Injectable Fillers

shutterstock 5

Fat Injection

Fat is the most natural filler used in cosmetic surgery. In our practice it is used for:

  • Augmentation of the lips, face, and cheeks
  • Buttock augmentation
  • Correction of scars

Because our practice has a heavy emphasis on body contouring, many of our patients are referred to us for liposuction and contouring with fat.

As one of our medical spa services, fat grafting can be performed on an outpatient basis, often times using only local anesthesia. Fat grafting often requires 2-3 sessions to achieve the desired results. The first session is to achieve maximum volume while subsequent sessions will concentrate on contouring. The degree of swelling varies from patient to patient based on the volume of fat injected.

Lip Augmentation

Our lips may often show signs of aging such as wrinkles around the lips, a downward turn of the corners of the mouth and loss of volume. Each of these signs of aging can be corrected with a combination of fillers and the use of lasers, and chemical peels.

Wrinkles above the lip line can be addressed with fat that is injected in one to three stages with the first session achieving volume and a second session for contouring. Fat is a more permanent method to correct the lines above the lips and to fill out the lip borders. Fillers may be used to correct the lines above the lips and to fill out the lip borders. This requires less recovery time than fat and lasts approximately 3-6 months. For highlighting the lip border, a small strip of fat and skin may be used and this is called a dermal fat graft. Since it is your own tissue, the risk of having a foreign body implanted is avoided. Chemical peels and lasers are also used to improve the wrinkles of the upper lip, and these can produce a very satisfying result.

American Society for Aesthetic Plastic Surgeons News Release

"Lip Enhancement" - Voluptuous lips are regarded as a sign of beauty and sensuality. Although, traditionally, cosmetic procedures for the mouth have not received the attention given to treatments for other areas of the face, the lips have recently become the focus for new enhancement techniques...... read more.

JUVÉDERM® Injectable Gel

From the makers of BOTOX® Cosmetic, JUVÉDERM is a next-generation dermal filler that is ideal for erasing wrinkles on the lower half of the face, including smile lines (running from the corners of your nose to the sides of your mouth) and marionette lines (running from the sides of the mouth down towards the chin). JUVÉDERM is approved by the U.S. Food and Drug Administration (FDA) for correction of moderate to severe facial wrinkles and folds, and is the only hyaluronic acid filler that is FDA approved to last up to 1 year.

There's no waiting and no downtime when it comes to JUVÉDERM results. Treatment takes as little as 15 minutes, and you will be able to see improved skin smoothness as soon as treatment is complete. Most people who choose JUVÉDERM have a topical local anesthetic applied to make their procedure more comfortable. Some minor redness at the treatment site may occur for up to a day afterwards, but it should not prevent you from carrying on with your day's activities. While results are not permanent, an easy touch-up treatment is all it takes when your wrinkles begin to reappear.

JUVÉDERM comes in 2 different strengths. The more concentrated formulation is ideal for deeper wrinkles and folds. Both formulations use hyaluronic acid, a naturally-occurring substance that helps your body maintain skin hydration and volume. Hyaluronic acid has been safely used in other medical treatments for over 20 years.

JUVÉDERM can be safely combined with other injectable treatments, and there is some evidence that combining this treatment with BOTOX Cosmetic will lengthen results.

Special Note: Some cosmetic uses of JUVÉDERM are termed "off label," meaning it has not been specifically approved by the FDA for use at that anatomic site. Off label use is based on the informed consent of a patient and the physician's clinical judgment.

Restylane® & Hylaform®

At last... longer lasting fillers. The FDA has approved two new fillers, Restylane® and Hylaform®, which are now offered in our practice. Both products are made from hyaluronic acid, which is naturally present in the human body.

Hyaluronic injections last between six to eight months. Many patients have experienced excellent results with injections of these fillers to the lips and the folds of the cheeks and for correcting the downward turning of the corners of the mouth. Restylane is used to fill out the hollow beneath the eyes, enhance cheek fullness, and contour the jawline. Restylane in Orlando is a great filler for the lips and can be used to improve smokers lines as well as to give nicely contoured volume. It also can be used to add fullness to the upper eyelids with elevation of the brow, as well as correction of deep furrows between the brows; this correction is enhanced by the addition of BOTOX Cosmetic. Hyaluronic acid absorbs water so there is no over correction of the injection site required. As Hyaluronic acid is present in all living species, allergic reactions are rare with its use, so a pre-treatment skin test is not needed.

We have seen very good results, which are also confirmed by many studies, that when using fillers in conjunction with BOTOX, there seems to be a prolonged effect. This has become a very popular combination in our practice.

Hyaluronic acid fillers usually require a topical local anesthetic or may require a dental block to make this a more comfortable procedure. There is a short period of redness after injection of Restylane usually lasting no more than 48 hours.

Special Note: Some cosmetic uses of Restylane are termed off label meaning it has not been specifically approved by the FDA for use at that anatomic site. Its use is based on informed consent of the patient and the physician's clinical judgment.

American Society for Aesthetic Plastic Surgeons News Release

"Injectables: Are Restylane and Hylaform the Next "Must Haves"?" - The list of cosmetic soft tissue fillers on the market and in the pipeline worldwide is growing rapidly. "FDA approval of Restylane and Hylaform could be the biggest news in dermal fillers since the advent of injectable collagen in 1981"...... read more.


Radiesse® (calcium hydroxyapatite) is a substance that has been used in many parts of the body for reconstructive purposes. It is now being used for cosmetic purposes and is pending FDA approval.

Radiesse is used to fill out the hollows of the cheeks and deep folds in the face, contour the jawline, and correct downward turning of the corners of the mouth.

It requires a local anesthetic prior to placement and requires specific depth of placement to achieve the desired result.

Radiesse lasts anywhere from 9 to 14 months and may require a touch up procedure. It is termed a semi-permanent filler.

Radiesse does not require over correction. There is a period of 3 to 4 days of mild swelling. Most patients are able to return to work the next day. Allergic reactions are rare.

Sculptra® Aesthetic

As we age, tissue breaks down and the skin grows thinner – causing the face to lose volume. The result is lax skin, lines and wrinkles. At our practice in Orlando, we offer Sculptra® Aesthetic - a unique tissue filler which helps to gradually replace lost collagen in the aging face. At Orlando Plastic Surgery, Dr. Spence or Dr. Ovalle use Sculptra to gradually correct facial hollows, folds and wrinkles. Sculptra works by thickening the dermis of the skin and is utilized in the cheeks, chin under the eyes to add back volume lost with age. Sculptra is not injected in the lips.

After a local anesthetic is administered, Sculptra is injected into the deep dermis, where it reinforces the structure of your skin and helps to replace lost collagen. Sculptra is thought of as a "collagen stimulator" in an addition to a filler – giving a longer lasting effect. Results from Sculptra injections appear gradually, as collagen builds and the skin thickens in the treated area. Visible results typically emerge in 4 to 6 weeks, at which time your skin will appear fuller and wrinkles and folds will be diminished.

The main ingredient in Sculptra is poly-L-lactic acid, derived from a fruit, which has been safely used by doctors for decades. There is no allergy testing required prior to treatment, as Sculptra contains no animal products.

Most patients require a series of 3 Sculptra treatments, with each treatment spaced 4 to 6 weeks apart. Patients can resume normal activities immediately post treatment. Dr. Spence or Dr. Ovalle will work with you to determine how many treatments you will need for your specific concerns. Results from Sculptra Aesthetic may last as long as 2 years, a factor to be taken into consideration when weighing affordability.

American Society for Aesthetic Plastic Surgeons News Release

"Considering Cosmetic Injectable Treatments?" - With the exception of the eye, the skin is the most sensitive organ in the human body. The incidence of adverse events, particularly those that occur shortly after the procedure, is often relative to the skill of clinician performing it. ..... read more.

To schedule a consultation with Dr. Spence or Dr. Ovalle at Hillcrest Plastic Surgery, call 407-999-2585 or request a consultation online. To see payment options, please visit our Web site's financing options page.

Let's Get Started

Request an Appointment

Start a Live Chat


Hillcrest Providers

Book An Appointment