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Soft tissue filler procedures are minimally invasive cosmetic treatments used to correct signs of facial aging and facial volume deficiency/volume loss. There are many different classes of soft tissue fillers, but they share the common characteristic of being injected under the skin. Older and younger patients alike use fillers for their cosmetic enhancements.

With age, injectable facial fillers treat the following changes:

  • Mild tissue sagging
  • Loss of youthful fullness in the face (cheeks, lips, eyelids, temples, etc.) and hands
  • Deepening of facial folds and lines (smile lines, frown lines, etc.)

With younger patients that do not have significant signs of aging, injectable fillers can enhance volume for the purpose of:

  • Improving fullness and pout in the lips
  • Enhancing the cheekbones
  • A “non-surgical rhinoplasty”

What Are the Advantages Of Soft Tissue Fillers?

Soft tissue filler procedures have the advantage of:

  • Being minimally invasive
  • Having little to no downtime after the procedure
  • Having little to no downtime during recovery
  • Not requiring sedation
  • Immediate results

There are many facial areas that can be cosmetically enhanced through this minimally invasive procedure. Please visit our page on the most popular treatment sites to learn more about common areas for soft tissue filler injections.

Types of Fillers Available

There are many types of fillers on the market; they are categorized by their “active” component.

The following fillers are the most popular:

Filler Type: Brand Name:
Human Collagen
Hyaluronic Acid Based
Restylane®, Restylane® Fine Lines,
Calcium Hydroxyapatite Based
Platelet Rich Fibrin Matrix
Poly-L-lactic Acid

To learn more about the types of fillers available and their varying distinctions, please read about the different categories of soft tissue fillers and their corresponding brands.

With so many fillers on the market, consumers can be confused with all of the choices (and hype) put out by the different manufacturers. In reality, differences between products within the same class (eg. hyaluronic acid based fillers) are not as significant as they are marketed to be. Even differences between products of different classes may not be very dramatic when comparing aesthetic outcomes.

Although the mechanisms of action and principal components may be quite different, the end results tend to be comparable, assuming the products are designed for similar applications. For any one area to be treated, there is usually more than one soft tissue filler that could be used very appropriately.

Dr. Tong can make a recommendation regarding which soft tissue filler would be best suited to your needs. Some factors taken into account are location, depth of lines, required degree of augmentation, skin quality, and skin thickness.

The Procedure Details

The selection of filler must be well-suited to the patient’s needs. Dr. Tong will make his recommendations when he sees you during a consultation.


Injections are usually supplemented with some form of local anesthetic. The local anesthetic helps to relieve discomfort that may occur during the injection procedure. Dr. Tong can administer the anesthetic prior to the start of the procedure. More commonly these days, the local anesthetic comes pre-mixed with the product and is administered simultaneously with the product.


The areas to be treated are marked on your face by Dr. Tong in conjunction with your input. The areas are cleansed with alcohol or antibacterial soap to remove dirt, oils, and bacteria. If local anesthetic is to be utilized before the procedure, it is administered at this point. The product is injected through a series of linear threads or puncture sites. There is no single method of soft tissue filler injection. Dr. Tong has specific configurations of injection for each specific area of the face.

Dr. Tong’s underlying principles regarding filler injections:

  • Distribute the filler evenly and at the correct depth
  • Assure symmetry
  • Do not fill beyond accepted limits (to maintain a natural-looking outcome)

Each area generally takes 15-20 minutes and Dr. Tong shows you the progressive result from time to time during the procedure.

Recovery from Soft Tissue Filler Injections

After the procedure, we will give you an ice pack, and recommend you ice the area for 20 minutes each hour as you are able for the rest of the day. This helps to decrease any swelling or bruising that may occur with the injection. You may return to work or daily activities, so long as they are not overly strenuous. You may begin exercising 24 hours after the procedure, unless advised otherwise by Dr. Tong. Bruising is unusual, but if it occurs, it can be covered with makeup and generally lasts a few days.

There may be some swelling of the area, which tends to subside over the first 48 hours. Sometimes, the product feels firm in the treated areas. This tends to be more common in some products than others. Patients may occasionally see some minor contour irregularities that are caused by the product as well. These issues are temporary and any firmness or visible contour irregularities should smooth out over the first few days as the product has some time to distribute itself.

The Liquid Facelift

Liquid facelift is the term used for facial rejuvenation done with a combination of minimally invasive techniques, without undergoing a traditional surgical procedure. In the right candidate, a significant degree of facial rejuvenation can be accomplished using only soft tissue fillers and BOTOX® Cosmetic.

This is an attractive option for patients who:

  • Do not want to have surgery, or are not ready for surgery
  • Cannot undergo surgery for medical reasons
  • Do not have the time/resources to commit to surgery/recovery
  • Want a “quick fix”

An example of what a typical liquid facelift would utilize:

  • BOTOX® Cosmetic in multiple areas of the face (e.g. glabella frown lines, “crows feet,” forehead lines)
  • Soft tissue fillers in multiple areas of the face (e.g. the nasolabial folds, cheeks, “marionette lines,” under the eyes, wrinkles around the lips, etc.)

A liquid facelift does not produce the same improvement as a traditional surgical facelift. This holds true in regards to the degree of correction and the duration of the results. Despite this, patients are generally very satisfied with the degree of improvement obtained. The key to success is having an educated patient with the correct expectations for the procedure.

Hand Rejuvenation with Soft Tissue Fillers

As we age, the hands can also appear aged. Soft tissue fillers can be used to camouflage veins, tendons, boniness, and general loss of soft tissue volume. Dr. Tong prefers to use volumizing HA fillers on the back of the hand to smooth out contours, which become more apparent as you get older. A more lasting alternative to using a tissue filler is using your own fat with a fat transfer procedure.

Collagen and Fillers at a Glance

What the procedure does
‘Fill in’ lines or wrinkles
Adds volume to needed areas
Duration of the result
Average: 9 months; depends on the area and filler used
Length of time to perform the procedure
15 – 20 minutes per area
Type of anesthetic most commonly used
local anesthesia with some fillers
many fillers already contain local anesthesia mixed in
Length of time off of work
No time off required
Time to get back to exercise
24 hours for heavy exercise
Pitfalls your Plastic Surgeon should avoid
  • Using a filler when a surgical procedure is needed