Fillers 101

What is Filler made of?

Simply put fillers are an injectable hyaluronic acid gel that is used to replace this volume loss, fill in facial wrinkles and help restore a smoother appearance. Hyaluronic acid is a naturally occurring carbohydrate in the body so it is very safe and guess what?!  It’s also completely reversible! I always point this out to my first-timers because I know it gives them some peace of mind knowing that they are not doing something permanent, and heaven forbid they would want it reversed, it could be! (You won’t, though). There is an enzyme called hyaluronidase that I can inject right into the filler and it simply dissolves the filler.  Every experienced provider keeps this antidote on hand at all times.

But I want to look natural and like myself!?

The biggest concern that I see with patients coming in for filler is that they are scared it won’t look natural and it will be like, “this person they saw on reality TV who looked ridiculous.” I’ll say it over and over, YOU WON’T! You are probably already surrounded by people who have a filler and you have no idea because its done naturally and tastefully – this is what 95% of people strive for – a natural look and “less is more”. It’s the 5% of people who choose to be over-injected and look overdone that everyone notices and is afraid of. If your filler is done correctly you should look just like yourself – just a more refreshed and polished version. The “5 years ago” YOU. This is because we are using filler to simply correct those areas of deficit and volume loss. Not create volume where there never was before. We are not using filler to change your face.

Filler treatment is completely personalized

Every person’s genetic makeup and anatomy is different therefore every person has their own customized plan with filler based on their needs and wants. For most people fillers are a restoration treatment. But for example, if your lips are naturally quite thin and you are looking for a more plump look then it will be different than your natural lips. But as always, it’s on a case by case basis.

I have heard there are many different types of filler, which one do I need?

There are many different kinds of filler that I use in my day to day practice. They vary in terms of thin to thick (consistency) and longevity. How I choose which filler to place where depends on the patient I am injecting and their anatomical needs. I determine which ‘tool’ I will pull out of my toolbox based on how much volume is needed or desired and the area of the face I am injecting. I commonly use fillers from the Juvederm and Restylane families. For example, I typically use a thin light filler like Juvederm Ultra or Volbella in the lips and something heavier with more ability to lift the face like Juvederm Voluma, in the cheeks.

Where can Filler be used on the face?

Below I will touch on a few areas where filler is commonly used. I also want to point out that I also commonly address multiple areas at once and I call this “full face correction.” With that being said I always let my patients know we can do as little or as much as they want in one visit. Some people like to take baby steps and start with one area whereas others like to go all in. Regardless of the number of areas we target, always allow your injector to determine how much of the product is needed. I can’t tell you how many times a patient will come in wanting me to use 1 syringe of filler for injecting multiple areas on the face. This is not possible! To put it into perspective 5 syringes of filler fit into a teaspoon. 1 syringe is not a lot of product since it’s only ⅕ of a teaspoon ie. 1 ml! When we are addressing multiple areas we need 3+ syringes. If you can only start with one syringe budget wise – we will instead prioritize and pick the area that bothers you most instead of doing one little touch in each spot. The best thing you can do is trust your injector and allow him or her to guide you and let you know how much filler and where it should be placed to benefit you most!


As we age, we lose that richly defined border of the lips and they start to sink and fold together. Lip filler can be used to restore that beautifully defined border as well as add subtle volume. The filler naturally causes more hydration to the lips, erasing those etched in wrinkles and making them appear more soft and plump. Lips can be done extremely natural to the point where no one would even know but you! We can customize the size based on the patient’s needs and wants. Restoring lips can create symmetry in the face. They immediately make the lips “pop” and lipstick goes on so much better and cleaner. Because of the defined lip edge lipstick sits on the lips perfectly and you will never see your lipstick bleed off the lip again! I love to use Juvederm Ultra, Volbella, and even sometimes Voluma in the lips!

Tear Troughs (Under eyes)

Tired of looking Tired? Several variables affect the under-eyes when it comes to hollowness; genetics, aging, sun, and stress to name a few. When the under eyes hollow out we often look sunken and tired. A little filler under the eyes can go a long way! Filler in this area can lift out hollowness, help reduce dark circles, and help to mask under eye bags if you have them. When the hollowness under the eyes is reduced it gives off the appearance of instant rest! Depending on the patient’s anatomy treating this area can provide tons of improvement, but not always perfection. I always go over realistic expectations with my patients. If you have fat pads or “bags” under your eyes you may be a better surgical candidate, this is more common in women over 50. For this area, which is very vascular, I always use the Cannula technique. This technique cuts down on bruising and swelling and is very safe and comfortable for the patient.


This is one of my favorite places to fill! The cheeks can be such a game changer for so many! Cheek filler helps to add contour and definition which is SO SLIMMING! It’s like walking around with perfect makeup highlighter on 24/7. Most people are worried that cheek filler means bigger “fatter” cheeks, but it is the complete opposite. Cheek filler in the back of the cheeks actually works to “tack” the cheeks up and lift the face and is very slimming. This is a great way to add contour to a rounder, fuller faces. It looks amazing on my 50-year-old patients all the way through to my 20-year-old patients. Cheek fillers are also a preventative measure as a treatment for sagging cheeks and a volume depleted midface.

Nasolabial Folds

Filler here is used to soften and reduce the heaviness of the folds around the mouth. This is typically used in my older patients.

Marionette Lines

Filler can soften and reduce the heaviness and folds below the mouth and also help raise the corners of a drooping mouth. This area is often paired with the nasolabial folds!


As we age and lose bone density and tissue, our temples actually sink in and give off a “peanut” shape. This is very aging as in we as a society associate this with a worn and aged even ill face. Filler in this area will round the temples back out and take them from concave to convex – which is VERY youthful. This is such a subtle tweak that makes a big difference.


Filler in the Jawline is another one of my favorites! In younger women, this will prevent sagging and give the illusion of a super straight and tight jawline. Such beautiful and perfect contour. In older women, we can mask pre-jowling and jowls. This can really take years off of the face. A lot of times targeting the jawline involves chin filler as well. Filler in the chin can help the jaw and neckline appear tighter. Adding projection to the chin is very slimming for the face and can create symmetry

Sleep lines

Filler can be used to reduce and eliminate sleep lines formed from repetitively sleeping on our faces. This might surprise you or you might feel like it’s impossible not to sleep on your stomach! I know it’s hard, but sleeping on our back is best practice for preventing sleep lines and wrinkles.

Acne Scars

Filler can be used to reduce and eliminate deep pitted acne scars. It can fill in the deepest “pock” marks and smooth out divots. My clients noticing much much smoother skin and reduced scar pigmentation.

Ear Lobes

Did you think about this one?! Fillers can be used to lift a sagging earlobe. Aging and use of heavy earrings over time can cause the ear lobes to sag and no longer hold up earrings. Filler can be used to add support and firmness in the earlobe and help to support the use of earrings.

Ultimately, fillers are used to correct deficits and enhance your natural beauty. Filler should look natural and beautiful. No one will know exactly what you did – just that you look the best version of yourself – rested. Soft. Beautiful!

Choosing your treatment is just the first step! I know you have more questions about bruising, swelling and after care so check my blog on what to expect after treatment here!

Be sure to check out my YouTube to watch many videos of the different areas above being treated with filler. Also check my highlight “injections” on IG.


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  1. Pingback: Bruising and Swelling after Cosmetic Injections and What to Expect – Racquel Frisella

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Racquel Frisella

Board Certified Nurse Practitioner & Aesthetic Specialist based in Saint Louis, Missouri

I work as a cosmetic injector and skincare specialist with 12 years of experience in the Aesthetic Industry. I see patients both in-office at Racquel Aesthetics for treatments as well as online for customized, complimentary skincare plans. I focus heavily on preventative and corrective injections, treatments, and skincare.  My career is my passion and I love to help people feel like the very best version of themselves. I am a wife and a mother of 3 beautiful children under the age of 3. I love all things beauty, fashion, and fitness. I am creating this site as a place to share my expertise on beauty, anti-aging, and skin while also giving a glimpse into my lifestyle as a mom, wife and lover of fitness!  


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