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Dermal Fillers: Resculpting Faces, Lips and Noses



It is easy to see why Injectable fillers are so popular at every age. With the educated, and artful use of fillers so much is possible: lines and crow’s feet disappear, lips plump up and become youthful again, indentations and troughs created by time, movement and the environment fade away. Modern fillers are more comfortable and long lasting than ever before. Most do require touch-ups. Regrettably, daily facial expressions, sun, free radicals, heredity, weight fluctuations and hormonal changes all break down the support structure of your skin.

We Advocate the Educated Use of Fillers.
The success of fillers in facial rejuvenation is really more determined by “the Indian than the Arrow.” Because of this, we encourage you to transcend the medi-spas and seek out the most experienced hands. Dr. Duffy is proficient in the use of an entire arsenal of fillers, each designed to address a specific type of wrinkle and location. Patients come in asking for fillers by name and price point when in actuality, fillers should be chosen like paints in an artist’s palette. Best to let the doctor select what’s best for you. To learn more about specific fillers, we have included basic descriptions and websites below.

Begin with a “Smart Evaluation.” Careful observation of your face, how it moves and ages is as important as good technique. The doctor may watch you as you speak to see how your movements affect line formation. He may palpate the wrinkle to feel for corrugations. Each face ages differently with changes (gains and losses) in fat, collagen and elastin. Fat generally resides in various compartments deep in the middle face. Refilling these compartments artfully enhances the structure of and lends shape to the face. Poor technique can leave you looking overstuffed and shapeless. Maintaining the age-appropriate contours and expressiveness is the key.

Lip Augmentation and Correcting Facial Anomalies
Dermal fillers give lips fuller contours but plumping up is rarely all that’s needed. Attention must also be paid to perioral lines, the upper lip area and nasial labial folds. The sophisticated approach resculpts the entire lip area. As always, Dr. Duffy’s extensive clinical experience and skilled injection technique will help you get your best result.

With time and trauma, the faces and noses can develop minor irregularities. Dr. Duffy can create better symmetry on nasal tips, to improve the jawline, straighten the bridge of the nose, etc. all using fillers. In the beauty press, this is often referred to as a “Liquid Lift” because it achieves immediate results using liquid fillers, without plastic surgery.

At each stage in life lines appear. It may start with some light crow’s feet or under-eye crepinesss. At middle age, perioral and jawline creases appear. Mature faces experience volume loss in the cheek area and hollows at the temples. Age-appropriate corrections will keep you looking healthy and lovely at any age.


Great Results May Call for a Combination of Therapies. Most lines and depressions respond to fillers. Soft U-shaped wrinkles plump up nicely with fillers. Rigid V-shaped lines will require the laser or other ablative methods. With patients over 30, Dr. Duffy will most likely suggest a neuromodulator in combination with an injectable filler to stave off deepening of visible lines. At times, he may recommend laser or light procedures or Ulthera/Pelleve treatment to effect an overall tightening.

Learn More About Fillers

Here is some general information your may find useful about some of the fillers we commonly use. 

Juvederm is now a family of injectable gels made from hyaluronic acid (HA), a substance that occurs naturally in the body, helping to hydrate tissues and lubricate joints. JUVÉDERM® XC is used in the central face for moderate-to-severe facial wrinkles and folds around the nose and mouth. JUVÉDERM VOLUMA™ XC is the first filler FDA-approved to add volume to the cheek area. It gives you a subtle lift, helping to restore contour and a more youthful profile, for up to 2 years, in patients over the age of 21. www.juvederm.com 

Radiesse is an injectable filler made of calcium-based microspheres. Most often used for wrinkle reduction by replacing lost volume. Can last up to 12 months. Radiesse comes mixed with a numbing agent to make it very comfortable. Excellent for volumizing. www.radiesse.com 

Artefil, the longest lasting filler, is made of PMMA microspheres that are not degraded, or absorbed by the body and therefore can provide a long-lasting wrinkle correction. Introduced in 2007, it is specifically used for corrections in nasial-labial folds. www.artefil.com

BELOTERO BALANCE®  Specially designed to integrate into your skin and mold easily, this filler is excellent for fine improvements around the mouth and lips. Belotero is soft enough to treat delicate areas such as vertical lip lines. Made of  hyaluronic acid or HA, Belotero finds to water allowing for an immediate and smooth correction. 

Sculptra Aesthetic is made from poly-L-lactic acid, a safe biocompatible, biodegradable synthetic material that has been used for decades. Sculptra is designed to work within the deep dermis to replace lost collagen, correct sunken checks, deep facial folds and volume loss. Provides gradual results that can last up to two years. Works gradually in a series of treatments — on average, three injection sessions over a few months — for a subtle, more youthful looking appearance. www.sculptraaesthetic.com