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Dermal Fillers

Dermal Fillers San Francisco, CA | Injectable Cosmetic Treatments

Belotero Balance in San Francisco

For the loss of volume in the tear trough area under the eyes, San Francisco, CA board-certified plastic surgeon, Dr. Leonard Gray, uses the subtle filler known as Belotero. Belotero is also a hyaluronic acid (a substance found naturally in the body) filler. Compared to other hyaluronic acid fillers, Belotero® is a little thinner in consistency, making it ideal for the thin skin under the eyes or the delicate lines around the mouth. By using this subtle filler, Dr. Gray is able to prevent the puffiness that can sometimes look unnatural from injectable dermal fillers. Belotero typically lasts 6 – 12 months.

model showing off aesthetics

What is Belotero Balance, and is it a good choice for the tear trough area?

Belotero Balance is a hyaluronic acid-based dermal filler. It’s used to address various facial concerns, including fine lines, wrinkles, and moderate folds.

Use in the Under Eye Tear Trough Area:

Belotero Balance is often used in the under-eye tear trough area to address hollowness, dark circles, and fine lines that can develop due to volume loss and aging. The soft and smooth consistency of Belotero Balance makes it suitable for this delicate area, as it can integrate well with the skin.

Advantages of Belotero Balance for the Under Eye Tear Trough Area:

  • Natural-Looking Results: The formulation of Belotero Balance allows it to blend seamlessly with the surrounding skin, resulting in natural-looking results.
  • Hydration: Belotero Balance contains hyaluronic acid, a naturally occurring substance that attracts and retains water. This can help hydrate the under-eye area and reduce the appearance of fine lines and wrinkles.
  • Subtle Correction: The soft consistency of Belotero Balance makes it suitable for fine lines and delicate areas, ensuring that the correction appears natural and not overly enhanced.


Belotero is often a single-session treatment that lasts up to 30 minutes, sometimes even less. Patients may experience pain is similar to any other injection treatments. A topical anesthetic may be applied to minimize discomfort during the session. The amount of medication, formulation and injection spot vary considering each patient’s circumstances. The entire process is repeated every 6 to 12 months as the formulation is naturally absorbed by the body.


Since this is a noninvasive treatment, patients will be able to go back to their normal routine shortly after the injection. Some swelling and redness may be present, but these usually subside after a few hours. Strenuous activities must be avoided for at least 1 day. The results are evident immediately, and can last from 6 months to 1 year. Generally, the skin treated will appear smooth with a rejuvenated glow that makes facial features look young and fresh.

Belotero Balance FAQs

There are a number of available injectable fillers that are hyaluronic based in the market today. However, Belotero is best known for its function to correct severe wrinkles commonly found around the nasolabial folds. Other fillers will be discussed during the initial consultation with the doctor to highlight the advantages of each, and the best approach to the patient’s facial features and cosmetic concerns.

Belotero is hyaluronic-acid-based filler that is FDA approved. It is backed with years of extensive testing for its function and safety. Since hyaluronic acid is a substance processed naturally in the body, it is a solution that integrates well with the underlying tissues, and provides great results in terms of adding volume and promoting skin hydration.

BOTOX® works in a way that once injected, the skin will appear smoother and softer because the solution is a muscle relaxant. It freezes the muscles beneath the skin where it was injected. However, it doesn’t add any volume to the area. Belotero, like other injectable derma fillers, can provide the same results as BOTOX, but works in a way that it adds more volume so that it stretches the skin to make it appear more youthful and smoother with wrinkles becoming less evident.

In most cases, yes. Since Belotero is made of hyaluronic acid, a substance that occurs naturally within the body, the injected solution normally gets absorbed. It is recommended to maintain injections every 6 months to 1 year to supplement the loss of volume. Some patients initially opt for dermal fillers to see if cosmetic enhancements will look and feel before proceeding with more permanent and invasive procedures such as facelifts.

Dr. Leonard Gray

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Instilling Beauty
Inspiring Confidence

Dr. Gray is a board-certified plastic surgeon with over 20 years of experience conducting surgical procedures of the breast, body, and face. His emphasis on patient education and attention to detail have made him the top choice for plastic surgery in the Bay Area. Dr. Gray invites you to meet with him for a friendly and informative consultation.

Radiesse In San Francisco, CA

In all areas of the face besides the lips and tear troughs, San Francisco, CA board-certified plastic surgeon, Dr. Leonard Gray, uses the dermal filler, Radiesse®. Radiesse is a filler that is comprised of tiny calcium-based microspheres that are similar in consistency to the natural calcium in your bones. Injecting it into specific areas like the cheeks and deep lines between the nose and mouth (nasolabial folds), instantly restores fullness and structure to your face by lifting sagging skin and stimulating your natural collagen production over time. Radiesse restores volume in a natural way without looking “puffy” or “overdone.” Results may last a year or more in many patients.

Radiesse in the Bay Area: What is this injectable filler and what are its uses?

Radiesse is a dermal filler that is commonly used to address areas of the face where there has been bone loss or a decrease in volume. It’s unique among dermal fillers because it contains calcium hydroxylapatite microspheres, which provide both immediate volume and stimulate the production of collagen over time. Here’s a detailed explanation of Radiesse and its use for addressing bone loss in the face:

How Radiesse Works

Radiesse is made up of calcium hydroxylapatite microspheres suspended in a gel. When injected, it immediately adds volume to the treated area, giving the appearance of smoother and plumper skin. Over time, the calcium hydroxylapatite particles stimulate the body’s natural collagen production, leading to longer-lasting results.

Areas of the Face with Bone Loss

Radiesse is often used in areas of the face where bone loss or volume depletion has occurred. These areas can include:

  • Cheeks: As we age, we may experience volume loss in the cheeks due to a decrease in bone density and fat pads. Radiesse can be injected into the cheeks to restore youthful fullness.
  • Jawline: Bone loss in the jawline area can lead to sagging and loss of definition. Radiesse can help restore a more defined and contoured jawline.
  • Chin: A receding chin can be caused by bone loss or genetics. Radiesse can be used to enhance the projection of the chin and improve facial balance.


  • Immediate Results: Radiesse provides immediate volume upon injection, making it suitable for addressing areas of concern during the treatment session.
  • Stimulates Collagen: The calcium hydroxylapatite microspheres trigger collagen production, leading to longer-lasting results that continue to improve over time.
  • Longevity: The effects of Radiesse can last up to a year or more, depending on the individual and the treatment area.
  • Natural-Looking Results: Radiesse is formulated to provide natural-looking results that blend seamlessly with the surrounding tissue.

Procedure and Considerations

  • During the procedure, Radiesse is injected into the targeted areas using a fine needle or cannula.
  • Some temporary swelling, redness, or bruising at the injection sites can be expected, but these usually resolve within a few days.


Radiesse is a quick procedure normally completed within 30 to 45 minutes depending on the size of the area being treated. The face will be thoroughly cleansed and then marked with ink so that the practitioner can conduct the injections with precision. A numbing cream is usually applied before the injection occurs. The gel is delivered using a fine needle into pockets just underneath the skin until the right volume is achieved.


After treatment, there may be redness, swelling and even bruising around the injection sites, but these go away after several hours. Patients will be able to resume their normal routine; although strenuous exercise should be limited for the first 24 hours. Patients will see their results immediately, and the results will continue to improve because Radiesse stimulates natural collagen growth, which is an agent for healthy skin.

Radiesse FAQs

There is an extensive selection of derma fillers available. Each filler has its own specific treatment to match the patient’s cosmetic issues. Whether naturally or artificially derived, these are all FDA approved, which means they are proven to be safe and effective. The one highlight of a Radiesse treatment is that aside from its volumizing capability it can function as a collagen stimulator. When collagen multiplies, it greatly benefits the skin tone. During the initial consultation, the face will be assessed and the appropriate filler will be recommended.

Several other derma fillers are manufactured using hyaluronic acid. Popular examples are Juvederm or Restylane. While these are great in adding volume back to facial depressions, Radiesse stands out as the only filler made of calcium-based microspheres, which have the ability to integrate with skin tissues and promote collagen growth. Every patient is unique and a treatment plan will be tailored to them that may include Radiesse, or another filler if the practitioner feels it will best benefit the patient.

Radiesse is FDA approved and backed by comprehensive testing. As it is derived from a substance that naturally occurs in the body, it poses no toxic risk. Temporary side effects may include redness, swelling, bruising, numbness or itching, which all subsides after a few days. 

Stunning natural results

Dr. Gray’s training, precision, and personalized treatment plans provide genuinely outstanding results. Want to see for yourself? Follow the link below to view before and after pictures of Dr. Gray’s actual patients.

Juvederm in San Francisco, CA

San Francisco plastic surgeon, Dr. Leonard Gray is proud to use Juvederm for wrinkle correction and to replace lost facial volume. Juvederm® is a popular dermal filler that is manufactured from hyaluronic acid, a naturally occurring substance produced by the body. It is commonly used to improve hollow areas on the face where additional contour and volume is desired. Hyaluronic acid injections, such as Juvederm, also work to stimulate the production of collagen and elastin, two proteins that contribute to a healthy skin elasticity. While there are many hyaluronic acid-based fillers on the market today, Juvederm continues to expand its product lines and remains popular among both men and women.

dermal fillers before an after

Juvederm Ultra Plus Dermal Filler in the Bay Area: What are its uses?

Juvederm Ultra Plus is a type of hyaluronic acid-based dermal filler. It is specifically formulated to address deeper wrinkles and folds and enhance lip volume.

Hyaluronic Acid-Based Filler:

Juvederm Ultra Plus, like other products in the Juvederm line, is made from hyaluronic acid (HA), a natural substance found in the body. HA has the ability to attract and retain moisture, providing hydration and volume to the skin.

Deep Wrinkles and Folds:

Juvederm Ultra Plus is often used to target more pronounced lines and wrinkles, particularly those that are deeper and have more volume loss. Common areas of treatment include nasolabial folds (smile lines), marionette lines (lines that run from the corners of the mouth), and other facial creases.

Lip Enhancement (lip fillers):

Juvederm Ultra Plus is also used to enhance lip volume and shape. It can help add fullness to the lips, improve symmetry, and enhance lip contours.

Our Juvederm Offerings

Juvederm XC

There are different variations of Juvederm available on the market today.  Juvederm XC® , which is used to correct moderate to severe facial wrinkles around the mouth and nose is still used, but now has a sister brand known as Vollure. Dr. Gray uses this product to target deep lines around the mouth. It smoothes lines without leaving a “puffy” outcome. Vollure is our newest offering by the Juvederm family and has become very popular with gorgeous results that can last up to 18 months.

Juvederm Ultra Plus

We also offer Juvederm Ultra Plus® . This is our “go to” for lip enhancement. This product is hydrophilic, meaning it draws in water to give the lips a soft and supple look. Dr. Gray has a unique technique he uses when injecting this filler into the lips, using an elongated approach to the upper lip so that it does not result in the dreaded “duck lip” look. This product of Juvederm can last up to 2 years, however, it is common for most patients to return 1 – 2 times per year to keep their lips looking full year-round.


Juvederm is a gel substance that is administered via a fine needle directly into the skin. There is no sedation needed, although a numbing cream is usually applied first to help with any discomfort. The injection sites will be sterilized and marked with ink. Once the filler is injected, results are immediately noticeable. The practitioner may massage the treated area so the filler spreads evenly. Other than temporary redness, the treatment has no after effect that will prevent a patient from going back to normal routine. Patients should avoid strenuous exercise for approximately 24 hours. After a Juvederm injection, the face will look refreshed, softer and smoother.

Juvederm FAQS

This procedure is almost pain-free. This really is determined on a patient’s overall pain tolerance. The product is administered with a fine injection needle and a numbing cream is usually applied first to help with any discomfort. After the treatment, tingling sensations may occur, and there could be some swelling and bruising. These after effects are temporary and usually subside within a few hours.

Dermal fillers have an outstanding track record for successfully reducing signs of aging with less risk than surgical cosmetic treatments. Other nonsurgical options include wrinkle relaxers, such as BOTOX and Dysport. Severe cosmetic issues such as loose and sagging skin may be better resolved by a surgical facelift. The approach taken will be based on the patient’s cosmetic condition and aesthetic goals.

It is important to set realistic expectations when undergoing any cosmetic enhancement procedure. While the treatment does take years off the face, it can only do so much for patients who have severe wrinkles and skin irregularities. Juvederm will definitely help decrease fine wrinkles and creases, and the skin will appear smoother and softer. 

Kybella in San Francisco

model displaying facial contours

Bay Area Plastic Surgery is pleased to offer the latest advancement in minimally invasive fat melting for that unsightly, unpleasant, and dreaded double chin. Welcome, Kybella®! Made from deoxycholic acid, the FDA-approved medication is injected directly into the fat beneath the chin by board-certified plastic surgeon, Dr. Leonard Gray. Kybella works by destroying the fat cells to diminish fat and prevent fat from accumulating in the future. Depending on the amount of fat present, most patients need between 2 – 4 treatments to effectively get rid of the appearance of the double chin.


Kybella is an alternative to surgical neck liposuction for patients who only need fat removed from the area under their chin. If the patient wants fat removed from the rest of the neck, surgical neck liposuction is the best option. The doctor will help every patient determine their best treatment plan after listening to their concerns and goals in the initial consultation.


Kybella is an alternative to surgical neck liposuction for patients who only need fat removed from the area under their chin. If the patient wants fat removed from the rest of the neck, surgical neck liposuction is the best option. The doctor will help every patient determine their best treatment plan after listening to their concerns and goals in the initial consultation.


After cleaning the area, the doctor will inject Kybella into multiple sites under the patient’s chin. Most patients will begin to see visible results in 2 – 4 treatment sessions. Patients can have up to 6 treatment sessions with less than a month in between each session. After the treatment, patients may have temporary swelling, bruising, pain, numbness, or redness.

Kybella in San Francisco

While it is being researched, Kybella is not currently approved to eliminate fat in any other areas of the body and a plastic surgeon will only inject Kybella into the area below the patient’s chin. The uses of Kybella will hopefully be expanded, but for now, patient can enjoy getting rid of their double chin with Kybella.

Before receiving Kybella injections, the doctor will ask about the patient’s current medications and medical conditions during their initial consultation. Patients who are pregnant or breastfeeding may not get Kybella injections. Kybella is also not available for anyone under the age of 18.

Deoxycholic acid, the active ingredient in Kybella, is a naturally-occurring molecule that can be by the body to breakdown and destroy fat. Once destroyed, these fat cells cannot return.