Dermal Fillers

People often clump neuromodulators such as BOTOX® in with dermal fillers such as Juvéderm®. Actually, the two classes of injectables couldn’t be more different in how they work and even the wrinkles they work upon. At Dr. Chalekson’s we offer these fillers for our patients: Juvéderm®, Restylane®, Radiesse®, and Sculptra®.

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What are dermal fillers?

Dermal fillers are true to their name — when injected beneath a crease or area of volume loss they simply fill in the depression and push the skin back upward. Dermal fillers work on what are known as “static” wrinkles. These are wrinkles caused by sun damage, declining collagen production, personal habits such as smoking, and other environmental factors. Static wrinkles can be seen all the time.

Dermal fillers are usually classified as either “natural” or “synthetic.” Natural fillers, such as all of the Restylane® and Juvéderm® lines, are made primarily with hyaluronic acid. Hyaluronic acid is a naturally occurring substance in the human body that is responsible for hydrating, plumping, and firming the skin. It does this by binding with nearby water molecules.

Synthetic fillers have man-made elements, such as calcium microspheres (Radiesse®), or poly-L-lactic acid (Sculptra®) that provide structural support and often trigger the body to produce new amounts of collagen. This delivers results from two different actions.

dermal filler uses

How are dermal fillers different from neuromodulators?

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Dermal fillers such as Juvéderm® and neuromodulators such as BOTOX® work in entirely different ways. As their name implies, when injected beneath a wrinkle, crease, or area of volume loss dermal fillers simply add instant volume. They “fill” in the space and push the skin back upward. This only works when the wrinkle is known as a “static” wrinkle. These are wrinkles caused by sun damage, declining collagen production, personal habits, and other factors. Static wrinkles always show themselves.

BOTOX® and the other neuromodulators work in a completely different fashion. They are made from the botulinum toxin type A, the same bacteria that cause botulism. When the botulinum toxin is injected into a muscle, it stops the muscle from contracting for a period. Certain wrinkles on the upper third of the face form above muscle contractions under the surface skin. These are known as “dynamic” wrinkles. These are crow’s feet at the outside of the eyes, glabellar/frown lines between the brows, and forehead lines. When BOTOX® is injected into the muscles that create these wrinkles when they contract, the botulinum toxin stops the muscle contraction. The muscle stays at rest and the wrinkle that forms on the surface skin is erased for a period of around four months.

Bottom line — neuromodulators only work on dynamic wrinkles on the upper third of the face, and dermal fillers only work on static wrinkles and areas of volume loss on the mid to lower areas of the face.

Are dermal fillers permanent?

No. Dermal fillers will eventually be absorbed by the body and its effects will go away. Of the dermal fillers Dr. Chalekson offers, the Restylane® and Juvéderm® lines are all hyaluronic acid-based fillers. Hyaluronic acid is a naturally occurring substance in the human body that is responsible for hydrating, plumping, and firming the skin. When Dr. Chalekson injects these various fillers into an area to erase a line or crease or to fill in volume, the hyaluronic acid instantly binds with water molecules and immediately adds volume. This fills the area or pushes the skin back upward, erasing the line or crease.

These results aren’t permanent. The rule is that the location of the injections directly impacts the duration of your results. For instance, an area that involves lots of movement, such as around the mouth, will break down the filler faster than an area such as the cheeks that doesn’t move much. For that reason, dermal fillers provide results from 6 months up to 18 months.

Radiesse® and Sculptra® are the non-hyaluronic acid dermal fillers we offer. They provide results from 15 months to two years.

Are there any risks involved with dermal fillers?

As mentioned above, the typical after-effects with these products are slight redness and swelling at your injection sites. This passes in just a few hours. Occasionally, lumps can form, but hyaluronic acid fillers have an interesting characteristic that can address that occasional problem. If a lump develops, or if you don’t like the look of the area where Restylane® or Juvéderm® was injected, the hyaluronic acid can be instantly neutralized by the injection of an enzyme called hyaluronidase. This enzyme instantly breaks down the hyaluronic acid in these fillers.

What areas can be treated with dermal fillers?

As mentioned above, dermal fillers only work on static wrinkles and lines, along with areas that have lost volume, on the mid to lower face. Fillers are not used on the upper third of the face, where BOTOX® and our other neuromodulators (Dysport® and Jeuveau®) erase crow’s feet, frown lines, and forehead lines.

These are the issues we treat with our dermal fillers: 

  •     Nasolabial folds (smile lines) — Running from the nose down to the corners of the mouth.
  •     Marionette lines — Running from the corners of the mouth downward.
  •     Barcode lines — Vertical lines above the upper lip.
  •     Parentheses lines — Framing the sides of the mouth, like parentheses.
  •     Sunken cheeks — Flattened and sunken cheeks.
  •     Lip augmentation — Adding volume and definition to the lips.
  •     Under-eye hollows — Tear troughs and areas under the eyes.

Is there recovery after dermal filler injection sessions?

There isn’t any recovery or downtime. You may have some slight redness and swelling for a few hours at the injection sites, but that’s about it. You can return to work or your normal activities immediately.

Which Dermal Fillers Are Available At Your Practice?

We provide an array of fillers:

  • Juvederm
  • RHA
  • Restylane
  • Versa
  • Radiesse
  • Sculptra

Your consultation will include a discussion of these fillers and what type(s) may be right for your goals. Some patients use more than one type of filler for a comprehensive result.
Dermal fillers remain one of the top non-surgical options today because people love the benefits:

  • No incisions, no sutures
  • No downtime or recovery
  • Beautiful results
  • Versatile
  • Temporary and reversible (low commitment)
  • Low upfront cost relative to surgery

Of course, the only way to know if they’ll be beneficial for you is to talk to Dr. Chalekson. With many years of experience, Dr. Chalekson can determine if you are a good candidate for fillers.

What Do Dermal Fillers Do?

These injections are truly versatile. They can smooth and soften these wrinkles:

  • Vertical glabellar “frown lines” between the eyebrows
  • Marionette lines extending from the corners of your mouth downward
  • Nasolabial lines extending from the corners of the nose downward
  • Forehead lines
  • “Smoker’s lines” above the upper lip

Dermal fillers don’t stop at wrinkle treatment. They may also be used for:

  • Hollow, sunken cheeks
  • Aging hands that have lost volume
  • Definition of the jawline, cheeks, forehead and other areas of the face
  • Tear troughs
  • Lips lacking volume and shape
  • Bags and dark circles under the eyes

Dermal fillers work by restoring volume beneath the skin.

The Dermal Filler Process

The dermal filler process involves coming to a consultation and then either receiving the injections that same day or scheduling an appointment to come back for the injections. That’s it! It’s painless, simple, straightforward, and convenient. Many people fit these appointments in on a lunch break or a spare hour or two in the afternoon.

Are Dermal Fillers Safe?

Dermal fillers have a long-standing safety record. They are generally safe and low risk, although side effects and adverse reactions are always a possibility. We will make sure you have a complete understanding of the risks possible and what we can do to reduce those risks. Some of the potential side effects include:

  • Infection
  • Swelling
  • Bruising
  • Allergic reaction
  • Skin irritation
  • Scarring
  • Asymmetry

Choosing an experienced, trained injector is an important part of mitigating risks and securing good results. Dr. Chalekson and our team are fully qualified to perform these injections and have been doing so for years. We hope you will browse our before and after gallery to get an idea of what results are possible.

“Dr. Chalekson is an excellent communicator, he possesses a bright and eager mind, extraordinary manual dexterity and genuine compassion. Dr. Chalekson’s team is a reflection of how well rounded he is.”


If you are considering dermal fillers, contact the plastic surgery practice of Charles Chalekson MD Inc., today online or at 805.434.2828 to schedule a consultation with board-certified plastic surgeon Dr. Charles Chalekson. In addition to women in Paso Robles & Atascadero, San Luis Obispo, Cambria & Morro Bay, Arroyo Grande & Pismo Beach, Santa Maria and Santa Barbara, we happily welcome patients from across California and the U.S.

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1310 Las Tablas Road Suite 202
Templeton, CA 93465

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