• Mary Dealy

Facial Rejuvenation with Dermal Filler - Your Questions Answered

If you are looking to rejuvenate your appearance and fight the effects of gravity, you may be contemplating a cosmetic procedure such as a facelift or dermal filler. For many clients, rejuvenation of the whole face is possible without the commitment of surgery. Thanks to the evolution of the cosmetic industry with new products and techniques, much of this rejuvenation can be performed with dermal filler. Treating deep and superficial fat compartments, lifting the upper face, volumising the mid-face and tightening the lower face with various fillers produce visible results while maintaining natural proportions, and with minimal trauma, pain, bruising and downtime.

Filler vs Facelift

In a traditional facelift, a surgeon makes an incision in front of the ear, extending up into the hair or hairline as well as behind the ear into the hair-bearing scalp. The surgeon lifts the skin off the deeper facial muscles and fat, gently pulls the skin in an upward and posterior direction, and removes the excess skin. The incisions are then closed with sutures and possibly staples. A drain may be placed under the skin behind the ear for one or two days, to remove any excess blood and fluids. This is certainly an appropriate avenue for some clients. However for other clients, treating deep and superficial fat compartments, lifting the upper face, volumising the mid-face and tightening the lower face can be achieved with dermal filler and minimal trauma, pain, bruising and downtime.

The aging face

The face is made of bones, muscles, and most importantly fat pads that lie underneath the skin. These fat pads form the facial contours, lifted cheekbones, and tight appearance of the jaw and neck that we see in the youthful face. As we age, we lose these crucial fat pads, causing a sagging appearance. By the time we reach age 55, most of this volume is gone, and it does not replace itself.

What is facial rejuvenation?

Facial rejuvenation is the practice of using dermal fillers as temporary to long-lasting solution to replace these fat pads. Dermal fillers are strategically placed in the temple, cheeks, under the nose and mouth, chin, and jaw to replace volume loss and lift the areas that are sagging.

How long does the procedure take?

The procedure is performed in the office and takes from 30 to 60 minutes depending on the individual situation. It is very important that the clinician first perform a complete facial assessment to target the areas needed, as every face is different! From there the specific products are chosen and injected in target areas.

How long does it last?

The effects last a year and in some cases up to two years. For optimal results, touch up sessions every 6 months or so may be recommended.

Risks and Complications?

Dermal filler is not without risks. The most common side effects are bruising, redness, swelling and tenderness at the injection site. These are relatively minor and resolve within one week. Infection is always a risk, however the risk can minimized with excellent pretreatment screening, (eg, avoid if there is any skin infection, cold sores, recent dental work or recent immunizations) as well as strict asceptic procedure technique. Occasionally patients may experience small nodules at the injection area, which resolve in 24-48 hours. There are some products that cause nodules that don't resolve, and will require injection of another substance to dissolve them, however this can be avoided by using the proper filler. While very rare, a small amount of filler that is injected into a vessel can cause occlusion, skin necrosis and even blindness. The use of cannula rather then needle technique has reduced this risk to almost zero.

How can I reduce these risks?

Choose a provider that is experienced and knowledgable and can minimize risks every step of the way. Thorough knowledge of facial anatomy and injection technique before, during, and after treatment the key to a safe procedure and beautiful outcome!


Dermal filler injections require very minimal downtime, allowing patients to return to work and their normal activities directly following treatment. However, for the first 24 hours, individuals may be instructed to refrain from strenuous activities and excessive sun or heat exposure such as hot tubs or saunas, and ice the area.

About the author

Mary Dealy, NP is a certified Nurse Practitioner with over 30 years of clinical practice. She is owner and primary injector at Beautoxetc, a boutique cosmetic dermatology practice in Medfield, MA.

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