What are facial fillers?
Facial fillers, the everyday name for dermal fillers, are soft gels injected beneath the skin to replace lost volume and smooth the lines that are there at rest, in 30 to 60 minutes with no downtime. A face empties as it ages: the cheeks and temples thin, the lips lose their border, the folds beside the mouth deepen, and filler injections put that volume back.
A filler does nothing for a line that appears only when you move: that is muscle, and Botox treats it. Our page on Botox or fillers explains which one your lines need.
Hyaluronic acid filler: Juvederm and Restylane
Hyaluronic acid is a sugar the skin makes to bind water, cross-linked in a filler into a gel that holds its shape for months. The FDA has approved specific products for specific areas; the two on the practice's published price list are Juvederm, made by Allergan Aesthetics, and Restylane, made by Galderma, and which gel goes where is decided at your consultation. Because it is hyaluronic acid, the gel can be dissolved with an enzyme, hyaluronidase, within a day.
Sculptra: the collagen stimulator
Sculptra is not a gel but poly-L-lactic acid, which prompts your own skin to build collagen over several months, in a series of sessions, for results lasting up to two years. It cannot be dissolved and is quoted at your consultation, per vial and per series.
How Dr. Cat approaches facial fillers
Dr. Cat is a board-certified plastic surgeon who completed two surgical residencies, one in head and neck surgery, microvascular and facial reconstructive surgery, and advanced training in general plastic and reconstructive surgery, Harvard-educated and UCLA trained. She treats filler as a true technical art, with the attention to detail of an operation, and her rules govern every syringe at the practice.
The facial analysis and your photographs
Every treatment starts with a detailed facial analysis: your anatomy, the corrections you want, any asymmetry, the look you prefer, and any event on your calendar, because swelling keeps its own timetable. Bring photographs of looks you like and looks you do not.
The multi-layer, multi-directional technique
Her multi-layer, multi-directional technique places small amounts of gel in more than one plane and from more than one direction, through a very thin needle, so the filler blends into the tissue instead of clumping; it is also why her patients bruise and swell less. A topical anesthetic, ice and a special probe keep it close to painless, the skin is cleansed with different solutions before a needle touches it, and a treatment takes 30 to 60 minutes.
Dr. Cat on fillersWho injects at the practice
Every syringe at Dr. Cat Plastic Surgery is placed by one of its two surgeons, never by a nurse injector or physician assistant, and the area decides which. Dr. Cat injects the lips, the nasolabial folds (smile lines) and the horizontal neck lines herself. The cheeks, the hollows under the eyes, the temples, the chin and jawline, the marionette lines and the nose are injected by our board-certified facial plastic surgeon, who has worked alongside her for more than a decade, with the same products, rules and $1,250 per syringe.
Lip fillers
Lip fillers are Dr. Cat's own area, and her rule is short: naturally fuller, in your own shape, never the duck look. No gel goes outside the lip line, the mistake that makes an upper lip look like a piece of gum is stuck there. Very thin lips start with about 1 ml; our post on filler for thin lips explains why. The six cases on this page are all Juvederm lips by Dr. Cat, among them 1 cc for a natural look (FLR-4100), an unretouched before and after (FLR-3706) and a patient who asked for no duck look (FLR-4101).
Lips last 6 to 12 months and swell most, peaking at 24 to 48 hours; our lip filler swelling guide follows them day by day, and our lip filler pricing guide covers prices and syringe counts. A long upper lip is a different problem: filler lengthens it; a lip lift, by our facial plastic surgeon, shortens it.
Nasolabial fold filler (smile lines)
The nasolabial folds run from the nose to the corners of the mouth and deepen as the cheek above them descends. Nasolabial fold filler is Dr. Cat's area: small amounts laid beneath the fold, in layers, so the crease softens without a ridge. Botox never goes here, because those muscles are the ones you smile with. The folds hold filler for 9 to 15 months; when a flat cheek feeds the fold, the cheek is treated too.
Under-eye filler (tear trough filler)
The tear trough is the hollow from the inner corner of the eye across the top of the cheek, the shadow that reads as tired. Under-eye filler places a small amount of a soft, thin gel deep along the trough, so the lid and the cheek become one surface. The tear trough is injected by our board-certified facial plastic surgeon, and the practice's rule there, set by Dr. Cat, is conservative: nobody should look puffy or overfilled, and gel placed too shallow under that thin skin shows as a bluish tint.
The caveat is puffiness: a bag is fat that has pushed forward, not a hollow, and filling beneath it makes it heavier, so a bag needs a lower eyelid lift, which Dr. Cat performs. Tear trough filler lasts 12 to 18 months; the syringes are set at your consultation.
Cheek fillers
Cheek fillers restore the volume over the cheekbone that goes first and shows most: a firmer gel placed deep on the bone lifts the midface and softens the fold beneath it. Cheek fillers are injected by our facial plastic surgeon, so the cheek reads as one curve rather than a bump, and last 12 to 18 months. A cheek that has fallen rather than emptied is a facelift question.
Temple filler
As the temple empties, the tail of the brow drops with it and the upper face looks drawn. Temple filler restores the curve between the brow and the hairline; a broad, flat surface wants an even layer, so the temples are injected by our facial plastic surgeon with the same layered technique, planned with the cheeks.
Chin filler and jawline filler
Chin filler projects a short or receding chin; jawline filler puts an edge back along the jaw and fills the prejowl hollow, the dip in front of an early jowl, so the jawline reads as one line. Both are injected by our facial plastic surgeon, both last 12 to 18 months, and the syringes for each are set at your consultation.
When you want a lasting change, or more projection than a syringe gives, a chin implant, placed by our facial plastic surgeon and permanent, is the better answer; many patients try chin filler first as a preview, and our page on facial implants explains the operation. Jowls and loose skin are not a filler problem; our sagging jowls page draws that line.
Marionette lines filler
Marionette lines run from the corners of the mouth toward the chin. Marionette lines filler places gel beneath the line so the downturn softens without bulk; they are injected by our facial plastic surgeon, hold filler for 9 to 15 months, and are planned with the chin and jawline.
Nose filler (liquid rhinoplasty)
Nose filler, the liquid rhinoplasty, places small amounts of gel above and below a hump so the profile reads straight, lifts a drooping tip and evens a minor asymmetry, in 15 to 30 minutes. It cannot make a nose smaller or fix breathing; those are surgery. Liquid rhinoplasty is performed by our board-certified facial plastic surgeon at a set price of $4,500 including two visits, lasts 12 to 18 months, and our post on non-surgical rhinoplasty covers what it can and cannot correct.
What is a liquid facelift?
A liquid facelift is filler, usually with Botox, placed across several areas in one plan: temples, cheeks, under-eye hollows, folds, chin, jawline and lips. The name overstates it: a liquid facelift refreshes, it does not lift. Jowls and a loose neck are tissue that has moved, and filler makes a fallen face heavier; that is a facelift, performed at the practice by our facial plastic surgeon.
For a face that has emptied in several areas and wants a result that stays, fat transfer to the face, which Dr. Cat performs, is the lasting alternative: your own fat, permanent where it takes. Filler is right for one area, a first try, or a patient with no donor fat.
How long do fillers last?
Fillers last 6 to 18 months, by the area, the product and how quickly your body clears hyaluronic acid. The change is visible before you leave and settles at about two weeks.
- Lip fillers: 6 to 12 months
- Cheek fillers: 12 to 18 months
- Nasolabial folds and marionette lines: 9 to 15 months
- Chin and jawline: 12 to 18 months
- Under the eyes (tear trough): 12 to 18 months
- Nose filler: 12 to 18 months
- Sculptra: up to 2 years with a series of treatments
Dr. Cat creates a personalized maintenance schedule for each patient, and a touch-up on it usually needs less filler than the first session; our post on making dermal filler results last longer covers the aftercare that stretches a syringe.
After facial fillers, day by day
There is no downtime after facial fillers; here is what the days after look like.
- The consultation and facial analysisThe areas and the number of syringes are agreed. For a week before treatment, no aspirin, anti-inflammatories, alcohol or herbal supplements.
- Treatment dayNumbing for 15 to 30 minutes, ice and the probe, a sterile cleanse, then 30 to 60 minutes of injection with a very thin needle, in layers.
- The first 24 hoursNo makeup or anything that could carry bacteria onto your face, and no strenuous exercise. Ice, and massage only if directed; head raised for two nights, no saunas.
- Days 3 to 7Swelling settles over 3 to 7 days by area and any bruise fades; the lips swell most.
- Two weeksThe final look. Your follow-up visit checks the two sides; a small touch-up, if needed, is planned then.
- 6 to 18 monthsThe maintenance visit, on the schedule set for your areas; touch-ups usually need less filler.
Filler migration and filler gone wrong: what it looks like and how it is avoided
Filler migration is gel that has drifted beyond the area it was placed in, most often the ridge above the lip line that reads as a filler mustache; it follows too much product, placed too shallow or topped up too soon. Dr. Cat has seen the rest of what face fillers gone wrong looks like in other hands: filler in the forehead, an upper lip overstuffed and filled outside the lip line, and, worst, filler placed in dangerous areas that cost a patient skin. The serious risk is vascular occlusion: gel injected into an artery blocks the blood supply to the skin it feeds and can kill it, and in the rarest cases gel that reaches the vessels behind the eye costs vision.
What can go wrong
- Bruising and swelling for 3 to 7 days, longer in the lips
- Asymmetry, corrected at the two-week visit
- Lumps, and migration, most often above the lip line
- Infection, uncommon, and a cold sore flare after lip injections
- Vascular occlusion, rare and serious: gel blocking an artery, which can cost skin or, near the eye, sight
How the practice avoids them
- A surgeon injects every syringe; Dr. Cat trained in head and neck surgery and knows where the arteries run
- Small amounts, injected slowly, in layers and from several directions
- A conservative plan, above all under the eyes, with volume added at the follow-up; no filler in the forehead
- A blunt cannula in the risky zones, and a gel matched to the area
- Sterile cleansing, the week-before list, and hyaluronidase in the room to dissolve a hyaluronic acid filler at once if the skin blanches
Dissolving filler with hyaluronidase
Hyaluronidase is an enzyme that dissolves a hyaluronic acid filler within a day. It is used for a lump, an asymmetry, migration, a result you do not like, filler from elsewhere that has gone wrong, and at once for a blocked vessel. Sculptra cannot be dissolved. Dissolving filler is quoted at your consultation.
Who is a good candidate for facial fillers?
The right candidate has a specific change in mind that volume can make.
You may be a good candidate if
- Your lips are thin, uneven, or have lost their border
- Your cheeks or temples have hollowed, or your folds have deepened
- The hollows under your eyes read as tired, with no bag of fat beneath them
- You want a stronger chin, an edge along the jaw or a straighter profile without surgery
- You are in good health, with realistic expectations
Not yet, or a different plan, if
- You are pregnant or breastfeeding
- You have an active skin infection or a cold sore near the lips: treatment waits until it heals
- You take a prescribed blood thinner without clearance from the prescribing doctor
- Your lines appear only when you frown or squint: that is muscle, and Botox is the treatment
- Jowls, a loose neck or hooded eyelids are the complaint: filler does not lift skin
How much do facial fillers cost in Beverly Hills?
Facial fillers cost $1,250 per syringe at Dr. Cat Plastic Surgery, for Juvederm or Restylane, the price on our published non-surgical price list, sold in full syringes and the same whichever of the practice's two surgeons injects. The number of syringes moves the total: a lip enhancement is often one, the cheeks or a jawline more, and the number for each area is set at your consultation. Sculptra is quoted at your consultation, per vial and per series.
Botox and filler fees are per unit and per syringe: if movement lines are treated at the same visit, Botox is $25 per unit and Dysport $8.50 per unit.
Consultation fee, insurance and financing
Your appointment is reserved with a $500 deposit credited to your treatment; new patients are evaluated and treated at the same visit, and the $500 stays as a credit if treatment is not right for you. The $500 surgical consultation fee and its credit toward surgery are a separate arrangement. The practice partners with Cherry, its primary financing partner, and also accepts CareCredit and Alphaeon Credit; see financing and payment plans. Facial fillers are cosmetic and not covered by insurance.
Your consultation with Dr. Cat
It starts with a free 15-minute discovery call with our Patient Concierge, who books your consultation. The consultation and facial analysis are with Dr. Cat, in person on Rodeo Drive or, for out-of-town patients, by private video consultation through OnPatient, the HIPAA-secure patient portal; for the areas that are his, you are seen by our facial plastic surgeon. You leave with a plan and a price.
Facial fillers before and after: what to look for
In filler before and after photos, one question comes first: at rest, does anything look added? Look at the lips in profile, where a ridge above the border shows, and at the three-quarter view, where the cheek and the under-eye hollow should read as one smooth surface. An after photo should be dated two weeks or later, because a face on day two is swollen. The six cases below are all Juvederm lip cases by Dr. Cat, from the practice's filler before and after gallery; results in our facial plastic surgeon's areas are shown at your consultation.
