Facial Fillers
Facial fillers restore volume that has been lost, or add volume where it was never present. Most are hyaluronic acid gels lasting 6 to 24 months and reversible with an enzyme; others stimulate your own collagen and last two years or more. At Naficy Rejuvenation Center in Bellevue, Washington, fillers are $750 to $990 per syringe, and more than 10,000 filler treatments are performed each year. Two of our five injectors are national trainers for Allergan Aesthetics and Galderma.
What are facial fillers?
Fillers are injectable gels placed beneath the skin to add volume. They work on a different problem from Botox: Botox relaxes the muscles that fold skin into lines when you move, while filler restores the substance that has been lost underneath.
The face loses fat, bone, and collagen steadily from the late twenties onward. What reads as "looking tired" is usually not wrinkles at all — it is hollowing at the temples, flattening of the cheek, and a groove under the eye where the cheek used to support it. Filler addresses that directly.
Which filler is right for me?
This is the question that matters, and the answer depends on the area and the problem rather than on brand preference. Every product below is stocked here.
| Product | Material | Typical duration | Best used for | Reversible |
|---|---|---|---|---|
| Juvéderm (Ultra, Volbella, Vollure) |
Hyaluronic acid | 6–18 months | Lips, nasolabial folds, fine lines. Volbella is the softest, for lips and under-eye | Yes |
| Juvéderm Voluma | Hyaluronic acid, firmer | Up to 24 months | Cheeks, midface, chin and jawline — where lift and projection are needed | Yes |
| Restylane (Lyft, Silk, Refyne, Defyne, Eyelight) |
Hyaluronic acid | 6–18 months | A range covering lips, cheeks, folds and under-eye. Refyne and Defyne flex with expression | Yes |
| Radiesse | Calcium hydroxylapatite | 12–18 months | Deeper structural volume, jawline and hands. Also stimulates collagen | No |
| Sculptra | Poly-L-lactic acid | 2+ years | Gradual, global volume restoration across the face. Stimulates your own collagen rather than filling | No |
| Bellafill | PMMA microspheres in collagen | 5 years | Nasolabial folds and acne scarring, where longevity is the priority | No |
The one distinction that matters most
Fillers divide into two groups, and understanding which you are getting is more important than the brand name.
Hyaluronic acid fillers — Juvéderm, Voluma, Restylane — add volume immediately and can be dissolved with an enzyme if you dislike the result or if a complication occurs. That reversibility is a genuine safety feature, and it is the reason HA is the right starting point for most patients and almost always the right choice around the eyes and lips.
Collagen stimulators — Sculptra, Radiesse, Bellafill — work by prompting your own tissue to produce collagen. Results build over months rather than appearing at the appointment, last considerably longer, and cannot be dissolved. They reward patience and demand a more experienced injector, because a misplaced result has to be waited out.
Which filler for which area?
| Area | Usually treated with | Notes |
|---|---|---|
| Cheeks / midface | Voluma, Restylane Lyft, Sculptra | The highest-value area in the face. Restoring the cheek supports the lower eyelid and softens the folds below it, so treating here often fixes several complaints at once |
| Under-eye / tear trough | Volbella, Restylane Eyelight | The most technically demanding area. Thin skin, low tolerance for over-correction, and best treated conservatively with a reversible product. Frequently the cheek is the real problem |
| Lips | Juvéderm Ultra, Volbella, Restylane Silk | Reversible products only. If the issue is a long upper lip rather than thin volume, a lip lift is the correct procedure — filler will not fix it |
| Nasolabial folds | Juvéderm, Restylane Defyne, Bellafill | Often better softened by restoring cheek volume above than by filling the fold itself |
| Marionette lines | Vollure, Restylane Defyne | Products that flex with movement suit this area |
| Chin | Voluma, Radiesse | For a modest change. For significant projection, a chin implant is permanent and often better value |
| Jawline | Voluma, Radiesse | Definition and contour along the mandible |
| Temples | Sculptra, Voluma | Hollowing here ages the upper face and is commonly overlooked |
| Whole-face volume loss | Sculptra, or fat grafting | Where the loss is global rather than in one area |
| Hands | Radiesse | Restores volume over the tendons |
How much do fillers cost?
At Naficy Rejuvenation Center, fillers are $750 to $990 per syringe, varying by product.
How many syringes will I need? Lips typically take one. Cheeks usually need two or more, one per side. Global volume restoration takes more, and Sculptra is priced and planned as a series of sessions rather than by single syringe. Your injector will tell you what is realistic before you commit, rather than after.
A note on economics: filler is a recurring cost. Two syringes replaced every 12 to 18 months adds up substantially over a decade. Where large volume is needed across several areas, fat grafting places far more volume in one session and the surviving portion is permanent — frequently the better long-term value, though it requires an operating room.
Non-surgical pricing · Financing
Can fillers be dissolved?
Hyaluronic acid fillers can be dissolved using hyaluronidase, an enzyme that breaks down the gel within a day or two. We offer dissolving, including for filler placed at other practices.
Patients come for this when:
- The result looks overfilled, heavy, or unnatural
- Filler has migrated — commonly seen as a shelf above the lip border
- Under-eye filler has left puffiness or a bluish shadow
- There are visible lumps or asymmetry
- They want to reset entirely and start again from their own anatomy
Hyaluronidase is also the emergency treatment for a vascular occlusion, which is why an injector should have it immediately on hand whenever HA filler is placed.
Radiesse, Sculptra, and Bellafill cannot be dissolved. That is the trade-off for their longevity, and the reason they should be placed conservatively by an experienced injector.
Who is a good candidate for fillers?
- Volume loss in the cheeks, temples, or under the eyes
- Folds and lines present at rest, rather than only with expression
- Thin lips, or lips that have lost definition
- A chin or jawline lacking definition, where surgery is not wanted
- Good general health, realistic expectations, and no active skin infection at the site
Who is not a good candidate?
- Your problem is descent rather than volume. Jowls and a heavy neck are position problems. Filler added to a face that needs lifting produces a heavier face, not a younger one — a facelift is the operation for that.
- Your lines are dynamic. Lines that appear only with expression need Botox, not filler.
- You have a long upper lip. More lip filler will not shorten it; a lip lift will.
- Pregnancy or breastfeeding.
- Active infection, or a history of severe allergy or anaphylaxis.
- Autoimmune or connective tissue disease may be a relative contraindication — discuss it.
- You are chasing a result seen on someone else. Filler placed to imitate another face rather than restore your own is the most reliable route to looking overfilled.
Does it hurt, and what is the recovery?
Most fillers contain lidocaine, and topical numbing is used. Lips are the most sensitive area. Discomfort is brief.
| Time after treatment | What to expect |
|---|---|
| Day 1 | Swelling and possible bruising, most pronounced in the lips. Ice, sleep elevated, avoid strenuous exercise |
| Days 2–4 | Swelling peaks then begins settling. Bruising can be covered with makeup |
| Week 1 | Most swelling resolved. The result starts looking like the result |
| Week 2 | Final settled appearance for HA fillers. This is when the result should be assessed and any refinement added |
| Months 1–3+ | For collagen stimulators such as Sculptra, this is when the effect actually appears |
What are the risks of fillers?
Common and temporary: swelling, bruising, tenderness, and small lumps that settle or can be massaged out.
Less common: asymmetry, visible product or a bluish tinge under thin skin, migration beyond the intended area, nodules, and infection.
Rare and serious: vascular occlusion — filler entering or compressing a blood vessel and interrupting blood supply. It can cause skin loss and, very rarely, vision loss. It is the reason injector training and anatomical knowledge matter more than product choice, why hyaluronidase must be immediately available, and why HA products are preferred in the highest-risk areas around the eyes and nose.
Who performs filler injections here?
Five injectors, two of whom train other injectors nationally:
- Jill Kandora, PA-C — National Speaker and Trainer for Allergan Aesthetics, makers of Juvéderm and Voluma
- Lorin Bates, RN, BSN — GAIN trainer for Galderma, makers of Restylane and Sculptra
More than 10,000 filler treatments are performed here each year, within a surgical practice with a board-certified plastic surgeon on site — unlike medspas operating without one. That matters most in the rare case where something goes wrong.
Meet our injectors · About Dr. Sam Naficy, MD, FACS
Frequently asked questions about facial fillers
How much do fillers cost in Seattle?
At our practice, $750 to $990 per syringe depending on the product. Lips usually take one syringe; cheeks commonly need two.
How long do fillers last?
Hyaluronic acid fillers last 6 to 24 months depending on product and area. Radiesse lasts 12 to 18 months, Sculptra two years or more, and Bellafill about five years.
Which filler lasts the longest?
Bellafill, at approximately five years, followed by Sculptra at two years or more. Both are collagen stimulators and neither can be dissolved, so longevity comes at the cost of reversibility.
What is the difference between Botox and filler?
Botox relaxes muscles to soften lines caused by movement. Filler adds volume where it has been lost. Different problems, frequently used together.
Can filler be dissolved?
Hyaluronic acid fillers can, using hyaluronidase, usually within a day or two. We offer this including for filler placed elsewhere. Radiesse, Sculptra and Bellafill cannot be dissolved.
What is the best filler for under the eyes?
A soft, reversible hyaluronic acid product such as Volbella or Restylane Eyelight, placed conservatively. The under-eye is the least forgiving area in the face. Often the actual problem is a flattened cheek, and treating the cheek corrects the shadow without touching the lid.
What is the best filler for cheeks?
Voluma or Restylane Lyft for immediate lift and projection, or Sculptra where the goal is gradual, global restoration.
Does filler hurt?
Minimally. Most products contain lidocaine and topical numbing is used. Lips are the most sensitive area.
How long is the swelling after filler?
It peaks at 2 to 4 days and mostly resolves within a week. Assess the final result at two weeks.
Will fillers make me look overfilled?
Only if too much is placed, or placed in the wrong plane, or used to chase a look rather than restore your own proportions. Conservative dosing with a two-week review avoids it — and with HA products the result can be dissolved if you are unhappy.
Is filler better than fat grafting?
They serve different needs. Filler is quicker, requires no operating room, and is reversible if HA. Fat grafting places much larger volumes in one session and the surviving portion is permanent. Where several areas need substantial volume, fat is usually better value over time.
Can I get filler while pregnant?
No.
Can filler replace a facelift?
No. Filler restores volume; it does not reposition descended tissue. Using volume to compensate for descent produces a heavier face rather than a lifted one.
Next steps
The most useful thing a consultation does is establish whether volume is actually your problem — or whether what is bothering you is movement, skin quality, or descent, each of which needs something other than filler. Once that is settled, product choice follows from the area being treated.
Naficy Rejuvenation Center is located in Bellevue, Washington, and serves patients from Seattle, the Eastside, and throughout the Pacific Northwest.
Schedule an appointment · Ask a question · Detailed filler FAQ
Medically reviewed by Sam Naficy, MD, FACS, board-certified by the American Board of Facial Plastic and Reconstructive Surgery.
