Where Dermal Fillers Can Go – Beyond the Smile Lines
By Amir Moradi, MD, MBA – Facial Plastic Surgeon & Clinical Researcher (26 years’ experience)
Why Fillers Are More Versatile Than Ever
Fillers like Restylane and Juvéderm (hyaluronic acids, HA), Radiesse (calcium hydroxylapatite, CaHA), and Sculptra (poly-L-lactic acid, PLLA) have evolved from wrinkle solutions to comprehensive volumizers and skin quality enhancers. Their varying particle sizes, rheological properties, and biostimulatory effects allow skilled injectors to lift, contour, and rejuvenate a wide range of facial areas—restoring lost volume and creating more youthful skin.
Hyaluronic Acid (HA): Nature’s Built-In Moisturizer
HA is a sugar molecule found throughout the body—in the skin, joints, and eyes—and can bind up to 1,000× its weight in water. Natural HA levels decline with age, leading to wrinkles, folds, and volume loss. Cross-linked HA gels (like Restylane, Juvéderm, RHA, and Evolysse) offer immediate volume restoration and last 1–2 years, making the skin appear more hydrated and youthful. A key advantage: HA fillers can be dissolved if needed.
Calcium Hydroxylapatite (CaHA): The Collagen Coach
Radiesse contains CaHA microspheres in gel, offering immediate volume and 12–18 months of collagen stimulation. When hyper-diluted, CaHA acts as a skin-tightening agent for the neck, arms, and décolletage.
Poly-L-Lactic Acid (PLLA): The Long-Game Rebuilder
Sculptra® is made of biodegradable PLLA particles that act as collagen seeds. Over 2–3 sessions (typically spaced 6 weeks apart), it stimulates natural collagen production for long-lasting dermal thickening (2+ years). Ideal for cheeks, temples, and the lower face.
The Master Map: Where Fillers Can Go
| Region | Goal | Preferred Products |
|---|---|---|
| Mid-face (cheeks & tear troughs) | Restore youthful contour | Restylane Contour, Voluma, RHA-4, Evolysse Form, “Radiesse+HA” mix |
| Nasolabial folds & marionette lines | Soften creases | Restylane Contour, Juvederm Ultra Plus, Evolysse Form, Sculptra |
| Lips & peri-oral lines | Plump, define border, smooth “smoker’s lines” | Restylane Kysse, RHA-3, Contour |
| Temples | Correct hollowing | Restylane-L, Contour |
| Jawline & chin | Sharpen definition, improve profile | Juvederm Volux, Restylane Contour, RHA-4, “Radiesse+HA” mix |
| Neck (“tech-neck” lines) | Fill horizontal rings, improve texture | HA micro-droplets, hyper-dilute Radiesse |
| Hands | Hide veins/tendons | Radiesse (FDA), Restylane Lyft, Radiesse+HA mix |
| Chest / décolletage | Reduce crepey skin | Hyper-dilute CaHA, HA micro-droplets, “Radiesse+HA” mix |
| Buttocks / hip-dips | Subtle lift & skin thickening | Sculptra |
| Earlobes / Nose | Support heavy earrings; non-surgical nasal refinement | HA gels |
*Final product choice depends on anatomy, skin thickness, and longevity goals.
Combination Protocols — My Signature Approach
I was among the first (if not the first) to publish on mixing HA with CaHA in the same syringe, combining HA’s moldability with CaHA’s collagen-stimulating effects. For enhanced results, I also layer Sculptra:
- Deep: PLLA (Sculptra) scaffold for long-term dermal thickening.
- Mid-depth: “Radiesse+HA” mix for structure and collagen boost.
- Superficial: HA (Restylane/Juvéderm) for contour refinement.
Result: fewer sessions, smoother transitions, and lasting results for 24+ months.
Treatment Experience & Downtime
- Session length: 30–45 minutes (includes topical numbing; most products have lidocaine).
- Immediate effects: HA & CaHA offer instant volume; Sculptra results appear gradually (~8–12 weeks).
- After-effects: Mild swelling/bruising (3–7 days). Light activity same day; avoid heavy exercise for 24 hours.
Why Choose Dr. Moradi
- Board Certified Facial Plastic and Reconstructive Surgeon
- 26+ years of facelift and injectable experience
- Principal investigator for FDA trials on HA, CaHA, and PLLA
- Numerous peer-reviewed publications and national faculty roles
