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Dermal Filler for Volume Restoration


Say goodbye to wrinkles

Dermal Fillers are used for two main purposes: First, to correct fine, medium, and larger wrinkles, depressed scars such as scars from acne, and other surface irregularities. Second, to restore volume and more youthful appearance in areas of the face which may appear sunken or sagging, due to the natural effects of aging, weight loss, or illness. Today’s fillers are very safe, when used with appropriate techniques. 

Wrinkles and irregularities, especially in the lower face, are most commonly treated today with fillers containing hyaluronic acid (HA). Hyaluronic acid exists naturally in the body. Gradual loss of the body’s HA, due to natural processes and sun damage, contributes to the appearance of aging skin. There are several excellent types of HA fillers currently available in the US, including Belotero Balance and Juvéderm. Older fillers containing collagen and silicone are less safe, and are no longer used.


Hyaluronic acid in fillers binds to water in the tissues, providing a smooth, gel-like consistency after injection. The available fillers vary in their thickness, or viscosity, and in their duration of activity within the skin. Some fillers now include a local anesthetic, lidocaine, to reduce discomfort at the time of injection, and it can be added to others before injection.

At Changes Medical Spa, we use genuine Belotero Balance, which is obtained directly from the manufacturer, Merz Aesthetics, Inc., and Juvéderm, which is obtained directly from Allergan Pharmaceuticals. These are FDA-approved for treatment of facial folds and wrinkles. Usual areas for treatment with HA fillers include:

  • Smile lines (nasolabial folds)
  • Corners of the mouth
  • Marionette lines (vertical lines extending below the corners of the mouth)
  • Vertical lines above the lip
  • Fine lines and creases elsewhere on the lower face
  • Lips
  • Deep scars, such as acne pitting

Belotero and Juvéderm Ultra are great products for fine to medium lines and wrinkles. Belotero can be used in close contact with the skin surface while still providing a natural appearance. For lip restoration, Belotero or Juvéderm Ultra may produce a softer and more natural result, compared with thicker fillers. They can also be used in the upper face, but relaxers, such as Xeomin and Botox, are usually the primary treatment in these areas, including frown lines and crow’s feet. They may also be used to soften the appearance of bumps or irregularities in the bridge of the nose.

Volume restoration is the second major purpose of dermal fillers. Thicker fillers are typically used for this purpose, because they provide more structural support, with less chance of shifting location over time, and more prolonged effect, often a year or longer. At Changes, our preferred volumizing fillers are Radiesse, also manufactured by Merz Aesthetics, and Juvéderm Ultra Plus. Radiesse contains microspheres of calcium hydroxylapatite suspended in a gel matrix. It is injected under the skin to restore natural appearance and volume. After injection, it causes the skin to gradually form new collagen. Juvéderm Ultra Plus is a hyaluronic acid filler, which is thicker and longer lasting, compared to Juvéderm Ultra. Other thick and long-lasting fillers which may be used to enhance facial volume include Perlane, Sculptra, and Artefill. Areas we treat with Radiesse and Juvéderm Ultra Plus include:


Changes Medical Spa & Laser Center
106 Pinnacle Drive, Suite 106
Johnson City, TN 37615
Phone: 423-328-0488
Fax: 423-328-7213

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