The Surgeon Minute

What You Need to Know About the Newest Facial Fillers

What You Need to Know About the Newest Facial Fillers

It’s a fact: facial volume loss is a major part of facial aging. The struggle to age gracefully is a struggle to replace lost volume, a task for the newest facial fillers.

In 2004, Restylane became the first hyaluronic acid-based facial filler approved by the FDA for cosmetic injection. Since then other fillers, including Juvederm, have entered the market. The latest hyaluronic acid-based fillers have the advantage of lasting longer than the previous generation of fillers. They also have the added benefit of being reversible when problems arise.

In the decade plus since the first generation of hyaluronic acid-based fillers hit the market, advances have been made to the science behind the fillers. Instead of just one option, injectors can now choose from a wide array of fillers, many of which last twice as long as the original fillers introduced in the early 2000’s.

Current FDA Approved Uses of Dermal Fillers:

  • Correction of moderate to severe wrinkles and folds
  • Restoration and/or correction of the signs of facial fat loss
  • Correction of contour
  • Lip augmentation
  • Cheek augmentation
  • Hand augmentation

Unfortunately, great technology and a multitude of options does not always translate to better results. Regardless of how many new and improved tools are available, if they are not used in the right hands, they will not produce great results.

Filler for volume loss.

Dr. Robert Whitfield, a board certified plastic surgeon in Austin, is no stranger to fillers. A busy plastic surgeon himself, he believes in the importance of taking the time to do all of his patient’s filler injections himself, rather than handing the job off to someone else.  

“I feel it’s very important that as board certified plastic surgeons we take ownership of this space, and we either perform the injections or we make sure that we understand what the patient needs, rather than delegate that,” says Whitfield.

While there are many exciting new options available to restore youthful volume to cheeks, lips, folds and wrinkles, it’s more important than ever to trust your appearance to an injector who is intimately familiar with the underlying anatomy of your face.

“We have a series of newer products that are lasting longer,” Whitfield begins. “These products have Vycross technology. The hyaluronic acids are of different molecular weights and the mixtures allow them to last a longer duration.” He goes on to list several of the latest fillers to receive FDA approval in the US, breaking down for us their targeted uses.

Juvederm's facial fillers.


In 2013, Juvederm Voluma was FDA approved for deep injection into the mid-face. Many injectors refer to this as a non-surgical cheek lift or a cheek augmentation. Voluma is much thicker than prior generation fillers, making it ideal for adding structure deep in the cheeks. It is typically injected just above the cheekbone.

“Many patients want to have their jowels treated,” says Whitfield. “If you support the cheek, you’ll actually improve the jowel. This is a great product to treat the upper third of the face.”


Volbella is another new product in the Juvederm line. It is aimed at delivering fuller lips and treating the vertical lines around the lips. Volbella was FDA approved more recently, in 2016.

“It doesn’t give you the ducky appearance,” Whitfield says of Volbella, when injected properly into the lips. “You can structurally help support the lip by horizontally placing this product along the perioral rhytids, the vertical lines. That really gives the lip more support without actually augmenting significantly the mucosal part of the lip.”

Volbella, the newest of the lip fillers.


Earlier this year the FDA approved another next-generation filler in the Juvederm family of fillers, Vollure. The product is the first facial filler approved for treatment of nasolabial folds that lasts as long as 18 months. Previously, fillers used in nasolabial folds lasted only six months to a year at most.  

Erasing Mistakes & Starting Over

In his practice, Whitfield often finds himself “fixing” filler mistakes done elsewhere. Filler-gone-wrong is not always a quick fix. Often it involves a series of visits for additional injections of an enzyme used to dissolve the  hyaluronic acid-based filler that was over-injected or positioned poorly. 

“I’ve spent the majority of the past several months dissolving products that were placed in the wrong space. Too much product,” shares Whitfield. “These people are mortified by their appearance afterwards. They weren’t properly advised on what they should have, and then they have too much product. They can’t go to work because they are ashamed of how their appearance is  All they wanted was a simple lip augmentation, which should be very straightforward to do.”

The best way to get the most out of any of the new fillers available on the market is to have them injected by an experienced, knowledgeable injector the first time.

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