As we age, it’s natural to lose volume in the face due to several factors. Fat pads that once provided youthful fullness shrink and shift downward while the body produces less collagen, elastin, and hyaluronic acid—key components that keep skin firm, plump, and hydrated. Additionally, bone density in the face diminishes, and muscles can weaken, leading to reduced support for the skin. Combined with the effects of gravity and lifestyle factors like sun exposure or smoking, these changes contribute to hollow cheeks, under-eye hollows, and sagging skin. Dermal fillers can help combat these signs of aging by restoring lost volume, redefining contours, and enhancing natural beauty.

Fine lines and wrinkles can leave you feeling like your reflection doesn’t match how vibrant you feel inside. At Midlothian Dermatology, we offer dermal fillers—an incredible solution to restore lost volume, smooth deep wrinkles, and enhance your natural features. Whether you’re looking to soften smile lines, plump up your lips, or define your cheekbones, dermal fillers can help you achieve a youthful, refreshed look you’ll love. Let us help you feel confident in your skin again!

What is Dermal Filler?

Dermal fillers, also called soft-tissue fillers, are a category of FDA-approved injectables that add volume beneath the surface of the skin. Along with skin sagging and loss of elasticity, volume loss is a normal part of aging. The loss of volume leads to deep facial folds and wrinkles, hollows across the face, as well as skin that is less smooth.

Dermal fillers help to create a smoother and fuller appearance in the face, including nasolabial folds (the lines extending from the sides of the nose to the edges of the mouth), cheeks, chin, lips, and back of the hands. A dermal filler is a great alternative to surgery. It offers clients a way to maintain a youthful look without surgery. 

Why are Dermal Fillers Used?

As you age, your body starts to lose collagen. Collagen is an important substance that exists all over your body, including in your skin, muscles, bones, and connective tissues. Decreased amounts of collagen in your skin cause skin laxity (loose) and volume loss. Skin becomes thinner, loses its elasticity, and starts to sag.

You may choose to get dermal fillers to:

• Add volume to sagging skin.

• Make your facial features more symmetrical.

• Plump up lips and cheeks.

• Smooth wrinkles and creases on your face.

How Common are Dermal Fillers?

Dermal fillers are very common. Every year in the United States, more than 3 million people choose to get dermal fillers.

How do Dermal Fillers Work?

Dermal fillers are gel-like substances that are injected under the skin to create a fuller or smoother appearance. They work by restoring volume and moisture to the skin, which can make wrinkles, folds, and lines less noticeable.

What are the Types of Dermal Filler?

There are many types of dermal fillers. In addition to “off-the-shelf” fillers that use synthetic (man-made materials) and substances that naturally occur in your body, fat from your body can also be used. Healthcare providers call this procedure “autologous fat grafting,” where they remove fat from one part of your body and inject it into your face.

The types of off-the-shelf fillers include:

Hyaluronic acid (HA)is a naturally occurring component of your skin. It gives your skin volume and keeps it hydrated. With age, your body stops making hyaluronic acid. Results from HA injections usually last six months to a year. Restylane® and RHA® are commonly used brands of HA filler.

Calcium hydroxylapatite (CaHA) is a type of filler that consists of a substance you have in your bones; it stimulates collagen, elastin and proteoglycans. Results from these fillers typically last around a year or two. Healthcare providers usually use CaHA fillers for deeper wrinkles or in a more dilute form for surface wrinkles and collagen support. Examples of CaHA fillers include Radiesse®.

Poly-L-lactic acid (PLLA) is a substance that helps your body create its own collagen. Healthcare providers usually use poly-L-lactic acid to smooth deep wrinkles on your face and provide volume. The results can last two years or more. Types of PLLA fillers include Sculptra®.

Polymethylmethacrylate (PMMA) fillers consist of collagen and tiny balls that stay under your skin after your healthcare provider injects them. The balls give your skin volume and keep it firm. Bellafill® is one type of PMMA filler.

Is Dermal Filler the same as Botox?

No, dermal filler and Botox are not the same and work in different ways. Botox is a neurotoxin that temporarily relaxes muscles, helping to smooth fine lines and wrinkles on the skin’s surface. Dermal fillers, typically made of hyaluronic acid, restore volume to areas of the face that have lost fullness over time.

Dynamic Wrinkles

Dynamic wrinkles form from repeated facial expressions like raising your eyebrows or frowning. These expressions cause muscle contractions, creating creases in the skin; they are present with movement. Common dynamic wrinkles include crow’s feet, frown lines, and forehead creases, which can be effectively treated with BOTOX Cosmetic. Botox, Dysport, Jeuveau, Daxxify, and Xeomin are used to reduce the appearance of dynamic wrinkles by relaxing the muscles involved.  RHA Collection of fillers is the first and only FDA-approved HA filler for dynamic wrinkles.

Static Wrinkles

Static wrinkles, on the other hand, are always present, even when your face is at rest. They result from gravity, loss of facial volume over time and repetitive muscle action causing creasing in the overlying skin at rest. The most common static wrinkles are the 11s between the brows, the forehead wrinkles, marionette lines, and the parentheses around the mouth (nasolabial folds). Botox can sometimes soften these static lines and prevent worsening or deepening of these, and sometimes dermal fillers are used to restore volume and smooth these areas.

What Areas Can Dermal Filler Treat?

Dermal fillers are excellent options for several concerns, such as:

• Lip augmentation (lip injections)

• Buttock augmentation (buttock injections)

• Tear troughs (correction of hollows under the eyes)

• Deep folds (correction around the mouth for “marionette lines” and nasolabial folds)

• Smile lines (correction of thin, superficial lines around the mouth)

• Correction of age-related volume loss and facial contouring (such as cheeks, chin, and jowl correction)

Each dermal filler varies in consistency or thickness. Dr. Adams tailors the specific filler’s use to a patient’s unique profile and the areas being treated. Thus, one or more types of filler may be used, depending on what results are desired.

Dermal Filler Options at Midlothian Dermatology

RHA COLLECTION

RHA Collection is a Swiss-designed hyaluronic acid filler intentionally designed to mimic the natural hyaluronic acid found in your skin. It has a unique combination of stretch and dynamic strength designed to adapt to facial dynamics. It moves with you for a much more natural appearance. Each product is designed for a different use: 

RHA® 2 is indicated for injection into the mid-to-deep dermis to correct moderate dynamic wrinkles and folds. 

RHA® 3 is indicated for injection into the mid-to-deep dermis to correct moderate to severe dynamic wrinkles and folds and is also approved for the lips.

RHA® 4 is indicated for injection into the deep dermis to superficial subcutaneous tissue to correct severe dynamic wrinkles and folds. 

RHA® Redensity is the first and only FDA-approved filler for injection into both the superficial dermis and dermis to treat moderate to severe dynamic perioral rhytids, aka “smoker’s lines.” This filler has a gentle quality allowing dermatologists to fill even the tiniest lines without bulking up the area. It’s meant for correction around the mouth and not an augmentation of the lips.

THE RHA® COLLECTION of fillers is resilient by design-made to move with the face by stretching and rebounding with dynamic facial movement.  It most closely resembles the natural HA found in the skin

RADIESSE

RADIESSE® is used for smoothing moderate-to-severe facial wrinkles and folds, such as nasolabial folds (the creases that extend from the corner of your nose to the corner of your mouth). RADIESSE® is also used for correcting volume loss in the back of the hands and for jawline definition.

RADIESSE® stimulates the body’s process of generating collagen and encourages growth for a more refreshed appearance. It is composed of calcium hydroxylapatite (CaHA) microspheres suspended in an aqueous gel carrier. Once injected, it provides immediate volume and correction and continues to work by stimulating the body to produce its own natural collagen for a long-lasting effect. Over time, your body absorbs the gel and metabolizes the CaHA microspheres, leaving behind your own natural collagen.

RESTYLANE

Restylane is a dermal filler composed of hyaluronic acid in a gel formulation. Each member of the Restylane® family is tailored to meet a different need.

Restylane®: The original formula adds volume and fullness to correct moderate-to-severe facial wrinkles and folds, including the nasolabial folds (the lines from your nose to the corners of your mouth).

Restylane® Silk: This product adds fullness and definition to lips with natural-looking results after just one treatment. It is also ideal for smoothing wrinkles and lines around the mouth.

Restylane® Lyft: Used to boost volume and smooth wrinkles in the mid-face/cheek areas, nasolabial folds, and the backs of hands.

Restylane® Refyne and Defyne: Formulated for injection into the mid to deep dermis to correct moderate-to-severe facial wrinkles and folds (such as the nasolabial folds).

Restylane® Kysse: A longer-lasting member of the lineup specifically designed for use as a lip filler.

Restylane® Contour: A great option for patients who want improved cheek volume but want a natural look.

What are the Benefits of Dermal Fillers?

Dermal fillers in Midlothian, VA, are used for an increasingly wide array of cosmetic problems. You’ll experience a wide range of facial rejuvenation benefits from dermal fillers. They can be used to:

• Restore the youthful “triangle” to your facial shape

• Restore youthful fullness to your cheeks, lips, and mouth area

• Remove hollows under your eyes

• Lift the drooping corners of your mouth

• Fill nasolabial folds and contour your jawline or chin

• Smooth lines and wrinkles

Ideal Candidates for Dermal Filler

Dermal fillers are very popular treatments for both men and women of a wide age range. We understand that each client’s need is personal, so it’s our job to help guide you through the process by assessing your needs and goals, examining the areas where you wish to receive the injectables, and determining whether you are a good candidate for one of our procedures. 

Good candidates for dermal fillers are those with the facial aging, wrinkles and fine lines, volume loss, realistic expectations, good overall health, non-smokers and commitment to maintenance. 

Dermal Fillers are less invasive than other facial procedures which is why it’s beneficial for a lot of clients with a wide variety of skin types. We encourage you to reach out to find out which dermal filler is right for you.

Is There an Ideal Age for Dermal Filler?

The best age to start getting dermal filler injections is a matter of professional opinion, but some recommend starting in your late 20s or early 30s before significant volume loss and wrinkles appear, a trend known as “prejuvenation”. However, most women typically get dermal fillers between 40 and 55. Dermal fillers are approved for use in people aged 22 and older

Lip Fillers:

Lip fillers, known for enhancing lip volume and shape, are popular among individuals of various age groups. Younger individuals in their 20s and 30s often seek subtle enhancements for plump, youthful-looking lips. Lip fillers can help combat natural volume loss and fine lines as we age, making them suitable for those in their 40s and beyond.  Lip fillers can also be used just to pinken up and hydrate the lips.

Tear Trough Fillers:

Tear trough fillers address the hollows or dark circles beneath the eyes- a concern that can affect people at different stages of life. While younger individuals may opt for tear trough fillers to correct genetic under-eye hollows, those in their 40s and 50s may seek them to combat age-related volume loss and skin thinning.

Cheek Fillers:

Cheek fillers are excellent for adding definition and contour to the cheeks. Younger clients may use them for a more sculpted appearance, while older individuals often benefit from cheek fillers to restore lost volume and counter sagging skin.

Other Dermal Filler Treatments:

Apart from lip, tear trough, and cheek fillers, dermal fillers offer a wide range of treatments suitable for various age groups. These may include jawline contouring, chin augmentation, and hand rejuvenation. The suitability of each treatment depends on individual needs and goals rather than a specific age range.

Are Dermal Fillers Safe?

Dermal fillers are generally very safe if injected by a trained and qualified professional like Dr. Adams. The dermal fillers used at Midlothian Dermatology are FDA-approved, and you can rest assured that they are authentic and have not expired. This may not be the case at non-medical facilities. Temporary dermal fillers are safer than permanent ones, as most of them can be dissolved if needed. Dermal fillers can achieve natural and beautiful results when done correctly.

What is Dermal Filler Treatment Like?

A dermal filler treatment at Midlothian Dermatology is relatively quick and minimally invasive. Most sessions take less than 40 minutes, making it easy to fit into your schedule, even during your lunch break. Here’s what you can expect during your Botox treatment:

1. Consultation: We will begin by discussing your aesthetic goals and evaluating the areas of concern. This will determine the best injection sites, and the quantity needed for optimal results.

2. Preparation: The treatment area will be cleansed, and a topical numbing cream or local numbing will be applied/instilled.

3. Injection: Dr. Adams’ dermal filler treatments consist of a series of targeted injections using a cannula or ultra fine needle. Pain is minimal and any discomfort is minimized using an anesthetic and other distraction techniques like music, squeeze balls or vibration. Most patients note a brief prick or pressure sensation when each injection is made. It is generally well-tolerated by those with even the lowest pain thresholds.

4. Post-Treatment: Once the filler injections are complete, you’re free to go about your day. You may want to ice the area for 5-10 minutes every 1-2 hours while you’re awake that day.

There’s no downtime, although we recommend avoiding strenuous exercise and alcohol for the rest of the day. 

How Do I Minimize Bruising Risk?

Bruising is a potential side effect of dermal fillers, but it can be reduced by selecting an experienced practitioner; however, it is the most common complication. In less skilled hands, bruising is more likely, especially around the eyes where the skin is thinner. To help prevent bruising, patients should avoid alcohol and certain supplements and medications for at least five days before treatment. These include Aspirin, NSAIDs (such as Advil, Ibuprofen, Motrin, Naprosyn, and Aleve), Vitamin E, Omega-3 Fatty Acids, Fish Oil, Ginseng, Ginger, Gingko Biloba, Green Tea, and alcohol. If bruising does occur, using topical arnica cream can speed up healing, and concealers work well for covering it temporarily.  Recommended Arnica is from VitaMedica which makes both topical Arnica-K cream and oral supplements.  VitaMedica also makes Bromelain/Quercetin supplements which contains a therapeutic enzyme found in pineapples known to help with bruising.

Are there any Special Instructions for After Dermal Filler Injection?

To ensure the best results and reduce potential side effects, be sure to follow these additional guidelines:

• Avoid dental work (including dental cleaning) or vaccinations a minimum of 2 weeks prior to and after injectable treatment.

• Skip alcohol for at least a day, as it can thin the blood and contribute to bruising.

• Avoid blood thinners like Aspirin or Plavix for 7 days prior to treatment (see above regarding bruising).

• Hold off on strenuous exercise for the rest of the day after the injection since exercise can raise your blood pressure and increase bruising.

• Avoid facials or facial massages to the treated areas for 2 weeks.

• If you were prescribed an antiviral medication, please fill the prescription the day of the procedure or before, start taking it immediately, and complete the full course as directed.

• LIPS ONLY: Avoid smoking, whistling, drinking from a straw and kissing for 24 hours after treatment.  Please avoid consuming hot liquids to prevent burning and be careful eating.

• Consider taking antihistamines after lip injections to minimize temporary swelling.

• You can wash your face that day; however, avoid any cosmetics, topicals or creams for the rest of the day.  You may resume your normal skin care routine the next day.

Following these guidelines can help minimize side effects and ensure you get the best outcome from your treatment.

When Will I See the Results from Dermal Filler?

You will see results almost immediately! There may be some initial swelling or redness after receiving the injectable. Still, after this disappears, you will visibly be happy with the results of seeing your youthful-looking appearance and smooth skin. Scheduling follow-up appointments every 6-12 months is also a key ingredient to maintaining these results.

How Long Does Dermal Filler Last?

Dermal fillers can last anywhere from three months to two years, depending on some key factors. The length of time that dermal fillers last depends on several factors, including: 

Type of filler: Different types of fillers have different lifespans. For example, hyaluronic acid (HA) typically lasts 6–12 months, calcium hydroxylapatite can last up to two years, and PMMA (polymethylmethacrylate) can last up to three years. 

Injection location: Fillers in more active areas of the face, like the lips, tend to go away more quickly. Areas with less movement, like the cheeks and temples, tend to retain results longer. 

Patient lifestyle: Habits like smoking and excessive sun exposure can accelerate the breakdown of fillers.

How Should I Prepare for Dermal Filler Treatment?

Plan your Dermal Filler appointment at least 10-14 days before any important social event or dental procedure/cleaning.

Avoid blood thinners - Stop taking blood thinners, like Aspirin and Ibuprofen, about 7 days before your treatment. (see other meds/supplements above)

Avoid alcohol - Don’t drink alcohol for at least 24 hours before and after your treatment. Alcohol can increase your risk of bruising by thinning your blood and causing blood vessels to widen. 

Avoid certain skincare products - Stop using products that contain Retinol, Retinoid, Glycolic Acid, or other exfoliating agents for 48 hours before your treatment. 

Avoid hair removal - Don’t shave, wax, thread, pluck, or use depilatory cream on the area to be treated. 

Stay hydrated—Drink more water in the days before your treatment. Well-hydrated skin responds better to treatments. 

Consider taking Arnica - If you’re prone to bruising, taking Arnica two days before your treatment can help reduce redness and bruising. Consider purchasing VitaMedica Arnica-K cream, supplements and possibly bromelain supplements (see above for tips to minimize bruising).

Avoid abrasive treatments - Don’t get chemical peels or microdermabrasion immediately before your treatment.

How Much Filler Do I Need?

Dermal Filler is sold both by the syringe and the result, and the number of syringes required/cost varies depending on the area being treated, the volume loss, and other factors unique to each patient. During your consultation at Midlothian Dermatology, we will assess your skin and discuss your concerns to create an immediate and longer-term plan to achieve your goals.

Why Choose Midlothian Dermatology?

Midlothian Dermatology is the place to come when you want to look more refreshed, youthful, and confident through nonsurgical procedures! Dermal filler treatments are part art and part science. Providing dramatic yet natural-looking results requires the aesthetic eye and trained hands of an experienced injector. Dr. Erin Adams, our board-certified dermatologist with advanced injection training, performs all dermal filler procedures. Our Midlothian Dermatology office offers several popular fillers, including the RHA® Collection of hyaluronic acid fillers, Radiesse®, and some Restylane® products.

Schedule a Dermal Filler Treatment at Midlothian Dermatology

If you are interested in Dermal Fillers in the Midlothian, Virginia area, call our office at 804-378-3048 to book a consultation with Dr. Adams or our RN, Lisa, to learn how a filler treatment can enhance your beauty!