Dr. Macdonald is a facial plastic surgeon intimately familiar with the musculature of your face. He is also familiar with the most popular tissue fillers including, Restylane®, JUVEDERM®, Perlane™, JUVEDERM® UltraPlus, RADIESSE® and Prevelle Silk®.

Treatment by a highly skilled injector tends to yield more satisfying, natural-looking results, and those results last longer. Read our Injectables FAQs to find out why.

About Hyaluronic Acid Dermal Fillers

There are a host of dermal fillers available today. Many are hyaluronic acid-based—a clear injectable gel of stabilized hyaluronic acid which hydrates and volumizes your tissue.

Restylane®, JUVEDERM® Ultra, Perlane™ and JUVEDERM® UltraPlus comprise the core of the hyaluronic acid products in Dr. Macdonald’s practice. These dermal fillers are popular injectable products that temporarily:

  • Soften “smile lines”, called nasolabial folds stretching from nose to mouth
  • Fill in marionette lines at the lower corners of the mouth, and vertical lines above the upper lip
  • Fill in acne scars
  • Lift cheeks to offset the drooping effect of midfacial fat loss
  • Redefine jowls or jawline left saggy by skin laxity and volume loss
  • Plump lips, giving a more full and voluptuous, kissable mouth

Prevelle Silk® is an alternative, silkier consistency hyaluronic acid filler. It’s the best choice if your priority is no recovery time. The thinner consistency of this product makes it well suited for treatment of very fine lines, and minimizes any injection-related swelling or bruising.

Using Prevelle Silk® reduces the potential risk of a temporary Tindel Effect. This side effect can occur with Restylane® or other hyaluronic acids when treating fine lines. The tradeoff is that results with Prevelle® are not as long lasting.

About Collagen Stimulator Fillers

RADIESSE® is the primary non-HA based filler Dr. Macdonald uses. It’s a collagen stimulator composed of Calcium hydroxyl-apatite microspheres (CaHA). These microsphere particles form a strong web through which your body’s own natural collagen grows.

Depending on the areas treated, RADIESSE® results easily last 1-2 years. Areas most often treated with RADIESSE® include:

  • “Smile lines”
  • Marionette lines (i.e., corners of the mouth)
  • Pre-jowl area
  • Chin wrinkles
  • Hands


Plump and Lift Cheeks

Facial “drooping” appears in varying degrees usually when you are in your late 30’s to mid-40’s. This is driven by genetics, time, gravity, and sun exposure. You can return your cheeks to their youthful fullness with dermal filler injections.

Dr. Macdonald prefers Perlane™, JUVEDERM® UltraPlus or RADIESSE® to augment cheek volume. The thicker consistency and longer-lasting nature of these products makes them ideal for use in your cheeks.

Fill Nasolabial Folds and Marionette Lines

Nasolabial folds refer to the lines between the nose (naso) and the outer corners of the lips (labial). Usually, in your late 30’s to early 40’s, these so-called “smile lines” deepen from a line to a crease to a fold. Marionette lines are the deep grooves (shaped like parentheses) that pull the corners of your mouth downward, giving you what’s often perceived as a constant angry or sad expression.

These subtle signs of aging, evidenced by the formation of deep nasoloabial folds and marionette lines, are easily corrected. This makes tissue filler injectables very popular non-surgical procedures, given how well they fill and smooth folds and deep lines. They easily take up to a few years off your appearance.

As you age, loss of elasticity in the skin and soft tissues of the midface cause the cheeks to descend with gravity. An obvious secondary effect of this gradual descent is deepening of the nasolabial folds. This aging effect can create hollows under the eyes as well. Both areas are often treated with dermal fillers.

To fill in nasolabial skin folds, marionettte lines, depressions from scars and wrinkles, Dr. Macdonald prefers to use Restylane® or JUVEDERM®. If the folds and wrinkles are particularly deep, he uses one of the thicker fillers like Perlane™, JUVEDERM® Ultra Plus or RADIESSE®.

Restore or Create Lip Fullness

Restylane® or JUVEDERM® is Dr. Macdonald’s preference for use in plumping lips to a fuller, more youthful, voluptuous state.

Through the natural course of aging, our lips slowly grow thinner and paler. But often when people think of tissue filler in the lips, they think of Angelina Jolie or other movie stars who have unusually large lips. This may not be your ideal goal for lip enhancement.

To simply restore the youthful sensuality of your lips, ask Dr. Macdonald about trying a conservative treatment with Restylane® or JUVEDERM®. It may surprise you how much a little fullness in your lips, and accentuation of your natural lip contours, wipes years from your face.

Treatment Expectations for Midface and Lips


Deciding which filler to choose can be confusing. Don’t worry. You have an expert to advise you prior to treatment. Dr. Macdonald studies the anatomy of your unique face. He listens carefully to your rejuvenation goals. Finally, he recommends the best treatment for you.

The treatment itself consists of:

  • Applying ice for vasoconstriction and numbing
  • Applying topical anesthetic to further decrease any discomfort
  • When treating lips, Dr. Macdonald prefers to use a “nerve block”, with a small injection of local anesthetic for complete numbing of this sensitive treatment area
  • Targeting select injections sites
  • Massaging injection sites to promote even integration into tissue
  • 30 minutes or less of treatment time

Note: Immediate results mat be exaggerated due to swelling

For recovery tips, visit our Patient Prep section and learn what to expect after your dermal filler treatment. Injectable treatments with tissue fillers typically require 24-48 hours for recovery.

Within this time, commonly experienced minor side effects of redness, itching, swelling, or bruising should subside. You may experience none of these side effects and enjoy no downtime.


Tissue filler results are generally seen immediately

  • Lines and wrinkles are smoothed
  • Skin folds, grooves, and scars are filled
  • Cheeks are volumized and lifted
  • Lips are subtly enhanced

The duration of your results varies depending on the product used and its placement within the face.

  • Core group of hyaluronic acid fillers—Restylane® or JUVEDERM®—last 4-8 months in more mobile areas of the face (i.e., lips)
  • Thicker formulated hyaluronic acid fillers—Perlane™, JUVEDERM® UltraPlus—last 6-12 months, especially in less mobile areas of the face (nasolabial folds, marionette lines, cheeks)
  • Thinner formulated hyaluronic acid filler—Prevelle Silk®—lasts 6-9 months but is best-suited for fine lines
  • Collagen stimulator filler RADIESSE® results last the longest, up to 2 years, but most commonly 15-18 months