Face fillers or volumizers are injected with a needle to create a more youthful appearing face. Many options are currently available: hyaluronic acid (Juvederm™, Restylane™, Perlane and several others), calcium hydroxyapatite (Radiesse™) and poly-L-lactic acid (Sculptra™). These vary in how they are used: depth placement, location placement, longevity of result, pain, bruising, swelling and price.

  • Voluma
  • Radiesse
  • Juvederm
  • Sculptra


What we call “Voluma” is officially called “Juvederm Voluma XC”. What we call “Juvederm” is officially called “Juvederm Ultra XC” and “Juvederm Plus XC. It would confuse everyone if we tried to use the official full names for these products, so we don’t. Neither do most other offices of Board Certified Dermatologists who are expert injectors.

Voluma is an injectable hyaluronic acid (HA) gel for deep injection in the cheek. It has some off-label uses too. Dr. Klein had the honor of Advanced Techniques training with Dr. Mauricio di Maio, a plastic surgeon from Brazil. Another term used for this procedure is the “liquid face lift”. It is truly an amazing product. It is safe in an experienced injector’s hands, like Dr. Klein’s. Voluma lasts 2 years per the label, but for many it has lasted longer.


Radiesse is a white firm calcium hydroxyl apatite suspension that is injected to add support and fullness to areas such as the nasolabial fold, the pre-jowl sulcus, and the cheeks. It can be used in the hands and forehead as well. It works great for saucer type acne scars. It lasts 1 – 1 ½ years, and has a mild stimulatory effect.

Marla M. Klein, M.D. has had the honor of being a Medical Education Faculty member for Bio-Form (maker of Radiesse) since 2006.


Juvederm is a soft clear gel that is injected into the dermis to plump it up. It can be used to make lips look fuller, soften smile lines. When used to fill in the depressed hollows under the eyes, it should be placed properly below the muscle. It is composed of hyaluronic acid, synthetically made, in a smooth preparation by Allergan. It is FDA-approved for wrinkles such as the nasolabial folds, and lasts approximately one year.

Marla M. Klein, M.D. has had the honor of being on the National Educational Faculty for Allergan (maker of Botox® and Juvederm) since 2003.


Sculptra has been approved by the FDA for restoration and /or correction of the signs of facial fat loss (lipoatrophy). The effects are long lasting: 2-3 years or more.

Instead of being a filler in the traditional sense of an instant fill and gradual decline of the result; Sculptra is best considered as a “stimulator” of new collagen to develop and thus fill or add volume to the skin via the body’s response to the PLLA particles.

Sculptra is supplied as a vial of particles of poly-L-lactic acid. The vial is prepared in the physician’s office and may vary from office to office.

Marla Klein MD has the distinction of being Oregon’s only Sculptra National Educational Faculty Member. She has performed Sculptra treatments on hundreds of patients since 2004 with incredible and long lasting results, and minimal complications.

PATIENT SAFETY: The average person does not understand the dangers of fillers being injected by a minimally trained person.  Blindness and skin necrosis are potential complications that can happen if an injector is not fully trained in the anatomy of the face and proper safety techniques. My staff are thoroughly trained to understand, recognize, and treat the serious problems that could happen if proper safety technique is not carried out; but most of all I insist on them knowing what proper safety technique is so these things don’t happen.  I have great concerns about the med-spas that have minimally trained staff with no or very little medical background (such as an esthetician or medical assistant) performing facial filler procedures.  The potential complications are so great if done incorrectly, I’ve got to believe that even the “supervising doctors” (who are often Internal Medicine or Emergency Room doctors) don’t even comprehend their malpractice risk by letting minimally trained staff perform these injections at their minimally supervised med-spas.   With facial fillers, it is very important to go to an experienced injector.