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Katya H. Bailor, MD

Vero Beach, Florida (772) 569-7800


Facial Fillers can add a more youthful appearance

All faces lose volume (fat and skin thickness) over time. Facial fillers, such as Juvéderm® Ultra, plump up an area under the skin to eradicate folds, creases and deep lines that age faces. Men and women are often dismayed that they have “marionette lines” coming down from the corners of the mouth or “parentheses” between nose and lips. Lips may need to be plumped to have more volume and obliterate some of the “lipstick” bleed problem. Adding volume especially in the upper lip, can erase the “old biddy” look, and present a more youthful appearance. Our Vero Cosmetic surgeons use Juvéderm brand fillers made of hyaluronic acid, a substance that is naturally present in the human body.

Does it hurt?

We inject local anesthesia before this procedure. A filler injection procedure should be painless. A provider might claim to use a brand that contains local anesthesia but that does not preclude feeling the pain of each injection. Our surgeons believe in comfort throughout this 25 minute procedure while checking for symmetry and esthetic correction.

In the state of Florida, fillers can legally be injected by medical providers with the following degrees: Medical doctor (MD), Doctor of Osteopathy (DO), Nurse practitioner (NP) or Physician Assistant (PA) with doctor’s supervision. However, a medical degree of this sort does not guarantee a patient that that person has had appropriate training in filler injection techniques or esthetics. Plastic and Facial Plastic surgeons have many hours of training in proper use of these injectables and patient care afterwards. The best trained doctor not only cares about pain eradication before the procedure but also is skilled in esthetics.

Is a filler permanent?

Some manufacturers and practitioners will say they can inject brands that are permanent. At Vero Cosmetic, we do not inject “permanent” products. A face changes over time– gravity creates change, hormones or illness create change, sun damage causes deeper facial grooves. Therefore, it is important that fillers be replaced or injection moved to another area to give the face a balanced appearance. Plump lips at the age of 55 might look silly on a 65 year old who has lost much of her facial volume. Just as one might regret a bad tattoo, people who have permanent fillers can have “filler regret” due to facial changes or poor placement. Humans are not permanent and neither should be fillers.


It is important to understand that ANY practitioner must inject with caution and understanding of muscle and tissue anatomy under an individual’s skin. If a filler is accidentally injected into a blood vessel, it can cause tissue damage and loss. This is especially true around the eyes where blood vessels communicate with the main artery and vein to the eyeball; cases of blindness have been reported. Thus, it is important to choose this particular injection NOT by price, NOT on whether the person can legally inject, but on that practitioner’s esthetic training and experience. Most skilled providers would be happy to answer questions about their training for a particular treatment or surgery.