Face Fillers – BOTOX, Juvederm, Restylane, Voluma

“Whether a subtle tweak to defy the first signs of lines and wrinkles, or as the perfect complement to a facelift, dermal fillers and Botox injections are the preferred nonsurgical way to address natural aging of the face.”

By the time we’re in our later 30s, most of us start to see some early signs of smile lines or folds around our mouth, squint lines (crow’s feet) at the corners of our eyes, and frown lines between our eyebrows or across our forehead. It used to be our only options to counteract these signs of aging were a bathroom counter full of creams and lotions that did little or nothing to erase the lines and wrinkles, or waiting until our 50s or 60s to have a facelift.

It’s a new day in facial rejuvenation. Thanks to science and the introduction of a variety of dermal fillers and Botox, also known as injectables, we now have an ever-growing number of non-surgical mini-steps to take stage a far better fight against moderate to severe facial lines and wrinkles.

Meet your nonsurgical anti-aging team to address facial lines, wrinkles and folds

Each has one or more specialty areas of the face where it performs beautifully.


BOTOX is the brand name of a toxin produced by the bacterium Clostridium botulinum. Cosmetic surgeons have been using BOTOX for years to temporarily treat and smooth facial wrinkles and creases to improve one’s appearance. Botox is specifically FDA-approved to temporarily improve moderate to severe frown lines between the brows and crow’s feet in adults. Both areas of the face can be treated at the same time. Botox works by reducing muscle activity (contractions) in the area where it is injected. As such, lines caused by repeated squinting or frowning are less easily formed. Results can be seen within just a few days and can last up to three to six months. Treatment takes only about 10 minutes and can be repeated as needed. Most people describe the slight needle stick similar to poking your face with your fingernail. For more details, visit www.botoxcosmetic.com.


Juvederm® is an injectable gel containing a modified hyaluronic acid identical to a naturally occurring building block found in the human body. Cosmetic surgeons use this FDA-approved, nonsurgical filler to instantly smooth away the deeper lines along the sides of your nose and mouth (nasolabial folds). Folds and creases in these areas can give us a tired, unhappy and older-looking facial appearance. Results typically last up to one year or longer. Treatment takes 30 minutes or so depending on how many areas of the face are treated. Juvederm contains a small amount of a common anesthetic called Lidocaine to reduce any discomfort caused by the injections. Juvederm treatments can be repeated as needed. For more details, visit www.juvederm.com.


Restylane® is the preferred injectable for filling sunken areas in the delicate area under the eyes, and for adding volume and fullness to the lips. It also can be used to correct moderate to severe facial wrinkles and folds, such as the lines from your nose to the corners of your mouth (nasolabial folds). Like Juvederm, this FDA-approved injectable contains a small amount of Lidocaine to help reduce any discomfort. Results can last up to 18 months. Restylane treatments can be repeated as needed. For more details, visit www.RestylaneUSA.com.


Voluma®, a member of the Juvederm family of dermal fillers, is the first and only FDA-approved injectable gel designed specifically to correct volume loss in the cheek area. Voluma allows your cosmetic surgeon to help restore a more youthful profile to your face by subtly filling, contouring and lifting the cheeks to the natural look of your younger years. Voluma contains a modified hyaluronic acid made from a naturally-occurring sugar. Like Juvederm, Voluma contains a small amount of Lidocaine to help reduce any discomfort during treatment. Results can last up to two years, and treatments can be repeated as needed. For more details, visit www.juvederm.com.

How to get the natural results you want

More isn’t always better. Too much Botox can leave you looking like your face is made of concrete. Too much of any filler can make you look unnatural and overdone. Start conservatively. Your cosmetic surgeon can always add more, if needed.

The art and precision of dermal filler and Botox treatments by Dr. Robert J. Smyth

The first step to getting the natural results you want is to choose a highly experienced cosmetic surgeon, and discuss with him or her your goals and expectations. As we like to say at Dr. Smyth’s office, “Experience matters, especially when it’s your face.”

With 30+ years specializing in just the face and neck, cosmetic surgeon Dr. Robert J. Smyth performs all dermal filler and Botox treatments himself. “There is a definite art to using fillers,” says Dr. Smyth. “It’s paramount to look at each person’s face individually, to have the person smile and frown, and to see how his or her face functions. Does one side of the face have more lines and wrinkles than the other? How does the person sleep? Do they hold a phone to their face all day in their work? Do they faithfully wear good sunglasses when outdoors? All of these issues can affect the application, effectiveness and results of fillers.”

Watch-outs and precautions

When considering Botox or dermal filler treatments, be sure to tell your doctor about:

  • All medical conditions you have
  • Any allergies
  • All medications you currently take
  • Any muscle or nerve conditions you have or for which you have been treated