Facial aging is a natural process characterized by the gradual loss of volume, the deepening of folds, and the emergence of fine lines. In the vibrant, professional environment of San Francisco, many individuals seek ways to maintain a refreshed and youthful appearance without the need for invasive surgery. Injectable dermal fillers offer a versatile, non-surgical solution to restore lost volume, enhance facial contours, and smooth away the signs of aging with minimal downtime.

At the practice of Dr. Karen Horton, our aesthetic team, led by Board-Certified Nurse Practitioners Emily Sespaniak (@bayareainjector) and Agnes Wong (@np.agnes), specialize in providing natural-looking results tailored to your unique anatomy. Whether you are looking for subtle lip augmentation or a comprehensive facial rejuvenation, our goal is to enhance your features while maintaining the integrity of your natural expressions.

Why Does the Face Lose Volume?

As we age, the underlying structures of the face undergo significant changes. The primary biological cause of these changes is the depletion of collagen and elastin, the proteins responsible for skin elasticity and firmness. The body’s production of collagen begins to decline in our mid-20s, leading to thinner skin and a loss of structural support.

Furthermore, the fat pads that provide youthful fullness in the cheeks and temples begin to shift or diminish, while bone resorption can alter the foundation of the face. These factors contribute to the development of:

• Nasolabial folds: The lines running from the nose to the corners of the mouth.
• Marionette lines: The lines extending downward from the corners of the mouth.
• Hollow temples and cheeks: Areas where volume loss creates a gaunt appearance.
• Tear troughs: The under-eye area where shadows and fine lines often appear first.

Comprehensive Range of FDA-Approved Dermal Fillers

We offer a curated selection of the most advanced, FDA-approved fillers to address a wide variety of aesthetic goals. Each product has unique properties, such as different levels of thickness and flexibility, allowing us to choose the perfect tool for each treatment area.

Hyaluronic Acid Fillers

Hyaluronic acid is a naturally occurring substance in the skin that helps maintain hydration, elasticity, and volume. Because it is biocompatible and reversible, it remains the gold standard for non-surgical facial rejuvenation.

• Restylane-L®: A versatile filler used to smooth moderate to severe facial wrinkles and folds, such as nasolabial folds.
• Restylane Kysse®: Designed specifically for lip enhancement, providing soft, natural-looking volume while maintaining flexibility and expression.
• Restylane Refyne® and Restylane Defyne®: Formulated to soften dynamic expression lines while preserving natural facial movement.
• Restylane Contour®: Developed for cheek enhancement, offering flexible lift and natural-looking midface contour.
• Restylane Lyft®: A firmer formulation used to restore structure and volume to the cheeks and midface, and also FDA-approved for use in the hands.
• JUVÉDERM® Voluma® XC: Used to restore volume in the cheeks and midface, improving contour and structural support.
• JUVÉDERM® Vollure® XC: Designed to soften moderate to severe facial folds while allowing for natural expression.
• JUVÉDERM® Ultra® XC: Commonly used for lip enhancement and smoothing moderate facial lines.

Collagen-Stimulating Injectables

• Sculptra®: A biostimulatory injectable composed of poly-L-lactic acid (PLLA). Rather than providing immediate volume alone, Sculptra works gradually by stimulating your body’s natural collagen production, improving skin structure, contour, and overall firmness over time.

Skin Quality Enhancers

• SKINVIVE™ by JUVÉDERM®: A microdroplet hyaluronic acid injectable designed to improve skin smoothness and hydration in the cheeks. Unlike traditional fillers, it enhances overall skin quality and radiance without adding significant volume.

What to Expect During Your Treatment

Your journey begins with a comprehensive consultation where Emily or Agnes will evaluate your facial anatomy and discuss your aesthetic goals. The actual injection process is relatively quick, often taking less than 30 minutes.

To ensure your comfort, we use various techniques, including topical numbing cream and fillers formulated with lidocaine. Most patients describe the sensation as a minor pinch. There is typically very little downtime, though some mild swelling or bruising at the injection sites may occur. Most minor side effects resolve within 7 to 14 days.