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Injectables Procedures and the Liquid Facelift

Facial fillers are a nonsurgical cosmetic solution to add volume under the skin to help soften the appearance of fine lines, wrinkles and hollow areas. An injectable filler uses a liquid substance to fill a facial pocket that has lost volume due to aging or weight loss, Liquid fillers reshape the natural contour of the skin, resulting in a younger appearance. They are commonly injected in the cheeks, chin, lips, under the eyes, in the nasolabial folds and other areas that require a “liquid lift.” It is common to combine a filler product with another facial cosmetic procedure. Fillers are noninvasive, do not leave scars and are highly effective in achieving natural results.


BOTOX is a nonsurgical facial rejuvenation treatment that uses a neurotoxin to relax facial muscles, softening facial lines and wrinkles.


Juvederm is a hyaluronic acid filler with multiple uses including adding volume to the lips, or cheeks, correct facial lines or smooth nasolabial folds.


Voluma is Juvederm hyaluronic acid filler used most commonly for cheek augmentation to correct loss of volume due to aging.


Volbella is a hyaluronic acid filler that is softer than the other Juvederm products and is ideal for adding volume and shape to lips as well as correcting facial lines.


Radiesse is an injectable filler composed of calcium hydroxyapatite used commonly for cheek augmentation to correct loss of volume due to aging.


Sculptra is a facial filler composed of poly-L-lactic acid that stimulates collagen production to replaced lost volume.

Types of Derma Fillers

Technological advances have made it possible to manufacture a variety of fillers. Most fillers are derived from natural substances (such as collagen) while others are artificially produced. The patient’s skin condition and aesthetic goals will decide which type of filler will be best to use.

Fat Transfer

Fat transfer is the harvesting of excess fat from a donor site on the patient’s body. The fat is extracted using liposuction. These fat tissues are then purified and reinjected gradually into an area of skin with layering precision. The doctor will massage the skin and ensure that the intended contour is achieved. The body naturally absorbs fat and the results often last up to 6 months.


Collagen is a naturally occurring protein in human and animals. Skin, bone, cartilage and teeth are rich in collagen. These are harvested and converted into a sterilized liquid form and used as a derma filler. It is a popular filler for lip augmentation procedures. Some collage is derived from animals. Patients using a derma filler of this nature will require allergy testing ahead of the procedure to ensure that they will not have any complications.

Calcium Hydroxyapatite

Usually found in the bones and teeth of humans, calcium hydroxyapatite is also harvested and processed to use as a liquid filler. It is considered as one of the heavier substances and ideal in adding volume to deep creases. This particular filler product usually lasts longer than some of the others on the market.

Hyaluronic Acid

Hyaluronic acid is another substance that is sourced from humans. Rich deposits of this substance are commonly found in ligaments and connective tissues. As with other natural substances, when used as a derma filler, the results are natural and effective, but they are not long lasting as the body reabsorbs the solution over time.

Polylactic Acid

Polylactic acid is an artificial substance. When injected, it doesn’t just add volume underneath the skin, but it also triggers the production of collagen, which helps in skin renewal. The contours will be visible immediately and the skin quality will be evident after several months. This filler can last up to a year or longer for most patients.

During/After the Procedure

Injectable fillers are performed in Dr. Critelli’s office at the UT Health East Texas Cosmetic Surgery Center in Tyler with the use of dental blocks and local anesthetic creams if necessary. Almost pain-free, your comfort and safety is our main concern. Patients will only feel a prick from the injection. The substance will be injected gradually in even layers to make sure a natural looking result and contour is achieved. Sometimes, it may take more than one full syringe depending on how much volume is needed. There may be slight swelling, bruising and redness on the treated area but this usually subsides after a few days. Patients will be able to return to a normal routine a few hours after treatment.


How safe is it?

All derma fillers are FDA approved, meaning they have passed comprehensive testing to prove that the product is safe and effective to use. The majority of fillers are made with a natural substance so if the result is not as the patient desired, the good advantage is that the filler, at some point, will be reabsorbed by the body, and the results are temporary.

Do I need reinjection?

Most likely. Natural fillers are absorbed by the body in an average of 6 months to 12 months. When this happens, there will be a loss of volume similar to the condition prior to treatment. Reinjection is recommended to maintain the desired results. Some patients find this high maintenance but feel its worth the natural feel of their cosmetic treatment.

Is BOTOX better?

Injectable fillers help to decrease wrinkles by adding volume to smooth the skin’s surface. BOTOX, Dysport and Xeomin offer a result that looks and acts similar, but with a different approach. These treatments use a neurotoxic agent injected into the skin to temporarily freeze overactive muscles causing wrinkles. When the muscles relax, the visible wrinkles on the outer layer of the skin relax and soften, resulting in a smoother, younger appearance.