Jawline, Jowls & Marionette Lines

Dermal fillers are injectable substances used to fill in wrinkles, lines, and hollow areas of the face, restoring volume and creating a smoother appearance.

Dr Grunau uses dermal fillers made from hyaluronic acid, a substance which occurs naturally in the body.

Dermal fillers work by adding small amounts of volume to the targeted area. Depending on the technique and the type of filler used, the effect may be to smooth out wrinkles and lines, add structure, and/or introduce volume into the tissues which may provide a lifting effect. Filler treatment  also allows the light to reflect off of the areas of the face differently, which leads to a more refreshed look.

• Both treatments are considered medical aesthetic injectables. Dermal fillers add volume and strategically “fill” certain areas of the face in order to enhance, volumize and add definition, whereas neuromodulators relax specific muscles in order to reduce lines and wrinkles.

Dermal fillers can be used on various areas, including: temples, cheeks, tear troughs (hollows under the eyes), nasolabial folds, smile lines, jaw, jowls, marionette lines, chin, lips.

No, not at this time.

The longevity of dermal fillers depends on the type of filler used, the amount used, the area treated and the individual's metabolism. Generally, results last between 6-18 months, but there are cases of filler remaining years after treatment, and cases of filler breaking down in 2-3 months. 

Factors that lead to variation in longevity include patient metabolism, and the type, amount and location of filler injected. For example, a lower dose of lip filler in a first time patient will tend to metabolize faster than a larger volume injected into a patient who has had many lip filler treatments over time. Lip filler tends to metabolize more quickly than other areas, due to the regular movements of the mouth muscles for activities such as eating, speaking, kissing, sipping, and laughing. 

Dermal fillers are considered safe when administered by a trained and licensed medical professional. However, like any medical procedure, there are possible side effects, and rare but serious risks.

Common side effects are expected, and may include redness, swelling, bruising, and temporary lumps at the injection site. 

Other complications are rare, but can include infection, allergic reactions, delayed onset nodules (bumps), filler moving (migrating) outside the intended target area. 

Extremely rare and serious complications involve filler blocking a blood vessel (medically referred to as a “vascular occlusion”). Vascular occlusion can lead to damage in the surrounding skin and soft tissue and - in extremely rare cases - blindness, due to a lack of blood supply caused by the blocked vessel.

Common side effects generally resolve within hours to days.

All medical procedures are associated with some risk, and it is important to be informed of the benefits and risks of any procedure. Dr. Grunau follows established safety protocols to minimize serious but rare complications. This includes knowing which anatomical areas of the face are at higher risk of vascular occlusion (and avoiding those areas), and understanding the anatomical layers of the face. As an ER doctor, she has almost 20 years of experience managing emergencies and complications. She equips her clinic with an emergency kit to treat allergies and anaphylaxis, and to reverse any signs of a “vascular occlusion” (the medical term for a blocked blood vessel). 

Informed consent is an important part of your medical care, and Dr. Grunau is happy to answer your questions prior to proceeding with your treatment.

Hyaluronic acid dermal fillers contain a numbing agent (lidocaine) to minimize discomfort. In addition, Dr. Grunau applies numbing cream to certain areas of the face prior to treatment, such as the lips. And when the cannula technique is used, a small amount of lidocaine may also be injected prior to cannula insertion, for patient comfort. Patients often report mild discomfort, stinging or a feeling of pressure during the procedure, which is typically well-tolerated.

In the hours or days after your appointment, if you notice significantly increasing or disproportionate pain and discoloration to the skin please contact us immediately.

There is typically little to no downtime after dermal filler injections. Some discomfort, swelling and bruising may occur, but the majority of people resume their daily activities immediately. The common side effects (swelling, bruising, for example) resolve within 3-14 days, and the treatment “settles” within 2 weeks. Bruises may be covered with makeup in the meantime. Tylenol and cold compresses/ice may be used for swelling and discomfort, if needed. Please refer to the before and aftercare instructions for more information. 

• It is important to note that leading up to a significant life event, particularly if you will be photographed, it is best to have your treatment at least 3-4 weeks prior. This allows time for the treatment to settle, and to make any micro-adjustments, if required. 

Yes, hyaluronic acid fillers can be partially or fully reversed using an enzyme called hyaluronidase. This enzyme can also correct overfilling or an undesirable result such as filler migration. In some cases if patients have had previous filler treatment in the past, Dr. Grunau may recommend dissolving residual filler in order to “start fresh”.

• The cost of facial filler starts at $700/syringe, which includes your initial consultation with the doctor, as well as your follow up care. 
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• The cost to treat an area or multiple areas of the face with dermal fillers varies based on the type of filler used, the amount of filler needed to reach the desired outcome, and the patient’s area(s) of concern. 
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• Some areas may require only a single syringe to appropriately treat, particularly if the patient’s goal is to address a single region of the face, such as the chin, nasolabial folds, lips or perioral smile lines (in isolation). Other areas may require several syringes and types of filler, if the desired outcome requires treating different anatomical areas, using varied techniques.   
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• During your complimentary consultation, Dr. Grunau will select the best product(s) and approach to achieve your goals, and discuss the cost of the treatment with you.