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dermal fillers facial cosmetic enhancement

Dermal fillers can be an effective way to soften creases and replace lost volume that occurs naturally with age.

Dermal Fillers


Juvederm Ultra XC

As we age, our faces begin a process of unwanted change.  Our bodies produce less and less collagen, elastin and hyaluronic acid.  These are the soft tissue components that give our skin its supple, youthful look and augment the structure of the facial bones that ultimately serve as the foundation of facial anatomy.  This overall descent and loss of facial volume leads to formation of fine lines, wrinkles, sagging tissues and decreased cheek projection, which can in turn create deep laugh lines (nasolabial folds) between the nose and mouth as well as hollowing of the eyes and sagging jowls.

Dermal fillers can be an effective way to soften creases and replace lost volume that occurs naturally with age.  Dermal fillers can also be used to enhance the volume and shape of the lips and to restore a more youthful appearance to other areas as well.

Get back your naturally youthful look with Dr. Long, Board Certified Plastic Surgeon specializing in minimally invasive procedures of the face.

There are multiple FDA approved dermal fillers available today, each with a recommended use.  Dermal fillers are commonly used to:

  • Attenuate the appearance of laugh or smile lines: Lines that running from the bottom of the nose to the corners of the mouth (Medical term: Nasolabial folds)

  • Correct the horizontal lines of the forehead

  • Rectify the vertical lines between the eyebrows or “11’s” (Medical term: Glabellar lines)

  • Restore the lost “apple” volume back to your cheeks, diminishing the creases around the mouth and Lifting sagging jowls

  • Smooth out the tear troughs running from the inner corners of the eyes down to the mid-cheek

  • Add lost volume back to the under eye area, reducing the “hollowed out” look

  • Address the deep “crows feet” around the eyes

Dr. Long offers an unsurpassed quality of patient care. His Dermal Fillers results are the product of his extensive training in cosmetic surgery and his teaching at a number of medical schools and hospitals, including lectures internationally.

Dr. Long uses a range of fillers and will choose the filler or fillers (sometimes he uses more than one type) to leave you looking rejuvenated, refreshed and most importantly – natural looking.

Dermal Fillers F.A.Q.

  • Dr. Long will determine the filler or combination of fillers to fit your treatment goals, your anatomy and your age to make you look refreshed, rejuvenated and meeting those goals with a natural looking result

  • Many dermal fillers are approved for use in the mid-face to restore volume loss and enhance the cheek. Through multiple injections performed with very small needles, Dr. Long can return your cheek to its is smooth, full curve while diminishing the creases around the mouth and Lifting sagging jowls.

  • Dermal Fillers are a safe and reliable way to enhance the volume and shape of the lips (upper and lower). Lip anatomy contains many structures like the vermillion (red part of the lip), white line (vermillion wet/dry border), philtrum (vertical lines between the nose and the upper lip) and the white roll at the edge of the lip all can be enhanced with dermal fillers. Dr. Long evaluates every single point of the lip anatomy and injects dermal fillers in the needed areas to give you a naturally enhanced lips without an overdone look. Dermal Fillers are routinely used to enhance the lip anatomy.

    To increase the volume of the lip, Dr. Long injects the body of the lip (vermillion or red area). This can create a pouty look and evert the lip outwards so that more red shows. As a general rule the lower lip has to be bigger than the upper lip in a two thirds to one third ratio to maintain an aesthetically pleasing look.

    To enhance the definition of lip contour Dr. Long injects dermal filler in the vermilion border, the junction between the white and red part of the lips, By injecting this region, the lip border is better defined, similar to applying lip liner. Injection of Dermal Filler along this line can also help with unwanted lines that cross through this area.

    To enhance the flattened upper lip skin, Dr. Long injects dermal fillers in the philtrum columns: two vertical lines in the center of the upper lip that runs from the base of the nose to the upper lip border. By enhancing this double-ridge, it is possible to give the upper lip more shape and curve, enhancing the sensuality of the lips, thus rejuvenating the upper lip (effacement of the philtrum (flat upper lip) is an unwanted visible sign of aging.

    To enhance the sensuality of the upper lip, the cupid’s bow, or the V shaped area in the center of the upper lip can also be enhanced with dermal fillers. Done in conjunction with the philtrum, it can achieve a pleasant overall shape to the upper lip.

    To improve the descended position of the corners of the mouth (oral commissures), Dr. James Long can inject injects dermal fillers in these areas, thus turning the corners of the lips horizontally, or even upwards creating a more positive and happy appearance. Often Dr. Long uses Botox in this area to further correct descended corners of the mouth.

  • Dermal Fillers can fill in horizontal lines on forehead and the vertical “11’s” between the eyes (glabella region), addressing the signs of aging and enhancing the effects or Botox in these areas. In patients that are not candidates for Botox of the forehead or glabella region because “droopy” eyebrows or excess of skin in the upper lids, dermal filers are a good options to improve forehead and glabellar lines.

  • Are your hands making you look older than you are? Once you’ve addressed your face, your hands may be a tell-tale source of aging, revealing that you may have undergone facial rejuvenation. Usually these changes are the result of volume loss which causes tendons on the backs of the hands to become more noticeable (and making them look like they belong on a much older woman) along with skin damage due to sun exposure. Dermal Fillers and fat grafting can be used for restore volume to the back of the hand. When combined with a gentle TCA chemical peel in this area, Dermal Fillers can significantly rejuvenate the appearance of your hands.

    Dermal Fillers for acne related sunken scars and other sunken scars.

    Certain types of sunken scars secondary to accidents, acne previous and some surgical procedures can be made less apparent with dermal fillers.  Dr. James Long, MD by injecting an small amount of filler under the depressed area of skin, can add volume to the area thus lifting the scar to the same height as the surrounding skin.  To improve a scar even more, resurfacing the skin with a TCA chemical peel can significantly improve the appearance of scars.

  • Due to sun exposure and aging, craggy lines in the skin can begin to appear at the site of breast cleavage (décolletage) around your mid to late 30’s. Dr. Long, by injecting very fine dermal fillers in the lines and little crevices on the chest, can improve this area.  This treatment can be combined with a TCA chemical peel to improve pigment and texture issues.

  • Dr. Long will ensure your comfort for a rewarding experience. Dr. Long will initially make some skin marks with an eyeliner pencil to identify the landmarks of the injection. Then, by using an ultra-fine needle or a smooth-tipped cannula, dermal fillers are injected into the skin lines, creases as well as underneath the skin with minimal discomfort. Dr. Long will explain the process so you know what is being done . At the end, Dr. Long will massage the treatment area to smooth the contours around the lips or any irregularities. In certain critical areas like cheek area underneath the eyes, Dr. Long will inject local anesthesia to minimize bruising while making the procedure comfortable. Some Dermal Fillers come mixed with lidocaine (a local anesthetic) thus there is no need to dilute the filler.

  • Dermal Fillers work by adding volume to the area where they are injected. When injected at skin lines or creases, they flatten creases thus smoothing the surface. When Injected deep, they lift the soft tissues (skin, muscles, fat) thus augmenting volume and accentuating contour similar to a facial implant.

  • The duration of the Dermal Filler varies depending on the type of Dermal Filler used and the patient. The movement of the area injected influences also the longevity of the Dermal Fillers. Most of the Dermal Fillers last between 8 months to 1 to 2 years.

  • Immediately following the injections, you may experience some mild redness, swelling or bruising in the treatment area. These symptoms typically disappear within few days. Allergic reactions are extremely rare.  Most patients are able to resume normal activities immediately following treatment.

  • Patient should refrain of any medications that make the blood “thin” (blood thinners) which greatly increase the risk of bruising with the injection process. Medications and supplements to avoid are aspirin, ibuprofen, Vitamin E, fish oil, and other blood thinners for at least one (1) week before treatment. Acetaminophen (Tylenol) can be safely taken prior to or directly after any injection since it doesn’t increase the risk of post injection bruising.

  • Patients are refrain from taking any medication or dietary supplement that can act as a blood thinner for 48 hours after injections. Patients should also refrain from doing exercise for at least 24 hours after injection (exercise increases blood pressure and increased the risk of bruising at the injection site. Patents are advised to use an ice pack at the treated area off and on for 6 to 10 hours post treatment.

  • Dr. Long is a Board Certified Plastic Surgeon who specializes in cosmetic surgery of the face, neck, breast and body. His residency and fellowship training followed by teaching at prestigious institutions have given him a unique set of skills to perform cosmetic surgery. Dr. Long wants his patients look their best and works hard to achieve their personal, social, and professional goals by providing natural looking results.

  • Practitioners who are not residency trained and Board Certified to inject Dermal Fillers have been found to have a higher rate of surgical complications. Among the most common patient complaints are minimal to no improvement, asymmetries, wound healing problems or worse. Always look for a surgeon who is Board Certified by the American Board of Plastic Surgery. Look for the ASPS logo, The Symbol of Excellence.

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