Best Doctor for Dermal Fillers?

Is it better to go to a Dermatologist or a Plastic Surgeon for things like Restylane and other fillers?

I am particularly interested in Nasolabial folds without a nerve block, because I recently had a Board Certified Plastic Surgeon hit a nerve during a dental block with severe complications.

Would a dermatologist have more understanding of facial nerves? Just curious as to how to find the best doctor. Thank you!

Doctor Answers 8

Dermatologist versus plastic surgeon for filler injections

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

First, it most important to seek a Board certified specialist in one of the "core" cosmetic fields, Dermatology, Plastic Surgery, Oculoplastic or ENT, Secondly, be certain that it is the physician who will perform the injection. Lastly, it is best if you have referral from patients or another physician so that you have some knowledge of the specialists experience and expertise.

Miami Dermatologic Surgeon

For fillers it is best to see somebody with experience

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There are many specialties who are trained to do different aspects of cosmetic and there are world renowned specialists who come from many fields. The majority of physicians who specialize in injectables like facial fillers come form (in alphabetic order)

Facial Plastic Surgery (a sub-specialty of ENT)
Oculoplastic Surgery (a sub-specialty of Ophthalmology)
Plastic Surgery

You should know that there are also truly outstanding cosmetic surgeons who have different backgrounds that those listed above.

That makes it difficult for the patient/consumer. Your best bet is to ask for a referral from a physician or a friend. Take the time to have a consult with a few specialists and decide what feels right to you.

The best results come from long term relationships with your cosmetic surgeon. It is worth taking the time to start our with somebody who makes you confident and comfortable.

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 26 reviews

Filler by Dermatologist or Plastic Surgeon

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The specialty does not matter as much as the training and experience of the individual doctor. You should ask around and find out from friends etc someone who is known to be good. Also, you can use numbing cream before you go for injections and that would avoid any need for nerve blocks.

Click below on a link for information and then 'Botox and Filler Instructions' on how to prepare for filller injections.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Best to see physician who does a lot of dermal fillers.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

An experienced physician who does a lot of dermal fillers is the best person for you to have this done. A dermatologist or a plastic surgeon is well qualified to perform these types of injections.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

It's not the specialty as much as the skill of the physician

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There are many specialties that cross the spectrum of what we call 'Cosmetic surgery' and some are better at some things than others. Anatomy should cut across all specialties, but keep in mind that knowing anatomy doesn't translate into doing a good job in injecting or numbing.

In fact, you can know a whole lot and do a lousy job of getting a patient numbed. Having said that, I would hope that the more educated a physician, the better job overall they would do.

In our office, we don't even find the need for nerve blocks as I add the injection medicine to the syringe of filler and use a super potent topical numbing medicine along with a very slow and steady technique. Usually, our patients who have done blocks in other offices or ours before we developed this technique ask to NEVER get a block again.

So, you see, there are many things to consider here. One other, by the way, is that you should always insist that the doctor do the injecting. If they are farming it out to a nurse or PA, stay away! Good luck.

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.9 out of 5 stars 50 reviews

Surgeon specialities are less important then experience

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The most important things is going to a well trained and experienced physician. There are physicians in all specialities of Cosmetic Surgery that Inject fillers and training and experience are key. Make sure that the actual physician you see will be doing the treatments and not a nurse or associate. Look through the physicians before and after photographs and even speak with some of their patients so they may share their experience with you. Injectables as with many things in Plastic Surgery...less is more and a natural appearance is the goal at all times.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Who should do dermal filler injections?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your question is a politically loaded one, and so you will get a variety of answers. First, I am sorry to hear that you had difficulty after the nerve blocks, but it is unlikely to be related to the specialty-specific training that your doctor had; in order to "hit" the nerve, he had to know where it was and of course that is where the block needs to be placed. Complications from nerve blocks are extremely rare. Secondly, there are a variety of clinicians who are skilled at injecting. I supervise several RN injectors who do it all day every day and so their experience is vastly greater than many of the doctors who assert that only MD's should inject. It comes down to dedication to the art of aesthetic medicine more than the specialty background.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Choose a Facial Specialist

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question. I'm sorry to hear about your unfortunate experience.

Board-certified dermatologists, plastic surgeons, and nurses alike can be highly skilled at injecting dermal fillers. In either case, it's crucial to choose a professional known for his or her extensive knowledge and passion for facial anatomy. As a double board-certified facial plastic surgeon who specializes in the face and neck, I use my training to provide my patients with the highest level of care. You deserve the same.

I would caution you against making your choice based on the least expensive option, but rather use the resources available to choose a facial specialist known for doing quality work. After all, you're putting your most valuable asset in their hands! YouTube can be a valuable tool because it allows you to see the doctor's work firsthand. I hope you'll use my Channel of an example of what to look for. 

David C. Mabrie, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 156 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.