Adam N. Summers, M.D.
Maryland Plastic Surgery
Cosmetic Surgery & Medical Spa


Restylane, Radiesse, Juvederm, Evolence & Sculptra in Baltimore, MD...

Skin rejuvenation has come a long way since its humble beginnings.  The advancement in technology alone has provided the industry with a much broader range of non-surgical options.  One of the most significant advances is in the use of "filler" substances.  Filler substances are based on the principle of replacing or enhancing soft tissue with biologically similar components.  Our soft tissues are made of substances that help your skin retain its soft and elastic qualities.

One of the first filler substance commercially available was bovine (derived from cow protein) collagen.  Because of problems with allergic reactions, companies eventually began offering human based collagen (derived from donors).  However, these collagen injections tend to be absorbed fairly quickly.  More recently, porcine collagen (Evolence®) has been developed which lasts 6-12 months.  Evolence® is superior in its ability to minimize swelling and bruising, while providing a very soft, natural result.

Hyaluronic acid is also a naturally occuring component of our skin.  Utilizing modern technology, we can now create hyaluronic acid.  Unlike collagen, which requires animal donor sources, hyaluronic acid is created through a fermentation process, thus there is no risk of transmission of viral particles or of an allergic reaction.

The most commonly used hyaluronic acid fillers include:

     Restylane, Juvederm and Perlane

Each of these is manufactured slightly differently, resulting in variations in side effects and in longevity.   Based on our experience, the following guide is useful in distinguishing the differences among these substances:







 4-6 months




 5-8 months




 6-9 months


Restylane, Juvederm and Perlane are gels consisting of hyaluronic acid, a substance which all living things produce. Wrinkling is often caused by a reduction of hyaluronic acid as we age.  Therefore, replacing hyaluronic acid with injections is an excellent way to reverse the effects of aging.  The gel is injected into the skin in tiny amounts with a very fine needle. The result is instantaneous and produces a long-lasting, natural enhancement, gentle and safe to your skin.

Treatment Goals:

Skin wrinkle treatments with injectable fillers can:

  • reduce the appearance of laugh or smile lines
  • smooth out facial creases or furrows
  • "plump up" sunken areas of skin
  • fill-in depressed scars

The results of Restylane, Juvederm, and Perlane injections can be seen immediately after treatment.  However, the effects of these treatments are not permanent and will need to be repeated from time to time to maintain their results.  For severe wrinkle problems, a face lift may be recommended in place of non-surgical wrinkle treatments.

What Is The Procedure Like?

Typically, a novocaine injection is given first.  This will completely numb the area to be injected with filler.  In this fashion, you will not feel any of the filler injection.  The numbing wears off in about an hour.  The injections are made with a very fine needle at various points in the wrinkled areas.  Usually, there is no bruising, but, as with any injection, a bruise is possible.  The injections take less than an hour and, in some cases, can be completed in just a few minutes.

What Can I Expect After the Procedure?

  • You may return to work and resume all normal activities immediately.
  • No bandages are required.
  • You may experience some minor swelling for a few days after the procedure.
  • There is a slight possibility of bruising - cold compresses can help avoid this.
  • The effects last approximately six months, but vary from person to person. 
  • Over time, your body will gradually absorb the filler.
  • Your skin will be more sensitive after the injection - protect yourself with sunscreen and lip moisturizers.

Other Fillers and Injections:

At the Maryland Plastic Surgery Center, we offer a variety of fillers and injections for permanent, semi-permanent and temporary facial rejuvenation and enhancement.  In addition to Juvederm, we offer the following treatments:

  • Sculptra - a volumizing agent that adds bulk to sunken tissues
  • Radiesse - a long lasting filler containing a gel of calcium particles
  • Botox - a muscle paralytic that prevents wrinkling of the skin
  • Fat Transfers - volumizing and enhancing treatments for the face and lips


Frequently Asked Questions About Fillers:

Click on a question below to see the answer.

Q: How do I know which filler is right for me?

Q: Does it matter how old I am?

Q: How long will it take to recover from my injection?