The Surgeon Minute

Returning Volume to the Face

Returning Volume to the Face

“One of the early ways that we see aging is by volume loss – we lose volume in our cheeks, we become hollow, our facial shape changes – and this is where fillers come in so beautifully.”

Dr. Kevin Smith of Charlotte, North Carolina is an experienced surgical injector. He utilizes the great number of available fillers as a painter utilizes his color palette and many brushes. After all, a great plastic surgeon is also an artist.

By: Kevin L. Smith, MD
and Chris Knisley


As we age, our story is inscribed upon our faces by the volume lost. To combat this, physicians utilize fillers to replace lost volume and smooth inconsistencies on and under the skin.

juvedermMany fillers, like those in the Juvederm family of injectables, contain hyaluronic acid. These acids are natural building blocks of the body and are injected in various forms of gel. Each form has a consistency designed to meet a variety of needs.

It may seem scary to inject something called an acid into your face, but they are naturally produced in the body! And in any case of complication, physicians are equipped with a neutralizing enzyme that can quickly and effectively remove the filler.

While the most commonly used fillers contain hyaluronic acid, there are brands of fillers that take an alternative approach for different needs. Sculptra is an injectable designed to stimulate collagen growth without actually providing any volume itself. Once injected, patients can expect to see volume return over a period of months as their body is stimulated into filling its own gaps.

Another unique filler is Radiesse. Radiesse is a calcium bead product excellent for sculptural filling. It is most commonly used in areas where there has been much volume loss.

Surgeons as Sculptors

“There are so many fillers on the market now. A good surgical injector chooses fillers as an artist would choose a brush. Each brush has a different effect; each filler has a different effect.”

The most important consideration for patients is their injector. Plastic surgeons like Smith are experienced and educated about anatomy, giving them quite the edge over your dentist or family doctor when it comes to getting fillers. Smith considers his work art and himself an artist, as all elite plastic surgeons should. With all of these factors in place, patients can rest assured that the results they want are going to be the results they get.


“Don’t go to a physician and ask for a filler,” says Smith. “Express your desires and needs to your physician and let them choose the filler. Trust that they will choose the right product and technique for you and your unique situation.”

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