Wrinkle Fillers: Dr. Binstock Answers Your Questions

The modern history of using fillers to improve our appearance began in the late 1800s, with the use of transplanted fat. But the breakthrough came in 2003 when U.S. Food and Drug Administration approved the first hyaluronic acid (HA) dermal filler for use. It was comparatively easy to use, with longer-lasting results compared to earlier options; and they don’t require allergy testing before treatment. Today, more than 2 dozen fillers are FDA-approved for use.

Here, Dr. Binstock answers some of the questions about fillers we often hear from clients.

Q: Why is an experienced aesthetic dermatologist the best person to give me satisfying results?

Dr. Binstock: Board certified aesthetic dermatologists understand how the anatomy of the face changes over time, secondary to bone and fat loss, to cause wrinkles and  facial atrophy (aka hollowing).  They understand how each filler works and are experts in using different injection techniques (i.e., depot, puncture, tunneling, threading, fanning, and cross-hatching) to get the best results.

Just as important, an aesthetic dermatologist takes time to learn about your expectations. You can feel confident that your special needs will be met aesthetically and naturally.

Q: How can I be sure that a dermal filler is right for me?

Dr. Binstock: No single injectable product fills every patient’s needs. We understand that convenience, longevity of effect, type of correction sought, and cost dictate the suitability of each product for you. The best way to determine if fillers are right for you is to make an appointment to speak with a member of our team.

Q: Will a single treatment session be sufficient to improve my appearance?

Dr. Binstock: Ultimately, the treatment strategy is based on your needs, as well as your expectations. Some people seek treatment for a specific event (e.g., a wedding). For them, one treatment session may be sufficient. Others desire long-term improvement in appearance. For them follow-up treatments may be most effective.

Q: How long can I expect a filler to last after treatment?

Dr. Binstock:  How long the filler will last is a commonly asked question.

Fillers last generally 1 to 2 years (6 months or so in the lips), depending on the filler and area injected. For example, fillers tend to last longer when injected in a tear trough area compared to the lips or laugh lines, which are constantly moving.

We don’t recommend “permanent” fillers as they cannot be reversed.

Q: Are fillers safe?

Dr. Binstock: Safety is an important consideration for people thinking about aesthetic rejuvenation. Most side effects are temporary and localized to the area treated. Bruising, redness, swelling, pain, tenderness, itching, and rash are among the more common effects.

Uncommon side effects include raised bumps in or under the skin, infection, wounds, allergic reaction, and rarely necrosis (tissue death). An extremely rare side effect is blindness if the filler happens to be inadvertently injected into a blood vessel. The best way to minimize the risk of these side effects is to seek treatment by an experience aesthetic dermatologist who throughtly understands facial anatomy, filler complications, and their remediation.

Q: Will treatment be painful?

Dr. Binstock: Fortunately, for most patients, the discomfort associated with injections is quite tolerable.

At Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D., we know that pain is best minimized by our superior technique and individualized care.

For consultation and more information about our approach to using facial fillers to achieve the best look for you, contact Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D. Drs. Binstock and Layton will answer your questions. Call our San Francisco office at (415) 956-8686, or in Mill Valley call (415) 383-5475.


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