Dermal Fillers

Dermal fillers are gel-like substances injected under the skin to “fill in” and soften crease lines, enhance lips and facial contours, and minimize signs of aging. Dermal filler treatment is a minimally invasive procedure to replace lost volume, smooth wrinkles, plump thin lips, and restore a youthful appearance. 

Most dermal fillers have been approved by the US FDA for correcting nasolabial folds. However, they are often used in an “off-label” capacity in other areas of the face. 

Injectable Lip Fillers

Non-surgical, minimally invasive methods of lip augmentation are typically performed using dermal fillers. The most popular method is to use injectable dermal fillers containing hyaluronic acid. This can include injectable fillers, such as RHA2 and RHA3, Juvederm Ultra Plus, and Juvederm Volbella.

The type of filler material used during lip augmentation can differ across patients and is usually determined by the condition of the patient's existing lip profile and the type and extent of change desired. Every filler tends to work in a slightly different way, depending on 

  • Texture and concentration
  • Interaction with the body
  • Area to be treated
  • Type of lip augmentation needed

For example, if a patient wants to achieve plumper, fuller-looking lips to correct age-related lip thinning, Juvederm® Ultra, Ultra Plus, or RHA3 can help. Another patient may want to add subtler volume to the lips or improve the appearance of vertical lip lines (which appear when the mouth puckers to drink from a straw or blow a whistle). In such cases, the effects of Volbella® or RHA2 may be more appropriate for them.

While our practice stocks a wide range of dermal fillers to tailor treatment to each patient's case, the Juvederm® family of lip fillers is used in most cases: specifically, Juvederm® Ultra, Ultra Plus, and Volbella®

It is important to note, however, that the injector's skill, injection technique, and experience are far more crucial to the results than the choice of filler used. You can rest assured that whatever your specific goals for lip augmentation may be, Dr. Greco and his hand-picked and knowledgeable nurse injector can advise you on which filler may be appropriate for you.

Effectiveness of Injectable Lip Fillers

The effect of injectable fillers varies based on the filler. Depending on the filler, they typically need a refresher every 6-12 months to maintain the effect. 

Side Effects of Injectable Lip Fillers

Injectable lip fillers may cause a few temporary side effects.

  • Swelling and bruising
  • Redness and tenderness at the injection site
  • Reactivation of cold sores or fever blisters (herpes simplex) of the lips or area surrounding the lips

Dr. Greco’s office can administer a preventative medication to patients that are prone to cold sores during their injectable appointment.

Risks of Lip Fillers

Hyaluronic acid is a natural substance found in the body, so the risk of an allergic reaction is unlikely with injectable lip fillers. Although all fillers are injected similarly and give similar results, some contain lidocaine, a local anesthetic. If you are allergic to lidocaine, please inform the doctor during your consultation or before treatment.

What to Expect with Injectable Fillers

Lip augmentation with injectable fillers can be performed in your doctor’s office with little to no downtime. Note that you should avoid aspirin or anti-inflammatory medications before the procedure to limit bruising after the procedure.

Before dermal fillers are administered, a topical anesthetic cream is applied to your face. Dr. Greco may use a dental block to provide more comfort for lip injections. Avoid touching the area and using lipstick or other lip products on the day of the procedure.

Lip Filler Results

Dermal fillers show immediate results. There may be some post-procedure swelling, which subsides within two weeks.

Causes for Facial Wrinkles

The skin is your body's largest and most visible organ. Your skin comprises two layers: The uppermost layer of skin, or the epidermis, acts as a protective barrier and controls water loss from cells and tissues. Without the epidermis, your body would dehydrate rapidly. 

Just beneath the epidermis is the second layer of skin, called the dermis. This layer is composed primarily of a protein called collagen, which provides structural support for your skin.

A healthy collagen-based support layer keeps your skin smooth and wrinkle-free. 

Unfortunately, as you age, your skin loses collagen and other components that help create its youthful appearance. This loss can lead to the development of lines and creases, as well as sagging and laxity of the face.

Young skin is resilient. The facial lines that appear when you smile or frown simply disappear when you stop smiling or frowning. These are known as dynamic wrinkles. 

Over time, the collagen framework weakens, and your skin loses its elasticity. Older skin is less resilient, so the facial lines that appear with a smile or frown don't disappear when you stop smiling or frowning. These are known as static lines. 

Other factors that can cause facial wrinkles include exposure to the sun, smoking, and genetics. These are known as extrinsic factors of aging. 

Areas Commonly Treated with Dermal Fillers

Dermal fillers treat static wrinkles caused by a combination of gravity and loss of skin elasticity. Common issues dermal fillers can help address:

  • Correcting the tear trough (depressions along the junction between the eyes and cheeks)
  • Correcting the nasolabial folds (crease line between the nose and the lips)
  • Correcting volume loss in the cheeks
  • Improving the marionette lines (crease lines going from the corner of the lips to the chin)
  • Filling in thin lips
  • Correcting hollow temples
  • Adding projection to a weak chin
  • Improving jawline definition

How Dermal Fillers Work

Modern dermal fillers are designed to restore volume where it's needed most, returning rounder contours to harsh hollow areas and softening the appearance of wrinkles. 

There are a variety of FDA-approved fillers that cosmetic surgeons may use. This includes Hyaluronic acid, Calcium hydroxylapatite (CaHA), and Poly-L-lactic acid. The difference between them lies in their unique chemistry.

We offer a variety of treatment options and will customize a treatment plan to meet your specific concerns. Dermal filler treatments are a popular minimally invasive procedure. Dr. Greco also performs surgical procedures, such as facelifts and structural fat grafting, for longer-lasting results. 

Hyaluronic Acid (HA) Fillers

Hyaluronic acid (HA) is a naturally occurring substance found in your skin. These fillers replace lost volume to keep your skin plump and hydrated. HA fillers are typically soft and gel-like. 

HA fillers provide results that can last 9 to 12 months or longer. During this period, the hyaluronic acid is gradually absorbed by the body until a touch-up treatment is needed.

FDA-approved HA fillers offered at Greco MD include the following products.

Juvéderm® Products

Juvéderm®  is a versatile hyaluronic acid dermal filler providing immediate improvement in skin wrinkles, texture, and appearance. It comes in three formulations, providing the ability to tailor treatment to an individual patient's needs. 

Juvéderm® is also the first FDA-approved hyaluronic acid dermal filler that has proved to be safe and effective in patients with darker skin color. 

Juvéderm® Ultra Plus provides volume for the face, while Juvéderm® Ultra is used for finer lines. Juvéderm® Voluma creates deep facial volume for cheek enhancement. And Volbella® can help create plumper, fuller lips, as well as smooth-out perioral wrinkles, which are lines that form around the mouth. Vollure is a versatile filler used to improve the nasolabial and marionette folds. 

These fillers can be layered on top of each other to improve results.


SKINVIVE™ by JUVÉDERM® is a hyaluronic acid microdroplet injectable treatment designed to enhance the smoothness of your cheek skin. It can help you achieve glowing and healthy-looking skin. SKINVIVE™ is administered as tiny, intradermal microdroplets of hyaluronic acid within the dermis to ensure your skin remains nourished, vibrant, and glowing. 

As the first hyaluronic acid intradermal microdroplet injection available in the U.S., SKINVIVE™ by JUVÉDERM® represents an innovative approach to skin rejuvenation. Unlike traditional dermal fillers, this microdroplet injectable treatment focuses on enhancing skin texture without adding volume. Imagine injecting your moisturizer directly into the skin, resulting in deeply hydrated, luminous skin for up to six months!

RHA® Products

RHA® filler products are the first and only FDA-approved injectable dynamic fillers. Resilient hyaluronic acid or RHA is designed to adapt to facial movements. 

The innovative hyaluronic acid (HA) formula in RHA® fillers maintains the natural structure of HA so that it behaves like the natural HA in your body. RHA® products offer a unique combination of dynamic stretch and enduring strength to deliver natural-looking results.

RHA® fillers can be safely injected into your skin with an ultrafine needle. RHA® helps plump and smooth away wrinkles and folds. It works on treating dynamic lines by allowing the injected gel to move with your facial muscles to create a natural look whether your muscles are in motion or at rest. 

These dermal fillers do not come from an animal source. They contain a small amount of anesthetic medicine (lidocaine) to help reduce discomfort during treatment, making the treatment near painless.

It has shown great results in treating:

– Laugh lines or smile lines (nasolabial folds)

– Forehead furrows (glabella wrinkles)

– Lines around the lips and mouth (perioral wrinkles)

Sculptra® (Poly-L-Lactic Acid)

Poly-L-lactic acid is a biodegradable synthetic substance. Poly-L-lactic acid has been used for many years in medical devices, such as dissolvable stitches. It is now approved by the US FDA for use as a dermal filler.

Sculptra® Aesthetic is a poly-L-lactic acid product. These fillers are classified as “collagen stimulators” because they smooth fine lines by helping your skin rebuild natural collagen. However, the filler itself dissipates a few days after treatment. 

Sculptra is a skin volumizer that is diluted in sterile water and injected beneath the skin to fill facial depressions for a more plump and youthful appearance. Sculptra® provides a gradual volumizing benefit for the face by stimulating new collagen growth for improved skin tone and ongoing aesthetic improvements. It has shown great results in the treatment of deeper facial wrinkles and volume loss. Results are seen after 2-3 treatments and can last more than 2 years. 

In addition to dermal injections, Dr. Greco’s nurse injector can also use Sculptra in the buttocks. When strategically and skillfully placed, it can improve the appearance of cellulite and add subtle volume and contour. 

Radiesse® (Calcium Hydroxylapatite Filler)

Calcium hydroxylapatite (CaHA) is a naturally occurring substance found in our bones. The consistency of a CaHA filler is typically thicker than that of a HA filler and can last about 12 months for most patients.

Radiesse® is an FDA-approved CaHA filler used for wrinkle treatment. It can stimulate your body to grow new collagen for improved skin tone. Radiesse® can restore facial volume to the cheeks and chin and minimize the appearance of wrinkles and folds around the mouth. Results are immediate and may last a year or more.

Dermal Fillers for Treating Wrinkles in Philadelphia

Dr. Timothy Greco is Philadelphia’s leading facial plastic surgeon, skilled at all types of facial treatments and procedures that help counter the effects of aging and reduce facial scarring. He is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) and the American Board of Otolaryngology/Head & Neck Surgery (ABOto). 

Dr. Greco focuses solely on plastic and reconstructive surgery of the face, head, and neck at his in-office, state-certified aesthetic surgical center. If you're looking for a younger, fresher appearance customized to treat your concerns, Dr. Greco can help!

Get in touch today to schedule a consultation with Philadelphia’s leading facial plastic surgeon. For appointments, call (610) 664-8830 or check the doctor’s schedule online

2 Bala Plaza | 333 E. City Ave
Suite PL-15
Bala Cynwyd, PA 19004
Phone (610) 664-8830
Fax (610) 664-8812

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Sat & Sun Closed

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