Learn more about Dermal Fillers such as Restylane and Juvederm performed by Dr. Margaret Mann at the University Hospitals Westlake Dermatology Clinic.  To schedule an appointment for a cosmetic consultation, please contact us at 440-250-2450.

What are Dermal fillers and how do they work?

There are many injectable cosmetic fillers on the market today.  Dr. Mann uses a variety of products depending on what is most appropriate for your particular needs. Soft tissue fillers are generally used to “plump up” or soften creases or wrinkles and to support areas of volume loss. They can be used to plump lips, fill hollow cheeks, repair facial imperfections such as scars, and elevate deep folds. Fillers can contour specific facial areas to give the skin a smoother and more pleasing appearance. While fillers cannot stop the process of aging, they can temporarily diminish the look of wrinkles and soft tissue depressions.

Dermal Fillers Not Just for the Face

These safe and effective injectables – which include Restylane, Radiesse, and Juvederm – are used most commonly to fill the smile lines. But they can be used to plump up other parts of the body as well including:


The backs of our hands can appear wrinkled, bony or prominently veined as we grow older and the skin thins – giving away our age even if we’ve undergone facial rejuvenation. The right filler, however, can plump up this thinning skin and give you hands to match a youthful-looking face.


Filler Face Location

Even earlobes can reveal the passage of time as they become creased, stretched and saggy from wearing earrings. Injectible dermal fillers can restore this lost fullness.

Acne Scars

Dermal fillers can soften the appearance of acne scars and other surface depressions.

Nose Remodeling

A crooked nose can be “straightened” without surgery with the appropriate placement of a filler.

Under-eye Circles or Hollows

By plumping up the under-eye area that has lost volume, fillers can eliminate that chronic tired look.


What are Dermal fillers made of?

Dermal Filler BrandsThere are numerous filler products available including hyaluronic acids (Restylane, Juvederm, Belotero), and hydroxyapatite (Radiesse). These are naturally occurring substances that is found within all mammals, therefore there is little risk of allergic reactions. In addition, they are biodegradable, which means that over time, the substance will be slowly absorbed by the body. The length of effect depends on the type of filler and the location of its placement. Our fillers are FDA approved for augmentation of the nasolabial folds (smile lines). Treatment of other areas such as the lips, forehead, cheeks, eyes, brows, scars, jawline and chin are well-documented in the literature and the medical community but the FDA has not approved those uses.

Longer acting filler products include Sculptra and Artefill. Sculptra is made of a biodegradable synthetic polymer that stimulates new collagen formation in the skin and is used for large volume restoration, especially to the upper cheek and chin. Artefill is a permanent filler made of polymethylmethacrylate, an inert synthetic filler that is not absorbed by the body, therefore provides permanent support for wrinkle correction.

What will happen during treatment?

Dr. Mann will determine the areas and extent of treatment by discussing your objectives and then use the most appropriate product to achieve an aesthetically pleasing result. Areas that can be treated include wrinkle correction and lip enhancements; correcting thin superficial lines around the mouth, forehead and smile; and shaping facial contours, such as cheeks and chin, correcting deep folds, and for volume augmentation.

Prior to the procedure, the face is cleaned and a topical numbing cream or local anesthetic may be used to reduce the discomfort. Dr. Mann will then administer several tiny injections in the areas to be treated.

How long does treatment take?

The treatment can usually be done in about 15-20 minutes and no recovery time is needed (see Aftercare Instructions). Generally, the only visible signs that you’ve had anything done are some potential redness or minor bruising around the injection points. We advise that you take it easy for the next day (no strenuous exercise, use ice packs) to reduce bruising and swelling.

How quickly will I see results?

All of the fillers produce natural enhancement that are long-lasting, gentle and safe to your skin. The results are instantaneous with all of the fillers; the only exception is Sculptra which is a collagen stimulator. After the initial swelling subsides with Sculptra, patients will notice gradual improvement over 3-6 months, as the sculptra product stimulates new collagen to form.

How long will it last?

The duration of enhancement depends on the type of product use and location of enhancement. When used along the smile lines or nasolabial folds, Evolence has been shown to last up to 9 months, Restylane and Juvederm up to 6-9 months, and Radiesse up to 12 months. Sculptra requires multiple treatments (2-6 treatments) with results that may last 2 or more years. Finally Artefill is the only FDA approved permanent filler that has been shown to last more than 5 years. The longevity of a product also depends on treatment location—generally product last shorter in areas of movement such as the lips and longer in areas without movement such as the tear trough. You always have a choice to continue or change the combination of treatments – and the procedure can be repeated as often as you like. Most patients choose to have a follow-up treatment 6 – 12 months after an initial treatment of wrinkles.

See Dr. Mann’s expert answers to Filler questions on



Dermatologic Surgery and Aesthetic Dermatology

615-266-3376(DERM) | Office in Hendersonville, TN

Dermatologic Surgeon Dr. Margaret Mann M.D., and Dermatologist Dr. Daniel Popkin, serving Hendersonville, Nashville, Rivergate, Gallatin, Goodlettsville, and the surrounding Sumner County, Tennessee area at Innova Dermatology