David B. Reath, MD
Knoxville, TN (865) 450-9253
HKB Knoxville Staff

Juvederm, Restylane, Volbella

Filler Fundamentals

Hyaluronic acid dermal fillers are the fastest growing non-invasive facial procedures in Knoxville. Juvederm Ultra, Volbella, Voluma, Vollure, and Restylane are all injectable wrinkle fillers made from hyaluronic acid. Fillers differ in formulation, and one size does not fit all. Some are more plumping, and some last longer than others. There is also a significant difference in cost and longevity.


The Artistry of Fillers

filler pallette
We exclusively use fillers made from hyaluronic acid, which is a jelly-like substance naturally found in the body in the skin and also in the eyes and joints. It absorbs water like a sponge and acts as a lubricant. Here’s the key: hyaluronic acid binds with collagen to provide structure, elasticity, and volume to the skin, making it look fresher, healthier, and better.

As your skin ages, the cells lose the ability to produce hyaluronic acid. As a result, the skin begins to lose volume, often resulting in thinning lips, facial wrinkles, and folds. Hyaluronic acid dermal fillers are used to temporarily replace the lost hyaluronic acid restoring the skin’s volume with a smooth, natural appearance.

Injectable fillers shape and sculpt the face from the inside to correct and contour. Injecting fillers is more of an art than a science and requires talent, practice, and extensive knowledge of facial anatomy.

Use the right brush.

Choosing the proper filler is the source of a lot of confusion for patients. Fillers differ in formulation and consistency. Even though they are made from the same ingredient, hyaluronic acid, they don’t behave the same when injected.

Which filler to use depends on the areas of your face that you want to improve. The places where your skin is naturally thin are the places where you’ll want the thinner products. Thinner formulations are perfect for under the eyes and to smooth fine, vertical lines around the mouth because they don’t absorb as much water and give a very subtle correction. For cheek volume or plumping lips, you’ll want the thicker formulations.

Juvederm XC

This is our best-selling facial filler for two reasons. First, it lasts longer than other hyaluronic acid fillers. Second, it contains lidocaine, so it is less painful to inject.

The hyaluronic acid in Juvederm XC is manufactured in a smooth gel versus a gel particle suspension in Restylane. This different formulation is providing a smoother, longer-lasting correction than current hyaluronic acid products on the market. Even better, Juvederm XC, in conjunction with Botox, makes both products last longer.

Juvederm XC is now available in five different formulations:

  1. Juvederm Volbella XC is the thinnest formulation and is used to correct vertical lips lines and outline the lips.
  2. Juvederm Ultra XC is a bit thicker than Volbella and is used for mild corrections in the nasolabial folds.
  3. Juvederm Ultra Plus XC has been our go-to filler for years. It has a thicker, plumping formula that is perfect for the lips.
  4. Juvederm Vollure XC is the newest member of the Juvederm family. It’s softer and easier to mold for those wanting a subtle, natural-looking correction. Vollure lasts six months longer than Juvederm Ultra and Ultra Plus.
  5. Juvederm Voluma XC is a formulation specifically designed to lift and add volume to the midface and cheeks.

Juvederm Formulas


Juvederm Pricing Cost per Syringe
Juvederm Volbella XC $400 .5ml
Juvederm Ultra XC $650
Juvederm Ultra Plus XC $650
Juvederm Vollure XC $750
Juvederm Voluma XC $900


Restylane Pricing Cost per Syringe
Restylane Kysse $750
Restylane Refyne $650
Restylane Contour $650

Multiple syringe discounts are available.

It’s possible to layer your fillers.

You don’t have to do everything all at once. Just like oil painters wait for their paint to dry before proceeding with fine detail, your injector may recommend more than one treatment of injectable fillers. Some of the best results come from starting with one treatment, waiting to see the results, then proceeding with the delicate blending.

Canvas carefully.

Many more wrinkle fillers are awaiting approval by the FDA, so it will become increasingly difficult to keep them all straight. It is crucial to understand that just because a filler is new, doesn’t mean that it’s better. The key is to find the right Knoxville office with a great injector who has access to the latest fillers and makes recommendations based on your goals and budget.


Before and After Photos of Facial Filler Patients

View Before & After Photos

We use blunt flexible cannulas to inject our fillers.- This is not only the safest way to inject fillers, but it also results in less pain and bruising for you! Flexible cannulas cost more than traditional needles, but we think your safety and comfort are worth the expense on our part. We are one of the only offices in Knoxville to use these miracle workers. Read more about the importance of flexible cannulas in our blog. You should never get fillers without them.

We’re “Stuck” on a Better, Safer Way To Inject Fillers

One of the things that I like about plastic surgery is that we are always trying to improve the things we do. I think it’s part of our culture or the way plastic surgeons are wired (no comments from the peanut gallery, please!). Usually the goal is to have a better result or make something … Read more »

Good to Know

Allergan has awarded our office Top 250 Status. Allergan not only distributes Juvederm and Botox, but they also supply Natrelle implants, SkinMedica, and the popular eyelash-growing drug Latisse.

What does this mean to you? It means that we have lots and lots of practice helping patients achieve the results they want. It means that our practice is in the top 1% of all providers by volume in the whole United States. Pretty good for Knoxville, Tennessee, right?

We are grateful to all our patients for their loyalty to our practice and kind referrals, which helped us achieve this milestone. Thanks, y’all.

Helpful Resources for Your Research

  • Artistry in injectables is particularly essential when it comes to the lips. We have a dedicated page with great advice on how to make sure you get the look you want. Lip Fillers Explained
  • Bruising after fillers is very common, especially if you tend to bruise easily. But, there are things you can do the week BEFORE your facial filler appointment to minimize your bruising afterward. Easy Ways to Minimize Bruising After Injectable Treatments.
  • Manufacturer’s rebates are frequently available for Juvederm XC. We have a page on our website dedicated entirely to keep you updating on what’s out there to save you money. Visit our Plastic Surgery Rebates Page

Reath Rewards is a loyalty program that everyone loves. For every dollar you spend on Botox and Dysport, you earn points towards special discounts designed exclusively for Reath Rewards members. These discounts are over and above any advertised specials and rebates.

Reath Rewards Earn points towards special discounts when you spend on products and nonsurgical procedures including Botox, Juvederm, and CoolSculpting. Learn More

Be the first to know when new rebates are available. Subscribe to our new rebate alerts.

Rebate Alerts Be the first to know about rebates! Subscribe Now

What Does the XC Stand For in Juvederm XC?

This is good to know. The XC in Juvederm XC indicates that the filler contains lidocaine in the syringe, which makes it much more comfortable for you, the patient. The Juvederm XC syringes also contain 25% more product. Some practices try to make more money by selling the cheaper, smaller syringes which are packaged without lidocaine. Trust us. You don’t want this. Don’t be afraid to ask to see the box. Any reputable injector will be impressed with your insider knowledge!

Juvederm Ultra Plus XC Knoxville





Studies show that 93% of the patients treated with Juvederm XC had less pain than when treated with the non-lidocaine formulation of Juvederm.

So, we did our side-by-side study, and here is what our patient had to say:

“I recently got to try Juvederm XC, and I must say that I am a believer in this product!

She first applied a topical anesthetic around the nasolabial folds (creases that run from my nose to the corners of my mouth). She then proceeded with a tiny injection of the Juvederm XC, waited 2 or 3 seconds for the numbing agent to take effect, and then completed the
injection. Other than the initial needle stick (which is quite minimal), the whole process was painless. Compared to previous procedures, I was actually able to sit back and relax.

At the last minute, we decided to add some filler to the lower corners of my mouth, where we had NOT applied a topical. Using the same process – a small injection, wait a few seconds, and then complete the injection – it was still a straightforward process. I believe that I could have done without the topical altogether, which will save me 20-30 minutes of “numbing time” on my next visit.

Post-treatment was also a much-improved experience. I typically review a lot of paperwork during the workday, so I am always looking down. The XC formulation really made a difference, as I was so much more comfortable compared to previous treatments without XC.

My recommendation — If you decide to use a filler, be sure to ask for
Juvederm XC!”


Radiesse has been a popular filler in the Knoxville area because it is longer lasting than most hyaluronic acid fillers and is cleared by the FDA. Anyone thinking about using Radiesse should also look into Juvederm’s brand new filler Voluma XC which is formulated to treat the mid-face and cheeks and lasts longer.

Radiesse is used to fill in deep lines and wrinkles as well as to contour the jawline and cheeks. The consistency of Radiesse is different from other fillers like Juvederm and Restylane. Radiesse is thick like toothpaste, whereas most hyaluronic acid fillers are thinner and more gel-like. Because of its thicker formulation, Radiesse should not be used in the lips or under the eyes.

Radiesse generally lasts about a year or more before naturally absorbing into the surrounding tissue. Radiesse is made of very tiny smooth calcium hydroxylapatite (CaHA) microspheres. These small particles form a scaffold. Once injected, the body’s collagen grows around the scaffold producing a correction that is longer lasting than most other fillers.injectables(1).png

Radiesse is a product that is better used to undercorrect, rather than overcorrect. Some of our best results have been using Radiesse in conjunction with hyaluronic acid fillers to get the best of both worlds.

If you are wondering which injectable filler is best for you, an injectable consultation with Dr. Reath or Dr. Walker is the place to start. It is free and beneficial to understand your options.

Radiesse Pricing Cost per Syringe
Radiesse $900


Sculptra is a semi-permanent filler (polylactic acid) that recently received FDA approval for cosmetic use. Initially, it was designed for correction of the signs of facial fat loss lipoatrophy) in people with human immunodeficiency virus. However, some Knoxville plastic surgeons have been using it cosmetically all along. We have decided not to incorporate Sculptra into our practice. The peer reviews are mixed as Sculptra requires three to six treatments and has side effects not associated with other fillers.

Meet Melissa Chambers, R. N.


Aesthetic Nurse Injector

We are thrilled to have Melissa join our practice. For many of you, she needs no introduction.  Her reputation for technical excellence and elegance is forged by 21 years of injecting experience right here in Knoxville.

Compassionate, nurturing, and calming, Melissa takes the time to listen to patients while kindly and expertly guiding them towards the results they’re wanting to achieve.

All of her patients from “Nervous Nellies” to injectable veterans are impressed by her personalized approach to their care and her gentle touch with a needle.

Melissa started her career as an Aesthetic Nurse Injector back in 1998. Those were the days of bovine collagen before anyone had ever heard of hyaluronic acid fillers like Restylane and Juvederm.

In an area where new products are often coming to market, Melissa is uniquely qualified to choose the right product for each patient’s budget and goals, rather than wasting money on trendy, short-lived injectables.

In addition to her vast experience with injectables, Melissa’s background in dermatology and proficiency with lasers is a great asset to our patients. Together, Melissa, Christy, Dr. Reath, and Dr. Walker will evaluate the newest technologies and ingredients to give the best results to our patients.


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