Cosmetic Facial Injections

January 16, 2013

By Scott C. Sattler

Cosmetic Facial Injections

A portion of my cosmetic practice is non-surgical. Cosmetic Facial Injections are an important tool to help rejuvenate the face by replacing lost or shifted facial volume, or by treating lines and wrinkles.

Facial Cosmetic Injection products fall into two broad categories.

1. Facial Fillers - add volume where it is depleted and can also be used to fill fixed lines and wrinkles to soften these features.

2. Neurotoxins - injections that temporarily weaken underlying facial muscles of expression to soften 'dynamic' lines and wrinkles.

Facial Fillers

There are three broad categories of facial fillers, and a few 'outliers' that don't fit into this scheme neatly.

Hyaluronic Acid (HA) dermal fillers - supply volume or dermal filling using an extra-cellular matrix sugar called hyaluronic acid. HA fillers commonly used in our practice include Juvederm (Allergan), Restylane (Medicis), Belotero (Merz) . These fillers can be used for volumization of the cheeks, regions around the eyes, and folds around the mouth. The HA fillers can also be used more superficially to soften fixed lines and wrinkles. Well tolerated by most patients, require no skin testing prior to injection and last a variable amount of time depending on many factors.

HA fillers treatments cost between $400-1000 per session, depending on the amount of material injected.

My favorite use for HA fillers: mid facial volumization of the cheeks and tear trough areas. Most patients are very pleased with the result and treatment can last 1-2 years in this zone of the face.

Radiesse and Sculptra - supply volume and last a longer period of time compared to the HA fillers. Both fillers promote collagen formation in the region of implantation. Sculptra is especially useful for volumization of large surface areas, such as the cheek and temporal hollowing area. Typical cost is about $400-1000 per injection session.

Fat Injections - one's own fat can be removed with a simple liposuction procedure and then injected using small cannulae into the cheeks, regions around the eyes and mouth to improve volume distribution. This is a powerful technique and uses one's own living tissues. I've observed actual improvements in overlying skin condition in regions that have received fat grafting treatment. Cost varies and procedure can be done under local anesthesia in the office.

Before and After Fat Grafting to the Mid Face


There are three neurotoxins approved for cosmetic use in the US currently. Botox (Allergan) is the product most are familiar with. Dysport (Medicis) and Xeomin (Merz) are also on the market. I've used each product and have some preferences, which I won't elaborate on here. 

The important points are that the neurotoxins are used to selectively weaken muscles of facial expression that create 'dynamic' lines and wrinkles. A classic application for neurotoxins is treatment of the vertical '11' lines between the eyebrows. The products can also be used to lift the lateral brow (chemical brow lift), soften crow's feet, soften forehead lines and reduce jaw width by weakening the masseter muscle.

A typical cosmetic facial neutrotoxin treatment in my clinic is about $350-500 - with the expectation that the result should last 4-5 months when injected in sufficient doses for the individual patient.

That's it for now. I'll post some before/after photos when I figure out how to do that on this blog.

For more information - check out my blog on Facial Cosmetic Injections.

If you'd like to schedule a Cosmetic Facial Injection treatment with me in my Seattle area clinic, give us a call at 206-729-2248.