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By Sarah Y. Wu and Lisa DeSantis
Once shrouded in mystery, facial fillers are gaining visibility—both on social media and IRL. With influencers posting live demos and friends debating over brunch whether or not to get filler, the procedures have become less of a secret and more of a socially acceptable subject of conversation.
We won’t go so far as to say the taboo has completely lifted, as the decision to book an injectables appointment still seems to elicit some strong reactions, but the discussion around cosmetic procedures is certainly more out in the open than it once was.
We’re not saying everyone should rush out and get a face full of filler—this still counts as a medical procedure and should be treated with more consideration than trying a new hair color or a trendy manicure. But if you’re thinking about undergoing any cosmetic procedure, you deserve to be informed. Choose to change your looks or don’t—the point is, the choice is yours.
And there are SO many options to choose from right now.
If you’re someone who hears the term “filler” and immediately thinks of over-the-top duck lips, you might be surprised to learn that there are nine areas of the face that are commonly injected with fillers—and many modern fillers are undetectable. (Just be sure to go to a licensed, board-certified dermatologist or plastic surgeon.
The first thing you need to know is that not all filler is created equal. The most common are made of hyaluronic acid (a substance that occurs naturally in our bodies and is highly attracted to water and binds to moisture; it's a popular ingredient in moisturizers). These typically last six months to a year, depending on placement and how your body naturally breaks down the substance. They can be instantly reversed with an injection of hyaluronidase, an enzyme that melts away filler should you decide you no longer want it.
Non-HA fillers are called biostimulatory fillers and are made from other materials. These include Sculptra (made with poly-L-lactic acid, a biodegradable manmade polymer), Radiesse (made with calcium hydroxyapatite, the mineral teeth and bones are made out of), and Bellafill (which suspends polymethylmethacrylate, or nonbiodegradable acrylic beads, in bovine collagen). Most (but not all) fillers have an immediately visible effect.
Jessica Weiser, M.D., says that unlike HA fillers–which are typically fully settled within two weeks–“biostimulatory fillers can take 6 to 12 weeks to take full effect.” These typically tend to last longer since they’re made to help stimulate natural collagen production (meaning your skin will start to plump naturally) but they can’t easily be undone. The FDA has approved biostimulatory fillers only for nasolabial folds and cheek acne scars, but many licensed practitioners use them off-label. (Or, in an area that hasn’t been FDA-approved.)
The second thing you need to know is a filler appointment will be pricey—and if it isn’t, something is suspicious. With every kind of filler, there’s a risk of complications, including scabbing and scarring as well as more serious side effects, such as blindness. So it’s imperative that you do your homework and go to a board-certified practitioner. We asked trusted dermatologists to share the average costs at their clinics, but understand that prices vary widely depending on your geographic location, the practice that you’re going to, and how skilled your injector is. The best thing to do is call practices in your area to get a price estimate and consultation.
Read on for more info on everything to expect at your filler appointment along with the lowdown on the many different types of filler and the areas that can be filled.
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If you’re investing in lip fillers, you may have to get them done more frequently than the rest of your face (possibly every few months). The reason: The more you move an injected region, the faster your body metabolizes the material and thus your filler runs its course faster. There are also a range of options for augmentation. “Your lips can be subtly enhanced to soften fine lip lines and define contour or more dramatically plumped depending on the individual desire of the patient,” says Dr. Weiser. “It can also soften vertical lines that result from loss of volume.”
Simon Ourian, M.D., whose Beverly Hills clinic, Epione, is particularly popular for injectables, counts lips as one of his most-requested treatments. He says that the average cost ranges from $2,900 to $4,900. “Fillers can be charged by units or by area,” he says. “In my practice, we charge by area to achieve the desired look each patient wants instead of limiting them to a certain amount of units per area.” Dr. Ourian’s pricing reflects the fact that he compounds his own formulations with FDA-approved fillers. “For a more youthful, plumped appearance, I use a combination of hydrophilic-based fillers and a nonhydrophilic formula to create a more defined appearance for areas such as the lip borders,” he says.
Dendy Engelman, M.D. prefers a thinner, softer product made from hyaluronic acid, such as Juvéderm Volbella, for lips. Her clinic charges by the syringe, so based on the amount of product you inject, the starting price is typically $1,000 to $1,400. ( FYI, achieving the look of most influencers typically takes two to three syringes, if not more.)
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Want more lifted and sculpted cheekbones? There's filler for that. But the mid-face is an area where you might see a cannula more commonly used than a needle. “Cannulas are blunt-tipped thin tubes used for filler placement,” says Dr. Weiser. Because they lack the sharp tip of a needle, they’re less likely to be inserted directly into a blood vessel, causing potential complications that can be as severe as blindness. Another reason that cannulas are sometimes preferred is to minimize bruising–this goes for other areas, too, such as the lips. “The one drawback of the cannula is that they are not quite as precise as needles, so occasionally more product volume is needed, or the result may be slightly less exact than intended,” she says. “Many experienced providers choose to use a combination of cannula for large-scale injections and then a needle for the fine and more precise aspects.”
Your dermatologist or plastic surgeon will apply or inject a local anesthetic to the area she's about to inject, then create an opening with a needle and slide in the cannula. Which technique she uses—and how much the procedure costs—depends on the result you want. "The midface loses fat and structural support from the cheekbone resulting in a flattening and shadowing of your cheek," says Dr. Weiser. "Filler can be used along the cheekbone to a more youthful contour to your cheeks." She estimates that this type of midface injection will cost around $1,200, and says those getting it tend to have lost volume in their cheeks due to aging. If you want the "Instagram face" look, the same filler can be used to contour your cheeks, creating a sharper, lifted cheekbone instead of making your midface look fuller. Expect that procedure to start around $650. Restylane Contour is FDA-approved to be injected by both a needle and a cannula, so your doctor can use her discretion based on your desired outcome.
Temples are another area of the face that will lose fat and become hollow over time, Dr. Weiser says. You likely won't need too much product here, but pricing also factors in the complexity of treatment. "Treating a temple hollow could cost $1,500 or more," she says. This is one of those "no-filler filler" treatments where, if the procedure is done correctly, you won't look like you've had any work done. Currently, this isn't an FDA-approved use, but it is a common off-label use among licensed practitioners. (Another common off-label injectable: Botox injected in the jaw to prevent teeth grinding.)
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Some patients ask for jawline filler to compensate for loss of bone structure over time, while others simply want to sculpt a more angular profile. Ourian says jawline contouring is the most popular treatment in his clinic. "For a chiseled appearance, I created a calcium-based and hyaluronic acid formula," he says. Dr. Ourian estimates that the procedure will cost between $3,900 and $5,900. (Note again, that this is off-label use.)
Juvéderm Volux XC was recently FDA-approved specifically for the jawline area. Volux is thick and has a high viscosity, so it mimics the appearance of bone well, says Dr. Engelman. “After injection, Volux stays in place and provides a great structure.” Because it essentially looks like bone, it gives the jaw and chin a natural shape and sharp definition.
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Juvéderm Voluma XC and Restylane Defyne are the FDA-approved fillers for this area. Both can be used as part of jawline contouring, or as a separate treatment entirely. Dr. Weiser says that chin filler "more sharply delineates your lower face from your neck and further enhances the contour of your jawline."
Dr. Ourian sees many patients who request chin and jawline augmentation together and estimates the total cost between $3,900 and $5,900. "It is important to understand each patient's natural facial structure anatomy and work from there," he says. "I use a 'pointillist' technique that creates a very natural, blended, and even look. This allows me to apply a fraction of a droplet at a time and blend the filler into the desired areas, as well as control the amount of filler being dispersed."
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Also known as nasolabial folds, this area was one of the first places where fillers were FDA-approved for treatment. These are the lines on either side of your mouth that resemble parentheses on your face. Dr. Weiser explains that they can be emphasized by sleeping on your side, which places more pressure on one side of your face, "breaking down collagen and structural skin support more quickly."
Cost may depend on how deep the lines are and how many syringes you require; one syringe may cost from $800 to $1,500. Dr. Weiser says that the parts of your face that have the most blood supply—notably, around the nose and mouth—are at the highest risk for bruising, which should subside within a week.
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The tear trough (also called the infraorbital hollow) is the area under your eye where dark circles can form. This popular yet specialized treatment calls for a provider who's well-trained in treating the area. The FDA-approved fillers for treating this tear trough are Juvéderm Volbella XC and Restylane Eyelight.
Although the procedure is highly specialized, it can safely be done. But there are complications you should be aware of: "There are major blood supplies around your nose and right under your eyes, which makes fillers in these areas very risky," says Dr. Engelman. Dr. Weiser says that "some of the arteries near the inner corner of your eye and surrounding the nose have direct pathways to the artery that supplies blood to the eye, and a serious error could result in blindness."
Injecting the tear trough with filler helps treat the appearance of dark circles more effectively than any topical eye cream. That's because the procedure creates volume, effectively minimizing shadows created by a hollowed undereye. "Shifting of the undereye fat pads creates a tired appearance," says Dr. Weiser. "Small droplets of carefully placed filler can help to lift the overlying skin to create a more rested appearance."
“A more complex tear trough could cost $1,500 or more,” Dr. Weiser says.
Alternately called smoker's lines, laugh lines, or perioral rhytids, these are the little vertical lines and creases caused by repetitive movement of the mouth. "By placing small amounts of filler into the vermilion border [the delineation of your lip] and also into the skin between your lips and nose, the lines and creases can be softened or eliminated," says Dr. Weiser.
You may not need a lot of product here, but due to the complexity of the procedure, the costs will likely be high. Dr. Ourian says the treatment starts around $3,000, and the filler that lasts one to three years.
Of course, pricing depends on which filler your provider chooses to use, but for the lip and perioral area in particular, Juvéderm Volbella and Restylane Kysse are both FDA-approved.
There's also a class of fillers called RHAs, or resilient hyaluronic acid. These treat static wrinkles (the ones that are etched into your skin when it's still) as well as dynamic wrinkles (those that appear when you're making an expression). They're still HA-based, so can be reversed if needed, but they have more of a gel texture. Revance RHA Redensity has been FDA-approved for treating fine lines and wrinkles in this area.
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So-called liquid nose jobs are gaining popularity on Instagram for their ability to temporarily reshape your nose without requiring you to go under the knife. Although the procedure is non-invasive, it's an off-label use of filler and requires someone who specializes in the technique, similar to undereye filler.
“This is one of the highest risk areas for filler injection and should always be performed by a board-certified dermatologist or plastic surgeon,” Dr. Weiser says. When performed by a highly skilled physician, liquid rhinoplasty can create many of the same effects as a surgical rhinoplasty, but the results will be temporary. “It can be done to soften a dorsal hump, lift the nasal tip, or to straighten the line of your nose,” Dr. Weiser says.
Dr. Ourian, who's shared videos of the procedure on Instagram, estimates the cost to range from $3,900 to $8,900. At other less popular (but still reputable) clinics, costs can start around $1,000. As for the amount of time it takes? 15 minutes.
Dr. Engelman told us about one of the newest treatments to be granted FDA approval: Skinvive by Juvéderm is “the first and only hyaluronic acid (HA) intradermal microdroplet injection for skin smoothness that is available in the U.S.,” she says. This is to replicate the hydrated look and smooth feel that comes along with facial fillers, just without the super plumped-up appearance. That's not to say there won't be some subtle plumping, though; you will notice that the overall smoothing effect helps to iron out fine lines and wrinkles in the most natural-looking way. Dr. Engelman says results can last about six months with optimal injection and care.
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