Dermal Fillers

Dermal fillers are popular for several reasons. Patients like that they can return to everyday activities immediately after getting most fillers. They like the immediate results that many types of fillers deliver. Patients also like that they can get this treatment during an office visit. Some fillers require a few office visits. 

Dr. Pantea Hashemi at the University Skin Institute in Sacramento California chooses only the best dermal fillers that integrate into the tissues and are undetectable when the face is at rest and with movement.   

What is hyaluronic acid?  

Hyaluronic acid is a sugar naturally found in the body that hydrate the skin. As we age and with excessive UV sun exposure, the supply diminishes contributing to facial aging. Augmenting HA supports the skin’s structure by stimulating collagen and elastin to rebuild facial volume, and smooth fine lines and wrinkles to renew a youthful appearance. Because hyaluronic acid is a natural substance, there is no risk of allergic response. These fillers breakdown slowly and are naturally absorbed by the body. 

New collagen and elastin aid in reducing deep lines and creases from the inside out.  As new collagen forms, the filler begins to breakdown, thus providing a more lasting rejuvenation than other types of fillers.   

Hyaluronic Acid (HA) fillers 

The Juvederm® Family of Fillers 

Juvederm is a family of products are made in different formulations for different purposes, to temporarily reduce the appearance of aging by diminishing the look of wrinkles and creases. All of the Juvederm fillers contain lidocaine for comfort during injection. 

Juvederm XC smooths moderate to severe wrinkles around the mouth, nasolabial folds (vertical lines that run from the corners of the nose to the mouth). 

Juvederm Ultra XC is perfect for lip augmentation, and to fill vertical lip lines; to improve the appearance of fine to moderate lines and wrinkles and facial folds. Results last about a year.   

Juvederm Ultra Plus XC is thicker and can correct deep lines and wrinkles and improve facial contours.  Results last about a year.   

Juvederm Voluma XC is designed to restore age related volume loss in the cheeks. It provides lift and contours for a more youthful appearance. It lasts about two years. 

Juvederm Vollure XC is used to soften moderate to severe wrinkles and folds and smooth vertical lip lines and provide subtle volume enhancement in the lips. 

Juvederm Volbella XC is specifically designed for the lip augmentation.

The Restylane® Family  

Similar to Juvederm, the Restylane family of fillers are used to add volume and fullness to correct moderate to severe wrinkles and folds, and for lip enhancement.  Restylane is a clear gel of hyaluronic acid formulated to act like your body’s naturally produced HA, adding volume, lifting and smoothing wrinkles. It can last up to six months, but some patients experience effects lasting for up to a year. 

While Restylane and Juvederm are both hyaluronic acid products, and can be used to treat similar conditions, Dr. Hashemi may have preferences based on experience. After evaluating your skin and goals she will recommend the best choice for you.  

The RHA® family of fillers by Revance Theraputics 

The RHA family of dermal fillers is made using the most advanced HA science that mimics the HA naturally produced in the skin. Because it moves and acts like our tissues, it is perfect to treat dynamic wrinkles and deliver very natural results.  

Until now, the only option to treat dynamic wrinkles was neurotoxins such as Botox. 

RHA fillers are the first HA fillers created to treat dynamic wrinkles without concern for unnatural results. RHA fillers are designed to adapt to facial movements without any limitation on mobility which leads to the most natural looking results.  

Dynamic wrinkles are created from repetitive facial movements that express how we feel. Over the years, facial expressions such as frowning, squinting, brow furrows, and crow’s feet crease the skin and are classic signs of skin damage and aging. RHA fillers are proven to last up to 15 months.   


Radiesse is not an HA filler. It is a dual action dermal filler that adds volume to the face to diminish facial wrinkles and folds. Treatment can fill out the hollows in cheeks and smooth wrinkles. Radiesse is made of microspheres of Calcium Hydroxylapatite (CaHA) in a gel base.  It is biostimulatory, meaning once injected, it provides immediate volume and correction and stimulates the production of your own natural collagen. Over time, the gel is absorbed, and the body metabolizes the CaHA microspheres leaving behind only your own natural collagen. 

Radiesse is an excellent option to plump your skin for immediate smoothing results and a long-lasting natural look. Effects last up to a year, but the new collagen helps to retain the improvements much longer.  

What happens when I get a filler? 

The procedure varies with the filler your dermatologist will use, the part of the body to be treated, and your medical history. Here are some general guidelines about what you can expect: 

What must I do after getting a filler? 

Most patients can return to their everyday activities after leaving the office. To reduce any redness and swelling from the injections, your dermatologist may recommend icing the area for 15 to 20 minutes before you leave. 

After leaving the office, you should:  

Is there downtime? 

This varies with the filler. Most fillers do not require downtime. Be sure to ask your dermatologist whether you will have downtime. 

When will I see results after getting a filler?  

This also varies with the filler. Most fillers fill the skin, so they produce immediate – or close to immediate – results. A filler also can stimulate your body to produce collagen, but this takes time. 

Will I look natural?  

To get natural-looking results, the person injecting the filler must have expertise in placing the filler.  

Dermatologists recommend not overdoing fillers. Your results will look more natural with a conservative approach. For example, patients who have very thin lips should not get dramatically fuller lips. Creating fuller lips in these patients could be extremely unflattering. 

How long will the results from fillers last? 

Most fillers offer temporary results and require repeat treatments to maintain the results. Temporary fillers offer one key advantage. These can be injected as needed to replace lost fullness. This is advantageous because no matter what we do, our skin continues to age.  

Contact Dr. Hashemi at the University Skin Institute in Sacramento to schedule a consultation and discover all your options for facial rejuvenation.