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Fillers and injectables are a dynamic and evolving practice area within cosmetic surgery. The following descriptions will help introduce the variety of options currently available through board-certified plastic surgeon David Bottger, MD.

BOTOX® Cosmetic

BOTOX® Cosmetic is a substance that when injected directly into a muscle will reduce its activity. This will subsequently reduce the appearance of furrows and wrinkles produced by the action of that muscle. The most responsive areas to BOTOX® Cosmetic injection are the frown lines (vertical line between the eyebrows), horizontal forehead lines, and “crows feet” wrinkles around the eyes. Additionally, BOTOX® Cosmetic is effective in raising the lateral brow area to simulate a surgical brow lift. Results are temporary, lasting usually 4-5 months.

The procedure is performed in the office and can be performed with or without a topical anesthetic, depending on the patient’s preference.

5-Star Average Rating

He is the best! I had Botox for a frown line that is between my eyebrows. I’ve hated it for 10 years! With just one visit to Dr. Bottger and his perfect placement of injections the line is barely noticeable, you can’t tell I’ve had anything done and everyone keeps telling me how young I look! I will definitely be going back when this treatment wears off!



RESTYLANE ® is a biocompatible gel made of a material called hyaluronic acid which is used to fill or “plump” wrinkles or furrows. The duration of RESTYLANE® is approximately six months. It works best for the line and fold between the nose and lips (nasolabial fold), the furrows that turn down at the corners of the mouth, and the frown lines between the eyebrows.

Injection of RESTYLANE® is accomplished in the office and, depending on the area injected, may require a topical anesthetic cream or local anesthetic block for pain free injection.

RESTYLANE® can also be injected in the orbital rim region to mask lower eyelid “bags” and simulate a surgical blepharoplasty.


RADIESSE® is an injectable agent made predominantly from a material called hydroxylapatite. This is a biodegradable material that may last for up to two years. Its applications are similar to RESTYLANE® – the nasolabial fold, glabellar frown lines, and the folds and wrinkles below the mouth. The procedure is performed in the office, usually with a local anesthetic block for a pain free injection.


The recent FDA-approved hyaluronic acid gel filler JUVÉDERM™ is very similar in composition to RESTYLANE®. The main difference is the availability of both a thinner and thicker gel. This allows treatment of finer lines such as the vertical mouth lines of the upper lips commonly known as smoker’s lines. The longevity of JUVÉDERM™ may be somewhat longer than RESTYLANE®.


Fat grafting is most effective in the orbital rim region and at the lower eyelid region where it is very effective in masking lower eyelid “bags”. It is also useful in augmenting the duct region and reversing the laxity atrophied appearance associated with fat loss due to aging.

Fat is an ideal filler material with multiple applications. It is removed by liposuction from either the abdomen, hips, or thighs using a small cannula attached to a syringe. It can subsequently be injected in small strands into the subcutaneous and muscle layers of the face. It can improve nasolabial folds and also augment many areas around the mouth and cheeks which atrophy or “deflate” with aging. A certain percentage of any fat graft can resorb or dissolve, requiring a subsequent procedure for optimum improvement. For fat that has successfully “taken,” results can be permanent.

Fat grafting can be performed under local anesthesia with IV sedation or can be performed under general anesthesia on an out patient basis.


AlloDerm™ is a product derived from human skin or dermis which has been treated to remove all cellular components. This “collagen matrix” serves as a scaffolding into which the body replaces its own collagen. Eventually the AlloDerm™ is absorbed, leaving the body’s own new collagen to produce the result. There is usually a degree of permanent improvement with AlloDerm™. It is most commonly used in lip augmentation but may be used in other areas where soft tissue augmentation is required.

Contact our facial plastic surgery office for your consultation. Dr. Bottger will listen to your needs, goals and concerns, and make sure that you’re fully informed as to what results you can realistically expect. Based on your individual circumstances, he’ll tailor the BOTOX® Cosmetic procedure(s) to achieve the look you desire.

When you meet with Dr. Bottger’s plastic surgery staff you will have the opportunity to view before-and-after photos and learn more about our practice. Also, we can help you choose and set up financing for your procedures.