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Dr. Beverly Friedlander


Fillers are one of the most often performed procedures after Botox. Have you thought of why that may be the case? Fillers offer an immediate result. Rather than looking in the mirror and wishing that things could be different, but feeling that you don’t need surgery, fillers offer a means of improvement performed in the safety of Dr. Friedlander’s office. They help to turn back the clock resulting in an improvement that can be subtle or profound.

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What is a filler?

“Filler” is a term that was coined to identify what these products do. They restore the natural contours (fill) to the face and improve the signs of aging. Simply put, they fill the valleys known as wrinkles and fine lines. The most commonly used filler, Hyaluronic Acid (HA), is naturally found in the body. As we get older, the rate of production of natural HA and collagen decreases resulting in the gradual onset of fine lines and wrinkles. Dermal fillers, such as Juvéderm, are able to restore some of this loss resulting in a more youthful appearance. They are different from Botox which also treats fine lines and wrinkles. Botox reduces the muscle activity (contraction or “squeezing”) that causes the lines. It is dynamic in that regard. Fillers are static. They address wrinkles and lines that are present at rest and that are caused by gravity and natural aging process.

Why do we need to use fillers?

As we age, gravity gets the better of us. Gravity, when combined with sun damage and heredity stimulates a gradual descent of the skin, muscle and fat of the face, leading to folds around the mouth (laugh lines), jowls and marionette lines, and a loss of volume sometimes described as a gaunt appearance in its extreme. Fillers can help to correct this and restore a more youthful appearance.

What kinds of fillers are there?

There are several types of fillers on the market. The 3 most common are:

  • Hyaluronic Acids (HA’s)-Juvederm and Restylane
  • Calcium Hydroxyl Appetite (CaHA) – Radiesse®
  • Poly L-Lactic Acid (PLLA)-Sculptra®

What is the difference between the fillers?

Besides having different chemical structures, these fillers behave differently after they have been injected. The result, however, is the same…more youthful, plumper skin with fewer, less noticeable wrinkles.

The largest group falls into the category of Hyaluronic Acids (HA’s). These are a group of naturally found sugars in the body that hydrate or plump the skin by helping to replenish the natural volume. Don’t worry. These products are not animal derived and are not associated with allergic reactions unlike their predecessor (injectable) Collagen. These fillers are unique in that it is possible to dissolve them with an enzyme called hyaluronidase if you are not happy with your improvement.

Both Sculptra and Radiesse stimulate natural collagen production which will volumize the tissue over time.

What are the side effects of fillers?

Treatment with fillers is performed in the comfort of Dr. Bev’s office, and is very well tolerated. All of the fillers she uses contain Lidocaine, a local anesthetic. A topical ointment and ice packs can be applied prior to the treatment to decrease discomfort. Nerve blocks, similar to what a dentist would use, are additional anesthetic options. Side effects are usually mild and commonly consist of swelling, bruising and tenderness. Dr. Bev suggests that you discontinue Aspirin and NSAID’s prior to your filler treatment as they are mild blood thinners and can be the cause of bruising. Ice packs and over the counter medications such as Arnica Gel may be helpful after the treatment. Swelling and bruising typically improve over a day or two, leaving a more youthful appearance.

What are the types of Juvederm?

Juvederm® is modern gel filler known for its flexibility. It is manufactured by the creators of Botox and Latisse, and is intended to improve facial wrinkles and folds. It is available in several formulations.

Juvederm Volbella®

Juvederm Volbella® is the newest addition to the juvederm family of fillers. With its patented Vycross technology it is particularly suited for lip lines and wrinkles. Dr. Friedlander creates a natural appearance, by injecting conservatively when indicated, without your having to worry about “duck lips” or being overfilled.

Some women are looking for natural fullness. Others who are noticing thinning lips and vertical lines (smoker’s lines) developing as they get older are looking for subtle correction without fullness. Juvederm offers 2 products that are FDA approved for use in the lips. Both provide excellent results with 75% of patients maintaining some correction at 1 year. Whether you are looking for subtle improvement in your lips or noticeable fullness Juvederm has a product for you. Volbella is uniquely designed for lip enhancement. With its patented Vycross technology, it is engineered with differing particle size to soften and fill the lines without the worry of puffiness or extra fullness. Its Hyaluronic content ensures that the lips retain moisture and softness.

Juvederm® Ultra

Juvederm® Ultra is used more superficially to treat moderate and fine lines. With its patented Hylacross technology, this HA is strongly crosslinked providing a smoother gel consistency. This along with its low viscosity helps the Juvederm to flow smoothly and easily. The juvederm is hydrophilic, meaning that it draws water into the tissue helping to hydrate and smooth wrinkles. This technology allows its use in many different facial areas.

It is an effective choice for vertical lines around the lips as well as deeper nasolabial folds (parenthesis or smile lines). It can also be used to enhance facial features or to add volume to the lips. Treatment is quick and easy. The product contains lidocaine, a local anesthetic which results in a relatively painless treatment. The wrinkles are instantly improved and the lines are smoothed away. Side effects are uncommon, but may include bruising, swelling and tenderness.

Juvederm® Ultra Plus

Juvederm® Ultra Plus is intended for deeper use in more severe lines. It smooths moderate to severe smile lines (parenthesis around the mouth) and wrinkles Useful in multiple different areas to soften lines and add fullness, it too uses the Hyalacross technology to create a smooth gel that is hydrophilic, attracting water that helps to hydrate the tissue resulting in improvement that last up to one year with total correction.

Juvederm Voluma®

Voluma® is a member of the Juvederm® / HA family and is approved for correction of mid facial laxity, instantly adding volume and fullness to the cheeks to improve age related volume loss. Like Volbella, it uses the Vycross technology which creates HA particles of varying size that permit better integration into the tissue. It is more dense than its siblings, providing a smooth, natural-looking fullness to sunken cheeks and softening the jaw line instantaneously. It is clinically proven to last up to 2 years.

Schedule a Juvederm consultation

For more details and to find out if you are a candidate for Juvederm, please contact us to schedule a consultation or call our office at 973-524-7124.

More Information About Juvederm & Other Dermal Fillers


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Beverly Friedlander MD
636 Morris Turnpike, Suite 1A
Short Hills, New Jersey 07078

Phone: (973) 524-7124

Fax: (973) 912-8070

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