?

Our Facial Rejuvenation Self Evaluation can help you decide if Injectable Fillers are right for you

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Overview

A Look At Fillers and What They Can Do

Injectable fillers are very versatile and can accomplish what plastic surgery can’t. While surgery removes excess tissue and fat, even tightens the skin, it fails to restore the volume loss that occurs with aging. When targeted correctly and used sparingly, injectable fillers can reverse many specific signs of aging:

  • Diminish hollow or dark under eye circles
  • Augment sunken cheeks softly and subtly
  • Soften or erase lines around the nose and mouth (eg. nasolabial folds, marionette lines)
  • Plump thinning lips subtly
  • Enhance the shape and proportions of the nose or chin
  • Fill in hollows that appear at the temples when we age
  • Rejuvenate the hands
  • Reverse signs of aging around the brows

Fillers create the ideal contour for your facial features and help balance your proportions with just a few short treatments each year.

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Before & After photos of Restylane injection to the nasolabial folds, marionette lines, cheeks, and lips.*

Candidates

You may be a good candidate for injectable fillers if you are bothered by the appearance of sunken cheeks, thinning lips, facial wrinkles, or folds.

Injectable fillers, along with Botox, are extremely popular and very effective for softening the appearance of wrinkles of patients in their 20’s, 30’s, and 40’s.

As one ages, however, it’s important to recognize when Botox and fillers are not enough on their alone to continue to help you look youthful and natural. There is a point beyond which using these treatments alone may actually begin to make you look unnatural and older if they are overused.

This is why it is important to choose an experienced plastic surgeon who knows how to perform both fillers and surgery so that your surgeon can tell you when Botox and fillers alone are no longer adequate.

Procedure Steps

What Happens During The Procedure?

Because fillers do not involve the same amount of time for recovery that plastic surgery procedures require, you will not need to take any time off work. In fact, treatment is performed in the office and takes no more than an hour in total. During the procedure, Dr. Fan will:

  • Use his artistic skills to determine which areas should be treated to enhance your proportions
  • Pinpoint the specific location to inject the filler
  • Slowly and precisely add filler, observing the changes to ensure the right result
  • Continue adding filler until the desired effect is achieved

Because there is no downtime, it is no wonder that injectable filler treatments are the fastest growing non-invasive cosmetic procedure in San Francisco.

Which Fillers Should You Choose?

Fillers are invaluable for achieve the ideal contour and shape of any facial feature that you want to enhance. There are a wide variety of FDA-approved fillers available today, with names including Juvederm, Restylane, Voluma, Perlane, Restylane Silk, Belotero, Radiesse, Sculptra, and Bellafill. Fillers differ in formulation, and one size definitely does not fit all. Some fillers are more plumping and some last longer than others.

An expert injector such as Dr. Fan will choose a filler based on how it functions in different areas of facial anatomy.  By incorporating his knowledge of anatomy and artistic understanding of facial balance, Dr. Fan will select the product that will achieve a beautiful result.

The main fillers that Dr. Fan uses in the office are:

  • Restylane and Juvederm to smooth nasolabial folds, reduce hollows and dark circles under the eyes, shape and add volume to the lips, and remove frown lines from the forehead.
  • Voluma to augment cheeks that have lost their volume and contour lasting up to two years
  • Radiesse to augment the nose, chin, or cheeks

These fillers are FDA approved and produce some of the best results for our patients.

Always make sure that you receiving FDA-approved, brand name fillers, which are only available through a licensed physician, such as a board certified plastic surgeon. In recent years, there have been horror stories of unfortunate patients receiving injections with industrial silicone or other dangerous materials performed by unlicensed “professionals” with disastrous results. Astounding. Don't let this happen to you.

 

Recovery

No Time Off Work Needed

Depending on the product and the areas treated, you should be able to notice results immediately after receiving filler injections. Some patients experience mild bruising, swelling, redness, and/or tenderness, but these are temporary and should subside over the days following treatment. You will be able to return to your normal activities right after treatment, although you may be instructed to take the day off from exercise or other strenuous activity. To be on the safe side, you should avoid planning any super special events for at least 2 weeks after your filler treatment.



Choosing An Injector

A highly experienced injector is important for obtaining natural, noticeable results.

Many people think that because injectable fillers are advertised in day spas and other non-medical offices, filler injections are on the same level as a manicure, facial, or haircut. This could not be further from the truth! Though non-surgical, filler injections are a medical procedure that requires specific training, knowledge, and skill to administer safely and effectively.

When selecting a provider for injectable treatments, give your decision the same level of care and scrutiny as you would for a surgical procedure. While many doctors begin advertising filler treatments after attending a weekend course in injectables, only board certified plastic surgeons have extensive knowledge of facial anatomy, a well-developed aesthetic eye, and a surgeon’s skill and precision.

Perhaps even more importantly, only a surgeon that knows how to perform both fillers and surgery can tell you when fillers and Botox alone are no longer adequate to help you look great, youthful, and natural.

Whomever you choose, make sure your provider has a proven background in facial aesthetic medicine and surgery as well as training and substantial experience performing filler injections. At many medical spas (as well as even some plastic surgery offices), filler injections are administered by nurses, nurse practitioners, physician assistants, or general medical doctors. While these providers may be competent with these procedures, their skill level, knowledge, experience — and consequently results — simply can’t compare to the expertise of a board certified plastic surgeon. Filler injections are commonly learned at weekend courses with a standardized approach. However, each patient has unique anatomy and skin, so a detailed understanding of facial anatomy and individualized treatment plans are needed to obtain consistently excellent and natural results.

At 77 Plastic Surgery, Dr. Larry Fan wants to provide the very best results for our patients, so he insists on performing all filler injection treatments himself. Dr. Fan has performed thousands of filler injections, and he will help you develop a customized treatment plan designed just for you.

Why Dr. Larry Fan & 77 Plastic Surgery

There are many physician’s offices and medical spas that are now injecting fillers. Why come to us?

  • Dr. Larry Fan performs all of his own injections. Your injection will NOT be performed by a nurse, physician assistant, or general medical practitioner, but a highly experienced, knowledgeable, and skilled board certified plastic surgeon! Patients appreciate Dr. Fan’s gentle hands and artistry and often express how their injectable treatment was the best they’ve ever received.
  • Dr. Larry Fan is skilled at performing both fillers and surgery, so he will be able to determine if you are a good candidate for injectables alone. This also means that he will help you achieve a natural look and to avoid that “Real Housewives” look that is so commonly seen from patients walking out of medical spas, some dermatology offices, and other practitioners who do not perform surgery.



Cost

The cost of fillers depends on the type of filler and the amount needed to achieve your desired result. We will help you create a customized plan, in person, that is tailored to your specific needs.

The cost of filler treatment starts at $700 and up.

See Your Results

Injectable fillers can immediately replenish the lost volume and youthfulness of the face, resulting in a more refreshed look and a more confident you.

How long the effects of injectable filler treatments will last varies widely, depending on the product used, the area of treatment, and the patient. Generally speaking, the denser the product is and the more deeply it is injected, the longer it will last. To maintain your results, repeat injections are simply performed.

Hyaluronic acid fillers are the most popular type of filler used and commonly recommended for first-time filler patients. HA fillers typically last 6 to 12 months, depending on treatment. For example, injections to the lips tend to wear out fast than those to the nasolabial folds. Certain HA fillers, such as Voluma, are formulated to last longer (eg. up to two years), but are usually limited to certain areas, such as the cheeks.

Synthetic fillers tend to be longer lasting. They can be a good option for the right patient, but you need to be ready to commit to results that will be there for several years.

Dr. Fan and his team are known for their artistic eye, experience, and meticulous attention to detail. Results are always natural looking with noticeable improvement.

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Fillers

What Are Fillers Made With?

There are a variety of FDA approved filler products that can be used to achieve your goals. Each filler is uniquely formulated to have a certain texture, density, and injection depth, which means that certain fillers work better for specific areas of concern. In general, fillers are categorized by the substance they are made from.

Hyaluronic Acid (HA)

Hyaluronic acid fillers are the most popular type of filler used today. Hyaluronic acid is a naturally occurring substance that is already found in your skin and helps keep your skin plump and hydrated. HA fillers are typically soft and gel-like. The results are temporary, lasting 6 to 12 months or longer before the body gradually and naturally absorbs the filler. Some HA fillers are infused with lidocaine to help minimize discomfort during and after treatment. FDA approved HA fillers include: Juvederm XC, Restylane-L, Voluma XC, Restylane Silk, Perlane, and Belotero.

Calcium Hydroxylapatite (CaHA)

Calcium hydroxylapatite is also a naturally occurring substance, found primarily in our bones. When used in a filler, the calcium particles are very small and suspended in a smooth gel. The consistency of a calcium hydroxylapatite filler is typically thicker than that of a hyaluronic acid filler, and the results will typically last longer as well, about 12 to 18 months for most patients. Calcium hydroxylapatite is typically used for deeper lines and wrinkles. FDA approved calcium hydroxylapatite fillers include: Radiesse+.

Poly-L-Lactic Acid (PLLA)

Poly-L-lactic acid is a synthetic, biocompatible substance that has been used in medicine for several years in devices such as dissolvable stitches. Poly-L-lactic acid fillers are considered longer lasting, as the results typically last more than 2 years, and can help stimulate new collagen production. Poly-L-lactic acid is a thicker filler material and is used to treat deeper facial wrinkles. FDA approved Poly-L-lactic acid fillers include: Sculptra Aesthetic. Sculptra requires 3 to 6 treatments.

Polymethylmethacryate (PMMA)

Polymethylmethacrylate is a synthetic, biocompatible substance that has also been used in medicine for several years. When used as a filler, PMMA takes the form of a microsphere that remains beneath the skin indefinitely to provide continued support. PMMA fillers may also contain collagen, a naturally occurring substance in the skin that provides structure and firmness. FDA approved PMMA fillers include: Bellafill.

Which filler is the best?

There are a wide variety of FDA approved fillers available today, with names including Juvederm, Restylane, Voluma, Perlane, Restylane Silk, Belotero, Radiesse, Sculptra, and Bellafill. Fillers differ in formulation, and one size definitely does not fit all. Some fillers are more plumping and some last longer than others.

An expert injector such as Dr. Fan will choose a filler based on how it functions in different areas of facial anatomy.  By incorporating his knowledge of anatomy and artistic understanding of facial balance, Dr. Fan will select the product that will achieve a beautiful result.

The main fillers that Dr. Fan uses in the office are:

  • Restylane and Juvederm to smooth nasolabial folds, reduce hollows and dark circles under the eyes, shape and add volume to the lips, and remove frown lines from the forehead.
  • Voluma to augment cheeks that have lost their volume and contour lasting up to two years
  • Radiesse to augment the nose, chin, or cheeks

These fillers are FDA approved and produce some of the best results for our patients.

At your consultation, our team will help you understand the differences between the fillers and determine which filler is best for you.

 

How are fillers different from BOTOX® Cosmetic?

BOTOX Cosmetic and its related products, Dysport® and XEOMIN®, use a purified form of the botulinum toxin to temporarily relax the muscles that contribute to wrinkles – specifically, the wrinkles caused by facial movement (think crow's feet and frown lines). The active ingredients in dermal fillers are used to physically fill in wrinkles, hollows, and other areas that lack volume. Fillers and Botox are commonly combined to help achieve a smoother, younger look.

How long do fillers last?

How long the effects of injectable filler treatments will last varies widely, depending on the product used, the area of treatment, and the patient. Generally speaking, the denser the product is and the more deeply it is injected, the longer it will last. To maintain your results, repeat injections are simply performed.

Hyaluronic acid fillers are the most popular type of filler used and commonly recommended for first-time filler patients. HA fillers typically last 6 to 12 months, depending on treatment. For example, injections to the lips tend to wear out fast than those to the nasolabial folds. Certain HA fillers, such as Voluma, are formulated to last longer (eg. up to two years), but are usually limited to certain areas, such as the cheeks.

Synthetic fillers tend to be longer lasting. They can be a good option for the right patient, but you need to be ready to commit to results that will be there for several years.

To maintain results, injections are simply repeated.

How long do fillers last?

How long the effects of injectable filler treatments will last varies widely, depending on the product used, the area of treatment, and the patient. Generally speaking, the denser the product is and the more deeply it is injected, the longer it will last. To maintain your results, repeat injections are simply performed.

Hyaluronic acid fillers are the most popular type of filler used and commonly recommended for first-time filler patients. HA fillers typically last 6 to 12 months, depending on treatment. For example, injections to the lips tend to wear out fast than those to the nasolabial folds. Certain HA fillers, such as Voluma, are formulated to last longer (eg. up to two years), but are usually limited to certain areas, such as the cheeks.

Synthetic fillers tend to be longer lasting. They can be a good option for the right patient, but you need to be ready to commit to results that will be there for several years.

To maintain results, injections are simply repeated.



What happens to fillers as they break down within the body?

Fillers are biocompatible, which means that they're not harmful to your body. Many popular fillers, such as JUVÉDERM®, Restylane®, and BELOTERO BALANCE, are made from synthetic hyaluronic acid, which mimics a substance that occurs naturally in your body. Over time, typically a period of several months, the ingredients in injectable fillers break down and are naturally eliminated from your body through its normal metabolic processes.

Are there any side effects from fillers?

The most common side effects from filler injections are temporary discomfort, bruising, swelling, redness, and/or tenderness. These side effects generally subside over the course of several days. You will be able to return to your normal activities right after treatment, although you may be instructed to take the day off from exercise or other strenuous activity. You should avoid aspirin or anti-inflammatories for two weeks before fillers are used, to minimize the occurrence of bruising. To be on the safe side, you should avoid planning any super special events for at least 2 weeks after your filler treatment.

What are the risks of injectable fillers?

Injectable fillers are one of the most popular non-invasive cosmetic treatments and are generally considered very safe.

Any injection is associated with a very small risk of bleeding, infection, or bruising. Injectable fillers also carry a small risk of contour irregularity, nodule formation, over-correction, or chronic swelling. In the unlikely event of one of these complications, the filler can be dissolved using a medicine called hyaluronidase. Fillers also carry an extremely small risk of allergy or granuloma formation.

Do Filler Injections Hurt?

For fillers, a very small needle is used and the quick injection feels like a small pinch. If you'd like, you may request a topical anesthetic, but many fillers come pre-mixed with anesthetic, so most patients find the treatment very tolerable. Some areas such as the lips may be more sensitive than others. We also provide cold compresses to patients for increased comfort and reduced swelling after their injections.

How Can I Prevent Bruising?

Injectable filler treatments work wonders in filling out lines and wrinkles, but they can cause bruising and swelling.

Many patients ask us how to prevent bruising and the good news is that there is a lot you can do before and after treatment to minimize bruising:

  1. Avoid medications and supplements that can increase bruising for two weeks prior to your treatment such as: NSAIDS (ibruprofen, aspirin, Motrin, Naproxen), Vitamin E, fish oil, CoQ10, and flaxseed oil. Plain acetaminophen (Tylenol) is permissible.
  2. Avoid alcohol the night before your injectable treatment and after your treatment until swelling and bruising are resolved.
  3. Take Arnica pills 4 days before and after the procedure to aid in reducing the bruising. Place four pills underneath your tongue, twice a day. Additionally, Bromelain may be helpful in reducing swelling and bruising after the procedure and may be taken three days before treatment. Arnica and Bromelain are both available for purchase from our office.
  4. Use a cold compress after your treatment. Place a cold compress (for example, a washcloth rinsed in ice water) or an ice pack wrapped with a thin cloth (frozen vegetables work great for this purpose, and be sure NOT to place the ice pack directly on the skin as this could cause frostbite) over the treated area for 15 minutes three or four times per day as tolerated for the first 1 or 2 days after treatment.
  5. Elevate your head for two to four days after your treatment. Sleeping with your head propped up on a few pillows can help.

6. Avoid vigorous physical activity or extreme temperatures until swelling is resolved to aid your recovery.

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Related Procedures

Botox

Botox, or botulinum, is a very popular treatment that reduces and prevents the development of facial wrinkles caused by facial muscles. Botox is most commonly used to treat unwanted lines across the forehead, the “11s” between the eyebrows, and the crow’s feet next to the eyes. Botox is administered as a quick, in-office injection with no downtime. Botox is commonly used as a maintenance treatment before and after facelift surgery.

Learn More About Botox

Fat Transfer

Fat transfer is a procedure that involves harvesting fat cells from other parts of your body and injecting them into a treatment site to increase volume. Fat transfer to the face is often performed in conjunction with a facelift to restore lost volume in the cheeks, folds around the nose and mouth, lips, and temples.

Learn More About Fat Transfer

Facelift

A facelift is a surgical procedure that lifts sagging skin and support tissues and restores a youthful contour to the mid and lower face.

Learn More about Facelift

Eyelid Surgery

Eyelid surgery, or blepharoplasty, is a surgical procedure to improve the appearance of eyelids. Blepharoplasty may be performed on the upper and lower eyelids. It is often done in conjunction with a facelift, or in some cases in place of a facelift when the main area of concern is the eyes.

Learn More About Eyelid Surgery

Brow Lift

A brow lift is a surgical procedure to improve the appearance of the forehead and eyebrows. It is different from a facelift because the facelift focuses on the mid and lower parts of the face below the eyes. A brow lift is often done in conjunction with a facelift.

Learn More About Brow Lifts

Laser Resurfacing

Laser resurfacing is a treatment to reduce facial wrinkles, blemishes, irregularities, and scars using concentrated beams of light. Laser resurfacing of the face is often performing in conjunction with or after a facelift to repair sun damaged skin.

Learn More About Laser Resurfacing

IPL Photofacial

IPL, or intensed pulsed light, is a photofacial treatment to reduce brown spots, redness, age spots, broken blood vessels, and rosacea. IPL is often performed after a facelift to repair aging skin.

Learn More About IPL Photofacial

Skin Care

Our skin care programs involve the use of medical grade skin care products that can brighten, smoothen, and even out aging skin. Our skin care programs are frequently used to enhance the results of facelift surgery.

Learn More About Skin Care

Ultherapy

Ultherapy is a non-invasive, non-surgical treatment that uses ultrasound energy to firm, tighten, and lift the skin. The improvement seen after Ultherapy treatment is much more subtle and modest compared to the results of a facelift. Ultherapy is often used for maintenance treatment after facelift surgery. Ultherapy is not a suitable replacement for a facelift; patients who desire a facelift but choose Ultherapy are seldom happy patients.

Learn More About Ultherapy

Total Facial Rejuvenation

Total facial rejuvenation encompasses a comprehensive treatment plan that includes tightening loose skin, restoring lost volume, repairing sun damaged skin, and relaxing the facial muscles. A facelift is one of the main components of total facial rejuvenation, as are eyelid surgery, brow lift surgery, fat transfer, injectable fillers, laser resurfacing, IPL photofacial, medical grade skin care, and Botox treatment.

Learn More About Total Facial Rejuvenation

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Dr. Fan is literally the nicest guy ever! I went to his office on a recommendation for filler and botox after my last not so great experience with another doctor. I am so glad I actually listened to my friend this time =)! Dr. Fan actually listened to me and gave me exactly what I wanted. What, a doctor that isn't egotistical and actually listens?! I know, crazy right? Hands down best plastic surgeon I have ever seen and I couldn't be happier! - Mr. D ...A year later I am THRILLED with my results! He is amazing and I love him! I go to him now for all of my botox etc. When I am ready to get my breast implants replaced, of course he will be the one to do it. I have referred a few friends for botox and fillers. They are super happy with their results, and I am very sure they will continue to see him."*

— Ms. A

Why Dr. Larry Fan & 77 Plastic Surgery

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Larry Fan, MD

 

Dr. Larry Fan is an award winning, Harvard educated, and nationally recognized plastic surgeon. He is a progressive, compassionate thinker who is committed to achieving the highest levels of excellence and the very best aesthetic results. Dr. Fan is an expert facelift surgeon who is known for achieving natural beauty, never “overdone.”

 
 
Meet Dr. Fan
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Harvard Trained & One of America's Top Plastic Surgeons

Dr. Fan is known for his elegant sense of artistry and refined surgical skills. He will perform your surgery with expert, world-class execution and has the results to prov

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Exceptional Results & Award Winning Care

Dr. Fan and his team are committed to providing you with exceptional care, counseling, and support before, during, and after surgery. We take pride and joy in caring for you and have received numerous awards for our compassionate care.

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State-of-the-Art Office & Private Surgery Center

Come relax in our beautiful office and enjoy the comfort, safety, and privacy of our fully accredited onsite private surgery center.

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"Beauty for Life"

In this feature length book, you will learn:

  • How to look great at any age
  • How to find a beauty team that you can trust
  • How to choose the right skin care products for your skin type
  • How to choose between The Needle and The Knife

This book was written by top plastic surgeon, Dr. Larry Fan.

 

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Do You Have Lines, Wrinkles, or Volume Loss That You Want Corrected?

Schedule your complimentary consultation with Dr. Fan here.

During your consultation, Dr. Fan will take the time to address your specific goals and to discuss your treatment options. He will determine if you are a good candidate for injectable fillers and review the results that can be realistically achieved. He will also help you determine which complementary procedures may benefit you the most.



 

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