As our skin ages, the dermis loses support and volume, leading to wrinkles and folds. Dermal fillers are commonly used to reduce or eliminate wrinkles, smooth depressed scars, enhance lips and replace soft-tissue volume loss.

A filler substance is injected beneath the surface of the skin where it temporarily plumps and smooths the skin. There are several classes of dermal fillers that are FDA- approved, including collagen, hyaluronic acid and calcium hydroxyl apatite-based fillers — each with different properties and characteristics.



Dr. Mann generally recommends the hyaluronic acid fillers, like  Restylane and  Juvederm, for their combination of safety, smooth and natural appearance, and good duration. Hyaluronic acid is a natural component of human skin and is the framework in which skin cells live. All hyaluronic acid products bind water and in the skin they create volume, resulting in a natural, youthful appearance.  They do not need skin testing.   Experts agree that hyaluronic acids are the products of choice for shaping lips.

Hyaluronic acid fillers typically last about 8- 9 months. Very long-lasting fillers made out of other substances not natural to the skin may sound good at first. But consider what would happen if you had a reaction to such filler, or if you weren’t happy with the result? With hyaluronic acid fillers like Restylane and Juvederm, a readily available and safe enzyme injection can be used to dissolve them.  Hyaluronic acid fillers combine an excellent safety profile with good durability.



For slightly longer lasting cosmetic filler which typically lasts between 9 – 18 months, Dr. Mann recommends Radiesse to smooth out your wrinkles and folds or give your cheeks a fuller, more youthful look.

Besides filling in lines and wrinkles, fillers can be used to:

  • Improve the shape/ profile of noses
  • Hide jowls and restore a smooth jaw line
  • Enhance sunken and flat cheeks
  • Rejuvenate hands

Treatments usually last 15-20 minutes and are usually painless. Depending on the areas treated, more than one syringe may be needed to create the best look possible. An enhancement may be needed 4-8 weeks after your first treatment to fine-tune your results and produce longer lasting improvement. Results typically last between 6-12 months (or 9-18 months if Radiesse is used) but can be touched up sooner if consistent full correction is desired.

Pre treatment tips:

  • Make sure you wash your face thoroughly before your treatment, including removing lipstick and face creams.
  • To reduce the risk of bruising and swelling you can avoid aspirin, ibuprofen (Advil), Vit. E, fish oil and similar meds for 1-2 weeks before your treatment. Arnica, starting the morning of your treatment or immediately after, will also help reduce bruising and swelling. A physician-strength version is available for purchase at our office.
  • If you have a history of herpes (cold sores) in this area, a medication that will help prevent these sores will be prescribed.
  • A cold spray will be applied at the time of treatment to numb the skin. To make lip treatments more comfortable, we usually inject a lidocaine anesthetic under your lips immediately before your treatment. These injections are nearly painless and will make your treatment almost or completely painless also.

Post treatment:

After injection, some common, temporary, injection-related reactions may occur: tenderness, redness, itching, bruising, bumps, pain or swelling. If any of these occur, they typically resolve within a few days. Occasionally they can last up to 7-10 days after lip injections. We recommend planning your treatments at least one week before any special events. Some minor swelling can sometimes persist up to several weeks after your treatment.

Aftercare tips:

Apply cold packs for 15-20 minutes every 30-60 minutes for several hours after your treatment to help reduce swelling and bruising. Taking Arnica for 1-2 days will also help. Avoid squeezing or massaging the treated areas for several hours after treatment as this may subtly change the shape we are trying to achieve. Sleeping on two pillows for the first night may help reduce lip swelling. If your cheeks have been treated, avoid sleeping on your face the first night.