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Soft Tissue Fillers

Soft tissue fillers are used to add volume to the face, to treat deep folds and creases. The first approved and most commonly area treated is the nasolabial folds (the lines beside the mouth, sometimes called “parentheses”). Fillers are placed beneath the skin surface to fill in and hide these folds, resulting in an improved contour and a more youthful face. Other areas frequently treated include the lines and folds below the corners of the mouth (often called “marionette lines” because of the resemblance to the mouth of a puppet), the lower eyelid region (often called the “tear troughs” because of the hollow area below the eyes, near the tear ducts), the lips, the cheeks, and the temple region (side of the face, above and in front of the ears). Finally, soft tissue fillers can be used to camouflage depressed scars in some cases.

Dr. Ransom is skilled in the use of Voluma®, Restylane®, Juvederm®, Juvederm Volbella®, Perlane®, Belotero® and Radiesse®. He uses each of these products according to patient preference. Dr. Ransom uses blunt-tipped microcannulas for sensitive tissues of the face, such as the under-eye or tear trough area. In addition, Dr. Ransom recommends the use of specific fillers in certain areas of the face due to the different thickness and durability of each filler formulation. In addition, each patient has a unique underlying bone structure and tissue characteristics. By employing a combination of fillers in an overall treatment program, sometimes called a “liquid lift” or “filler facelift”, Dr. Ransom can give you a quick, non-surgical rejuvenation without any downtime! Many patients will combine soft tissue filler treatments with Botox® Cosmetic or Dysport® for a simple, refreshing update to their look, or add a chemical peel or laser treatment for a complete non-surgical makeover! Please visit the photo gallery for examples. Also, more information about fillers is available on our pages for non-surgical chin and cheek augmentation, as well as non-surgical rhinoplasty. Lastly, Sculptra® is a different kind of “filler” that causes the body to make more of its own collagen. For more information about Sculptra® treatments, see the dedicated page on our site.

Who is a candidate?
Anyone who is looking to add volume to the face or treat deep lines and folds is a candidate for soft tissue fillers. Depending on the areas you want to be treated, and the severity of the folds or devolumization, different filler products may be recommended. The only contraindications for filler injections are active infection in the area to be injected or a history of allergic reaction to the product. Dr. Ransom can discuss the details of filler treatments, and the “liquid lift”, during your consultation. In addition, certain fillers (e.g., Radiesse® or Voluma®) can be used for non-surgical facial augmentation in the chin area, the cheek bones, or the nose.

Frequently Asked Questions

Q: What are the fillers made of? Are they safe?
A: Most of the commonly used soft tissue fillers today are made of synthetic hyaluronic acid (HA), a natural component of cartilage. This material is safe, non-toxic, and does not spread throughout the body. Examples include Voluma®, Restylane®, Juvederm®, Belotero®, and Perlane®. In addition to the volume of the material injected, HA is very hydrophilic – meaning it attracts water molecules. This increases its potential for revolumization. Lastly, HA is easily broken down by an enzyme called hyaluronidase (marketed as Vitrase or Wydase), which can be used to reverse the treatment or reduce areas that are overfilled, if needed.

Radiesse® is a different material, know as calcium hydroxyapatite. This is a natural component of bone, but is used in a gel form for soft tissue filling. Calcium hydroxyapatite is also safe and non-toxic, and does not spread throughout the body after injected. The advantage of Radiesse is that it lasts longer than HA-based fillers. It is thicker, however, and is therefore not suitable in all parts of the face. Finally, studies have shown that calcium hydroxyapatite filler injections may stimulate your body to make more collagen, leading to a permanent improvement in soft tissue volume.

Q: How long do the fillers last?
A: Different fillers last for different amounts of time, and there is certainly some variability between patients. This variability depends on each persons’ unique metabolism, level of activity, diet, and other factors. In general, the HA fillers will last six to nine months, though some patients will receive a longer effect. Calcium hydroxyapatite (i.e., Radiesse®) lasts longer, generally a year or more in some people. A new kind of longer-acting HA filler has just been released: Voluma®. This product has been shown to last up to 2 years in clinical trials. It is an excellent option for midface and cheek augmentation that is safe, long-lasting, and even reversible if needed.

Q: Can fillers be removed?
A: This depends on which filler is used and where it is placed. HA fillers (see above) can be dissolved using a tiny dose of an enzyme. If needed, this is a quick procedure and the enzyme reduces the filler volume within a couple days. Calcium hydroxyapatite fillers cannot be dissolved once injected, though they are metabolized by the body over time.

Q: Will the treatment hurt?
A: This is a common question for first-time patients. Dr. Ransom uses a specially formulated topical numbing cream before filler treatments to make the process as comfortable as possible. In addition, he uses fillers that have been pre-mixed with numbing medicine, so that each injection is accompanied by a small dose. Finally, for sensitive areas such as the lips, Dr. Ransom can perform specific nerve blocks to make the procedure completely painless. All patients are then encouraged to ice the treated areas in our office afterward. Our goal is to make you as comfortable as possible during your visit!

Q: Can different fillers be combined?
A: Absolutely! In fact, Dr. Ransom recommends specific fillers for specific areas of the face and specific aesthetic goals. It is very common to use Restylane® for the under-eye area, followed by Juvederm® for the folds around the mouth, and Radiesse® for the temples, jawline, and upper cheeks. A new filler that is now available is Voluma®, which can be used for longer-lasting volumization of the entire cheek and midface areas. This can be combined with any of the above treatments in a single, refreshing session.

5.0

Based on 19 reviews

Christina G.
I had several nasal/sinus issues including a severely deviated septum and a dorsal hump, which I wasn't crazy about. Dr Ransom did both the medical and aesthetic parts of my surgery and he did a wonderful job! While I did have some swelling, I didn't experience much bruising at all. I loved that he left the natural look of my nose just making small corrections. My breathing has GREATLY improved. His office staff was super helpful in scheduling and making sure payment and everything was very clear. I am very, very, very pleased with my results!!
Tk I.
I had a terrible surf accident in Bali and needed to get 50 stitches to repair what the reef did to my face. I had emergency cosmetic surgery in Bali the day of the accident. Immediately when i got back to the states i was introduced to Dr Ransom through some mutual friends. I was searching for the best cosmetic surgeon in San Francisco to help in my recovery. He and his team have been amazing! he helped establish a plan for my post-op wound care/treatment and administered some initial laser treatments. Dr Ransom and his team are extremely knowledgeable and very patient / helpful. I am very grateful for their help and support. I am finally looking normal again!
Joey B.
I had three issues with my nose - which inhibited my breathing: 1- broken nose, 2 - narrow nostrils that collapsed when I inhaled through my nose, 3 - deviated septum. When I was living in New York, I went to see a doctor about my breathing issues, and he said my skin was too thin and there was likely nothing he could do to rectify the problem. Dr. Ransom was recommended by an ENT I saw through One Medical. As soon as he saw him, he said he could easily fix my nose, and remove the bump that had formed from the trauma. His confidence and strong sense of self immediately put me at ease, and I had little doubt that he could accomplish exactly what he promised. He showed me a modified picture of my nose , and really liked what he proposed. The end result very closely matched what he promised. Not only can I now breath much more easily through my nose, it looks much better. He managed to make it look like an improved version of itself, however I still look like me, and unless I tell anyone I had it done, it's not overly noticeable, which I prefer. I'm pretty vain and very critical, and I can say that Dr. Ransom is great, and comes highly recommended.
Edward T.
Doctor Evan Ransom took my surgery on relatively short order and did a wonderful job. He is very talented and has a nice friendly professional support staff. I can not thank him enough, he was calm, caring, professional and interested in the follow results of his work . He seemed to bring a certain artistry to the profession.
Lisa C.
Dr. Ransom is a talented physician. He is knowledgeable, professional and goes the extra mile to make you feel comfortable during your treatments. He has been blessed with an artistic eye which brings wonderful results. I highly recommend Dr. Ransom and would refer all of my friends and family members to choose him as their physician.
Cheryl H.
Dr Ransom is very kind, honest, and conscience doctor. I was referred by my best friend, she is also Doctor Ransom patient. She has so much good things said about Doctor Ransom. So I had a face lift done by Doctor Ransom on July 2015. He did a wonderful job on my face and I have a lot of compliments on my face. So if anyone want to get their face done. I would highly recommended Doctor Ransom to you. I give Doctor Ransom a five stars.
Jill P.
I have currently been getting botox regularly with Dr. Ransom and he does a fantastic job. My previous doctor's office moved to another location where it was no longer convenient. I didn't realize what I was missing until I went to Dr. Ransom. I felt really comfortable, but most important he did a terrific job blowing my previous doctor out of the park. (Sometimes it's good switch it up a bit to make sure you are getting the best treatment.) On top of that, Dee the office manager is an incredible asset to the office. She personalizes your visit and relationship with the office to an extent I have never experienced before. I even get follow up calls to see how I am doing after a treatment. I highly recommend Dr. Ransom for his great work, and his team's impeccable customer service.
Arielle C.
Dr. Ransom and Dee are the BEST! Whether it's aesthetic or reconstructive, I'd trust him over and over again with my face.