What are Dermal Fillers, and How Do They Work?

Dermal fillers like Juvederm® can be used in a variety of ways to help enhance and contour the face with a natural looking result.

Dermal fillers can help restore the youthful volume that is lost in the cheeks over time. They can also smooth the lines around the nose and mouth, known as marionette lines. Dermal fillers can also be used to contour the jawline, reshape the nose, sculpt the chin, and add fullness to thin lips.

Juvederm® works by increasing facial volume and reducing the signs of aging through its main active ingredient, hyaluronic acid. This substance occurs naturally in the body to stimulate the production of collagen, which plumps the skin.

As you get older, your skin produces less collagen and hyaluronic acid, which increases the appearance of wrinkles and sagging skin.

At Northern Medical Center, we use only brand name dermal fillers with a trusted reputation for quality, results, and a track record of safety. According to the American Society of Aesthetic Plastic Surgery, more than 2.4 million procedures using hyaluronic-based fillers were performed in 2016.

When you receive a dermal filler, the treatment is injected directly into your skin, replacing lost hyaluronic acid and improving facial volume and fullness. It also hydrates and smooths the skin, creating a more youthful look.

Why Choose Northern Medical Center’s Medical Aesthetic Services?

At Northern Medical Center, located in Middletown, N.Y., we treat the whole person, and put our patients first. When you come in for a consultation, we take the time to understand your treatment goals and provide a plan that is right for you.

In addition to dermal fillers, our aesthetics services also provide Botox®, Aquagold® microneedling, double chin reduction with Kybella®, Facial contouring with Evoke, and facial tightening with Newa.

Our board-certified physicians, nurses, and healthcare professionals work collaboratively to help our patients achieve optimal result.

What is Juvederm®?

Juvederm® is FDA-approved, and is one of the most popular brand names for a collection of dermal fillers that are used to improve signs of aging. Juvederm®  has a line of fillers tailored to target specific signs of aging on the skin.

How does Juvederm® work?

Juvederm® is a smooth gel consisting of a modified form of hyaluronic acid. Hyaluronic acid is a natural substance found in the body that delivers nutrients and contributes to volume and hydration of the skin.

Juvederm® works by temporarily holding more water at the injection site and adding volume to create a smoother appearance to the skin.

The results with Juvederm® are longer lasting than many of the older filler types like collagen.

What Can Dermal Fillers Help With?

  • Facial wrinkles, fine lines, and creases
  • Wrinkles around the nose and mouth
  • Thin lips
  • Vertical lip lines
  • Sagging cheekbones and flat cheeks
  • Neck and decolletage
  • Back of the hands
  • Improve the appearance of acne scars

What to Expect During a Dermal Filler Treatment?

Your aesthetic practitioner will take your medical history, discuss your areas of concern, and provide a facial analysis.

Prior to treatment, your dermatologist will prepare your skin with an alcohol wipe. You might also receive a topical numbing anesthetic, but this isn’t always necessary because the filler contains pain-reducing lidocaine.

A series of strategic injections will then be made with fine needles, while your practitioner molds the filler with his or her fingers to ensure a natural result.

Depending on the area being treatment, your session will last around 15 to 30 minutes. You can resume your normal life afterward, but it is advised to avoid strenuous exercise for a few days.

How do I decide Between Dermal Fillers and Botox?

Depending on what type of wrinkle you want to treat, dermal fillers or Botox could be a better choice. It depends on the type of wrinkle you want to treat. There are two main types of wrinkles: static and dynamic.

Static wrinkles are lines and folds that are caused by gravity, and the loss of volume in the skin as we age. Dermal fillers are a good choice to treat static wrinkles because of their ability to restore volume within the skin to fill in these lines and folds.

Dynamic wrinkles are caused by repeated facial movements, which become more permanent as the skin loses elasticity. These typically appear in the upper part of the face. Dynamic wrinkles are best treated with Botox because of their relationship to the underlying muscles in the face. Botox works to relax those muscles that contribute to unwanted wrinkles.

What is the Difference Between Dermal Fillers and Botox?

Compared to Botox, the plumping effect from dermal fillers is usually instant, compared to 3-7 days with Botox. Dermal fillers can also last longer, up to 2 years versus 3-5 months for Botox.

Botox is made of botulinum toxin type A, a neurotoxin produced by the bacteria Clostridium botulinum. The toxin causes temporary muscle relaxation by blocking nerve signals in the offending muscle. The brain no longer gets the message to contract the muscle, and the appearance of wrinkles in that area is reduced.

The most popular dermal fillers are typically made from hyaluronic acid, a naturally occurring substance in the human body. Hyaluronic acid is responsible for providing moisture and suppleness to the skin. In a dermal filler the hyaluronic acid is suspended in a gel that fills in loose and sagging areas under the skin to reduce the appearance of wrinkles.

Both treatments involve a series of fine needle injections. With Botox, the injections are made into the muscle, while with dermal fillers, injections are made under the skin.

Juvederm Before and after

Avi BAs
Ashlyn BAs
Dylan BAs
Mona BAs
Ashley BAs


> How long does a dermal filler treatment last?

Although you will notice changes immediately, it may take up to 2 weeks for the full results to develop. At first, the treatment might look fuller than it actually is.

Depending on the type of treatment, results can last anywhere from 6 months to 2 years. Since hyaluronic acid is a naturally occurring substance, the rate at which your body metabolizes it, is another factor that affects how long a dermal treatment will last.

> How do I prepare for a dermal filler treatment?

You are advised to avoid certain medications and supplements for 1 week prior to your treatment to reduce the risk of bruising.

These include:

  • Aspirin
  • Anti-inflammatory medications like Motrin and Aleve
  • NSAIDS, such as cold medicines
  • Blood thinners like garlic and fish oil
  • Vitamin E, gingko biloba, ginseng, and St. John’s wort
  • Alcohol

Two days before the treatment, stop using topical anti-aging ointments, serums, and creams containing glycolic acid, retinoids, retinol, and Retin-A as they can irritate the skin and negatively impact treatment outcomes.

> What should I do after the dermal filler treatment?

You are advised to avoid touching or massaging the treated area for 24 hours. Strenuous exercise and alcohol should also be avoided for a few days after treatment.

For the first two weeks after a treatment, avoid unnecessary sun, heat, and cold exposure, as well as using any products on the skin that contain alcohol.

Avoid dental procedures for 2 weeks.

It is advised to return for a follow up visit 1-2 weeks after your treatment to address any issues or concerns.

> Are there any side effects?

The most common side effect is minor swelling and bruising at the injection site. Bruising can be hidden with a concealer. Skin redness or tenderness is also possible. These effects are temporary, and will subside quickly within 1-2 weeks.

The occurrence of cold sores around the mouth, or near an injection site, is something you want to tell your doctor about prior to treatment. He or she may prescribe an anti-viral medication to prevent an outbreak.

Also, tell your doctor if you are pregnant or breastfeeding, or if you have a history of excessive scarring and/or pigmentation. The safety of the products has not been studied for these situations.

The use of blood thinners, aspirin, and ibuprofen is also something you want to disclose as it can prolong bruising and bleeding.

For a complete list of possible side effects, visit the Juvederm website: https://www.juvederm.com

> What happens if I am unhappy with the result?

After 2-weeks, in the event that you are dissatisfied with how you look after receiving a dermal filler, a substance called hyaluronidase can be injected to dissolve the filler either partially, or completely.

> Who should not receive dermal fillers?

Do not use if you have a history of multiple severe allergies or severe allergic reactions (anaphylasix), or if you are allergic to lidocaine or the Gram-positive bacterial proteins used in Juvaderm products.

What is the cost of dermal filler treatment?

The cost will vary depending your personal goals, the areas being treated, and the amount of product that is required. Please contact us for a customized consultation, so we can provide you with the options available.