Dermal fillers are gels injected under the skin to add volume or smooth lines. In Houston they are offered by plastic surgery and dermatology practices, med spas with a medical director and some primary care offices. This guide explains the types, what the FDA has approved them for, and how to check who is treating you in Texas.
Lip Filler Houston is a free referral service, not a clinic or med spa. A request sent from this page goes to an independent provider in the Houston area, who is responsible for their own care and prices.
What a dermal filler is
The FDA regulates dermal fillers as medical device implants, and each product is approved for specific uses only. Most fillers used today are made of hyaluronic acid (HA), a substance the body also makes. HA can bind water and swell as a gel, which gives the smoothing or filling effect. Some fillers also contain lidocaine, a numbing medicine meant to reduce pain during the injection.
Fillers are not the same as neuromodulators such as BOTOX® Cosmetic (Allergan). A neuromodulator relaxes a muscle; a filler adds volume. A lip flip is a neuromodulator treatment, not a filler.
What the FDA has approved fillers for
According to the FDA, dermal fillers are approved for these uses in adults:
- Moderate to severe facial wrinkles and folds, such as the lines from the nose to the mouth
- Lip augmentation (only with products approved for the lips)
- Adding volume to the cheeks and the chin
- Restoring volume to the back of the hand
- Facial fat loss in people with HIV
- Some types of acne scars
Every product has its own list. A filler approved for the cheeks is not automatically approved for the lips. The Juvederm and lip products guide lists the products approved for lips, with the year of each approval.
Types of filler
| Material | How it behaves | Notes |
|---|---|---|
| Hyaluronic acid (HA) | Absorbable: the body breaks it down over time | The usual choice for lips; can usually be dissolved with hyaluronidase |
| Calcium hydroxylapatite (CaHA) | Absorbable | Used for deeper folds and contours, not for lips |
| Poly-L-lactic acid (PLLA) | Absorbable, slowly; lasts longer than HA, per ASPS | Builds up over about three monthly sessions |
| PMMA microspheres | Non-absorbable: the only approved material the body does not absorb | Approved only for nasolabial folds and certain cheek acne scars |
Some providers call CaHA and PLLA biostimulators. The American Society of Plastic Surgeons (ASPS) describes fillers as temporary treatments for facial aging that do not give the result of a facelift.
Areas the FDA advises against
The FDA recommends against filler for body contouring, such as the breasts, buttocks or feet. It also advises against injecting the area between the eyebrows, the nose, around the eyes, the forehead or the neck, because of the risk around blood vessels. Some providers offer filler in these areas anyway; that is off-label, and you should ask why they consider it suitable for you.
Never inject yourself
The FDA says not to buy filler online, not to inject yourself and not to use needle-free injection pens, which it has not approved for filler. No filler is approved for over-the-counter sale, and injectable liquid silicone is not approved for any filling use.
Who may inject dermal filler in Texas
Texas Medical Board rules (22 TAC 169.25) treat nonsurgical medical cosmetic procedures, including the injection of medication or substances for cosmetic purposes, as the practice of medicine. A physician may inject, or may delegate the injection to a qualified person, such as a registered nurse, nurse practitioner or physician assistant, and supervise the work.
In Houston you may meet a physician, a nurse injector or a physician assistant. What matters is knowing who treats you and who supervises them:
- Physicians and physician assistants: check the license, education and any disciplinary actions on the Texas Medical Board license lookup.
- Registered nurses and nurse practitioners: check the license on the Texas Board of Nursing verification page.
- Ask which physician is the medical director or supervising physician, and look that name up too.
The FDA advises choosing a licensed health care provider with dermatology or plastic surgery experience who is trained in filler injection. The American Academy of Dermatology says fillers should be given after a medical evaluation.
Risks of dermal fillers
The FDA lists common side effects as bruising, redness, swelling, pain, tenderness, itching and rash. Less common are bumps or lumps (nodules or granulomas), infection, open sores, allergic reaction and tissue death. Rare effects include severe allergic reaction and filler moving away from where it was placed. Some side effects appear weeks, months or years after treatment.
The most serious risk is accidental injection into a blood vessel. It can block blood flow and lead to tissue death, vision problems including blindness, or stroke, and the FDA says these can be serious and lasting. Get care right away for unusual pain, vision changes, white or blue skin near the injection, or any sign of a stroke.
Before treatment, tell the provider about bleeding disorders, allergies (including to lidocaine), active skin inflammation or infection, cold sores, pregnancy or breastfeeding. FDA-approved filler uses are for adults 22 and older for many products, and safety in pregnancy and breastfeeding is not known.
Want to ask a Houston provider about fillers for your face or lips?
Questions to ask at the consultation
- Which product do you suggest, and is it FDA-approved for this exact area?
- Is it hyaluronic acid, and can it be dissolved if I do not like it?
- Who will inject me, and who is the supervising physician?
- What risks apply to this area, and what will you do if a blood vessel is affected?
- How long did the effect last in the product’s clinical studies?
- What will it cost in total, including any follow-up?
For fees, see the lip filler cost guide. If you live north of the city, see lip filler in The Woodlands.
Questions people ask
What is the most common type of dermal filler?
Hyaluronic acid. ASPS reports that HA fillers made up about 30% of minimally invasive procedures in 2025, and 23% of HA filler treatments were for lip augmentation.
Do dermal fillers wear off?
Most do. HA, CaHA and PLLA are absorbed by the body over time. PMMA is the only approved material the body does not absorb, and it is approved only for nasolabial folds and certain cheek acne scars.
Can a nurse inject filler in Texas?
Under 22 TAC 169.25, a physician may delegate cosmetic injections to a qualified person, such as a nurse, and supervise the work. Ask who supervises your injector and check both licenses.
Is filler under the eyes approved?
Only some products have approval for under-eye hollows. The FDA advises against filler around the eyes in general, so ask which product is used and what it is approved for.
Can filler be removed?
Hyaluronic acid filler can usually be dissolved with hyaluronidase, which is an off-label use. The FDA warns that some fillers may be hard or impossible to remove.
Who will I talk to if I send a request?
An independent provider in the Houston area. Lip Filler Houston is a free referral service, not a clinic, and does not perform treatments.
This site gives general information, not medical advice. A licensed provider decides with you whether a treatment suits you.