What Are Dermal Fillers? Hyaluronic Acid Gels Explained

Dermal fillers are soft gels injected beneath the skin to restore volume, soften folds, and refine the shape of the face. Most of the fillers used in aesthetic practice today are made of hyaluronic acid, a sugar your body already produces, and the body absorbs them gradually over months. Used with restraint, they return the support a face loses with time, so you look rested and proportionate rather than changed.

Dermal fillers at a glance

What they are: Injectable gel implants, regulated as medical devices and placed by a licensed medical provider.

What they are made of: Hyaluronic acid in most cases; a smaller group use calcium hydroxylapatite or poly-L-lactic acid, and one permanent type uses PMMA beads.

Where they are placed: The folds beside the nose and mouth, the lips, the cheeks, the chin, and the backs of the hands, with some products also used in the temples and under the eyes.

How long they last: About six to twelve months for most hyaluronic acid gels, longer for some products and some areas.

What recovery looks like: Swelling, tenderness, and bruising at the injection sites, usually settling within a few days to two weeks.

Whether they can be reversed: Hyaluronic acid gels can be dissolved with an injected enzyme when a result needs adjusting.

Who injects them here: Deborah Lenchus, MSN, APRN, a nurse practitioner, at every visit.

What a hyaluronic acid filler is

A hyaluronic acid filler is a smooth, clear gel made from a sugar that occurs naturally in your skin and cartilage. The gel is made to hold its shape under the skin for months, and the body absorbs it gradually over time, which is why the result is temporary and why it can be adjusted. Because the material is one your tissue already recognizes, it integrates softly rather than sitting as a foreign lump.

Not every filler is hyaluronic acid. Calcium hydroxylapatite, a mineral found in teeth and bone, and poly-L-lactic acid, a biodegradable polymer, are also absorbed over time; the practice groups them as collagen biostimulators. One permanent filler uses tiny PMMA beads that the body does not absorb. At LuXe Concierge Aesthetics, hyaluronic acid gels do the fine work of shaping and volume, and the biostimulator products are reserved for broader, more gradual support, which is a different conversation at your consultation.

Within the hyaluronic acid family, gels differ in firmness and in how they move. A firmer gel is built to hold structure in the cheek or along the jaw. A softer, more flexible gel is chosen for the lips and for fine lines, so nothing feels stiff when you talk or smile. Choosing the gel for the area is part of the skill of the injector, not a decision a patient needs to make from a menu.

How dermal fillers work

Dermal fillers work by occupying space. As we age, the skin loses its fullness, the cheeks flatten, the folds beside the mouth deepen, and the jawline softens. A filler placed at the right depth and in the right spot replaces lost volume where it sits and supports the tissue above it, which is why a small amount in the cheek can soften a fold around the mouth without any product going into the fold itself.

That support is immediate. You see the change before you leave the room, and the final shape settles over about two weeks as any swelling resolves and the gel integrates with your tissue. The most natural results come from treating the face as a whole rather than chasing one line, which is the approach described on the facial balancing page.

Where dermal fillers are used on the face

Hyaluronic acid fillers are FDA approved for moderate to severe facial wrinkles and folds, such as the folds that run from the nose to the corners of the mouth, and for adding volume to the lips, the cheeks, the chin, and the backs of the hands. Individual products also carry their own uses, for example the temples and the hollow beneath the eyes, and each product has its own list of areas rather than the face as a whole.

Areas treated with hyaluronic acid gel at LuXe Concierge Aesthetics include the cheeks and midface, the lips, the chin and jawline, the hollows under the eyes, the folds and lines around the mouth, the temples, and the backs of the hands. Which areas belong in your plan, and in what order, is worked out from your own anatomy at your consultation; Deborah Lenchus will tell you where filler is the right tool and where it is not.

Dermal fillers and wrinkle relaxers do different jobs

Dermal fillers add volume; wrinkle relaxers soften movement. Many patients ask whether filler is the same as Botox, and it is not. A wrinkle relaxer relaxes the small muscles that fold the skin when you frown or squint, so the lines they make become softer. A filler does nothing to a muscle; it replaces volume that has been lost, so it suits folds and hollows that are present even when your face is at rest.

The two are often used together in one plan, a relaxer for the lines of expression across the upper face and a filler for the support the lower face has lost. How the practice layers them, and why, is covered in the article on combining wrinkle relaxers, filler, and biostimulators.

How long dermal fillers last

Hyaluronic acid fillers last about six to twelve months for most people, and some products have been studied to a year or longer in the cheeks. Calcium hydroxylapatite lasts about eighteen months and poly-L-lactic acid up to two years, which is part of why those products are chosen for a different kind of result. No absorbable filler is permanent, and that is by design.

Where the gel is placed matters as much as which gel is used. Areas that move constantly, such as the lips, tend to break product down sooner than the cheeks or the jawline. Most patients return for a light maintenance visit rather than waiting for the result to fade entirely, because small, timely amounts keep a result consistent and use less product over time.

What a filler appointment is like here

A filler appointment at LuXe Concierge Aesthetics begins with a conversation and a good look in the mirror together. Deborah Lenchus maps what will make the most difference to your proportions, and she will say no as readily as yes. In her words: “I treat the face as a whole and add support where it has been lost, using the smallest amount that gives a natural, proportionate result.”

The skin is cleansed, and a topical numbing cream can be applied; most of the gels used here also contain a local anesthetic, so the injection itself is well tolerated. The product is placed with a fine needle or a blunt tipped cannula, depending on the area. Most treatments take 30 to 45 minutes, and you see a difference before you leave. Every injection is performed personally by Deborah Lenchus, a nurse practitioner; nothing is delegated to a technician.

Afterward, for the first 24 hours, keep strenuous exercise, heat, and sun exposure to a minimum, and ask when makeup may be applied. Avoid pressing on the treated area for the first few days, and plan dental work, if any is scheduled, more than two weeks before or after your filler visit. The practice will give you written aftercare for the areas treated.

Risks, side effects, and when to call

Dermal fillers carry risks, and you deserve the full picture before you decide. The expected effects are reactions at the injection sites: swelling, redness, tenderness or pain, bruising, firmness, and occasionally small lumps or itching. In the clinical studies these generally resolved within a few days, and most clear within two weeks; the lips tend to run longer than the cheeks. Delayed inflammation at a filler site has been reported weeks or months after treatment, sometimes following an illness, a vaccination, or dental work, and it usually responds to treatment or resolves on its own.

The serious risk is unintentional injection into a blood vessel. The chance of this happening is very small, but when it does happen the complications can be serious and may be permanent, and they can include vision changes, blindness, stroke, scabbing, and permanent scarring of the skin. Rarer risks named in the FDA patient information include infection, tissue death, movement of the filler away from where it was placed, and firm nodules that may need treatment. Hyaluronic acid gel can be dissolved with an injected enzyme, and prompt dissolving is the treatment the American Society for Dermatologic Surgery task force recommends for a blocked vessel; it is a reason to choose an injector who is trained to recognize the signs and prepared to act.

Call the clinic right away if you have any of the following after a filler treatment: changes in your vision; signs of a stroke, including sudden difficulty speaking, numbness or weakness in your face, arms, or legs, difficulty walking, face drooping, severe headache, dizziness, or confusion; a white, gray, or blue appearance of the skin near the injection site; or unusual pain during or shortly after treatment. Also call if you have significant pain away from the injection site, redness or visible swelling that lasts more than a few days, any side effect that appears weeks or months after treatment, or any other symptom that concerns you.

Before treatment, tell us if you have a history of severe allergies or anaphylaxis, an allergy to lidocaine or similar anesthetics, a bleeding disorder, a tendency to keloid or raised scarring, a history of cold sores, or an active rash, pimple, cyst, or infection at the treatment site; if you are pregnant or breastfeeding, treatment is deferred. None of this is a diagnosis; it is the health history that lets Deborah Lenchus decide what is appropriate for you.

What dermal fillers do not do

Dermal fillers do not tighten loose skin, and they do not change skin texture. Lax skin and surface damage call for different treatments, such as energy based skin tightening or laser resurfacing, and a consultation will say which applies. Fillers are a treatment for the face and the backs of the hands. Injecting any filler to enlarge the breasts, buttocks, or any other part of the body is a use the health authorities warn against, and it is not something LuXe Concierge Aesthetics does.

More is not better. The overfilled look that gives filler a bad name usually comes from too much product, the wrong gel for the area, or new product layered before the old has broken down, and avoiding it is a matter of restraint and judgment. Finally, filler is a prescription medical device placed by a licensed provider: never buy a filler sold directly to the public, and never allow one to be injected with a needle free device.

Questions patients ask about dermal fillers

Are dermal fillers safe?

Dermal fillers have known risks, which is why the right question is whether the person holding the syringe can prevent and manage them. Serious side effects are more likely when the injector does not have adequate medical training, so choose a licensed medical provider who knows facial anatomy, keeps the dissolving enzyme on hand, and explains the risks before you decide. At LuXe Concierge Aesthetics that person is Deborah Lenchus, MSN, APRN, a nurse practitioner.

Do dermal fillers hurt?

Most people describe a brief pinch and pressure rather than pain. A numbing cream can be applied before treatment, and most of the hyaluronic acid gels used here contain a local anesthetic that takes effect as the product is placed. Tenderness for a few days afterward is normal.

Are dermal fillers permanent?

Hyaluronic acid fillers are not permanent. The body absorbs the gel gradually, so results last about six to twelve months for most people, longer for some products and areas, and maintenance visits keep a result consistent. One PMMA filler is permanent, and it is a different product used for different reasons.

Can dermal filler be dissolved?

Yes, if it is a hyaluronic acid filler. An injected enzyme breaks the gel down, and it can be used to adjust a result or to treat a complication. Fillers made of other materials cannot be dissolved this way.

Can dermal fillers be used around the eyes?

Some hyaluronic acid products are made for the hollow beneath the eye, and the area is treated here when it suits your anatomy. The under eye region is thin skinned and close to important vessels, so it belongs with an experienced injector, and Deborah Lenchus will tell you if a different approach would serve you better.

How much do dermal fillers cost?

The cost depends on how many areas are treated and how much product each needs, so it is quoted for you at your consultation, with what the price includes. The consultation carries a fee, which is applied toward any treatment or product you choose.

Book a consultation

A consultation at LuXe Concierge Aesthetics is a conversation with Deborah Lenchus, MSN, APRN, about your face and your goals, with a plan built around your own proportions rather than a fixed menu. The consultation carries a fee, which is applied toward any treatment or product you choose. Book online or call (754) 715-5667.

Keep reading

Sources

U.S. Food and Drug Administration. Dermal Fillers (Soft Tissue Fillers) Content current as of 07/06/2023.
U.S. Food and Drug Administration. FDA-Approved Dermal Fillers Content current as of 11/09/2020.
U.S. Food and Drug Administration. Dermal Filler Do’s and Don’ts for Wrinkles, Lips and More Content current as of 07/07/2023.
U.S. Food and Drug Administration. Juvederm Voluma XC Patient Information Labeling (P110033/S070) Approved 10/06/2023.
American Academy of Dermatology. Fillers: FAQs Accessed 10/26/2026 (page undated).
Jones DH, et al.. Preventing and Treating Adverse Events of Injectable Fillers: Evidence-Based Recommendations From the American Society for Dermatologic Surgery Multidisciplinary Task Force. Dermatologic Surgery. 2021;47(2):214-226.

Dermal Fillers Explained: What Hyaluronic Acid Gels Are and What They Do