An expert facial plastic surgeon shows how Botox and fat transfer plus Juvederm, Restylane, Voluma XC, Radiesse and other filler treatments can make a real difference. Learn what works with wrinkles, sunken cheeks, marionette lines, nasolabial folds and whole range of issues that make you look older than you feel.
Editor’s Note: Dr. Ritu Malhotra, of Cleveland, Ohio, is one of the nation’s most experienced board certified facial plastic surgeons. In just under two decades she has performed nearly 4,000 facial plastic surgical procedures. Her special combination of charisma, passion, and confidence has won her multiple recognition awards for superior ratings in patient satisfaction.
Throw away the creams and get real results with Filler treatments A to Z—here’s what you need to know… First, all those lines that you stare at in the mirror, the ones that weren’t there until recently. They all have a name and non-surgical treatment options to erase them…instantly. Sometimes we fill them in, other times we relax the muscle movement that causes the line, and still other times we do both for the best result.
Next, the most popular muscle relaxer, Botox, is often used for the top one third of the face. Three well-liked types of fillers are used for the bottom one third of the face. Belotero Balance, Juvederm and Voluma XC are fillers that closely resemble Hyaluronic Acid, which occurs naturally in the skin.
Hyaluronic Acid insures that the necessary nutrients are carried to skin cells. However, it dissipates with aging. Belotero Balance is preferred for fine lines – duration 6 or more months – cost $600.
Juvederm is used mostly for nasolabial folds, marionette lines and volumizing lips for fullness – duration 9-12 months – cost $600. Voluma XC is the newest of these fillers and restores and enhances cheek contour and adds a subtle lift – duration 2 years – cost $800. All are injected with a very fine needle during a comfortable procedure that requires no downtime.
The next generation filler, calcium based fillers, has calcium-based microspheres suspended in a natural gel that actually stimulate new tissue development and therefore, extended correction. Radiesse is this type of filler and is injected into the skin during a minimally invasive procedure with immediate results and without downtime. It is used mostly for deeper nasolabial folds and marionette lines and restoring volume to cheeks-duration 12-15 months – cost $750.
An all-natural filler, fat, comes from your very own body. It is processed and felt to contain “stem cells” that are able to develop into new tissue leading to long lasting results. Naturalyn is this type of filler and is usually obtained from the abdomen with minimal downtime. Results last years and costs $2500.
Last, certain fillers are preferred for specific areas of the face, and we have detailed these in the following listing to de-mystify filler treatments and tell you what you need to know.
A: Acne scars: that are atrophic, leave a surface hollow, and benefit from a combination of fillers under the skin and surface laser treatments that cost $550, $600 or $750.
Angry “11”: These are the vertical lines between the brows that make you look angry. Botox— five injections usually quiet down this very active muscle and cost $275. Or if the lines are very deep some filler along with the Botox is recommended and costs $600.
B: Brows sagging: This makes you look tired. Botox—usually just one injection on each side results in a chemical brow lift and costs $110.
C: Crow’s feet: These are the radiating sunburst lines from the outside corners of your eyes. Botox—usually 2 to 3 injections on each side lets you smile without those lines and cost $220 to $330.
D: Downturned corners of the lips make you look sad or “grumpy.” Juvederm ($600) or Radiesse ($750) works well here.
E: Every line on the face: Fillers can now fi ll in just about every crevice on the face, including drool lines. Ask your doctor regarding insurance coverage but don’t be surprised if it is not covered by insurance yet!
F: Forehead creases: These are the horizontal lines across the forehead. Botox—usually 3 to 4 injections takes care of the entire forehead and costs $165 to $220.
Fine lines, furrows and folds: Hyaluronic acid fillers such as Restylane and Juvederm are used for fine lines and Radiesse is better for deeper furrows and folds.
G: “Grumpy” look: When volume loss causes the smile to look “upside down.” Fillers can help and costs $600 to $750.
H: Hands: Fillers are an absolutely wonderful option for the hollowing and volume loss of aging hands and costs $750.
I: Immediate results: Fillers offer instant softening of lines and wrinkles that just appear out of nowhere.
J: Jowls: Fillers can be used in the pre-jowl depression areas to camouflage early jowls while waiting for a face lift.
K: 
L: Lips: Would you like fuller lips? Whether you have thin lips, or your lips are disappearing as time goes by, fillers can enhance your lips’ natural features. Use fillers for fullness or fill in those pesky lipstick bleed lines. Juvederm is the preferred filler for fullness and Belotero Balance is best for lip lines and both cost $600.
M: Marionette Lines: These are the “puppet” lines that radiate from the corners of the lips and fi llers are a wonderful liquid face lift for these lines.
N: Nasolabial Folds: These are the creases that run from the outside of the nostrils to the corners of the mouth…sometimes called smile lines. All fillers work well in this area and cost $600 or $750.
O: Other hollows: such as indentations due to facelift surgery or skin cancer procedures are amenable to filler treatment.
P: Painless: With the use of “freeze spray,” filler procedures can be relatively pain free.
Q: Quick: Filler treatments are a quick office procedure.
R: Rhinoplasty: The “10 minute rhinoplasty” procedure uses fillers to fill in the indented area above the “hump” of a nose on the profile view. It works like a charm and often does not have to be repeated for years. Radiesse works best and cost is $750.
S: Scars: Some scars can benefit from filler treatment.
T: Tear troughs: These are the dark indentations that run from the middle corner of your eyes diagonally down your cheek and sometimes around your eye. Fillers are what you need, not the newest, latest and greatest under eye cream! Belotero Balance filler for this and costs $600.
T: Temporary: Although all the fillers discussed here are temporary. They all stimulate collagen to some degree, leaving you better than you were before the filler, even after the actual substance has completely disappeared.
U: Under eye hollowing: Volume loss in the tear trough and orbital rim are treated with fillers. Belotero Balance is preferred and costs $600. 
V: Volume Loss: Specifically in the cheek with loss of youthful cheek contour can be restored and enhanced with the new filler Voluma XC- duration 2 years and cost $800 or Radiesse- duration 12-15 months and cost $750.
W: Wrinkles: Fillers magically erase wrinkles and prevent the development of future furrows and folds.
Quick filler treatments can help you rediscover your beauty…Get back the you…you used to know without surgery!
