Dermal Fillers

Here in Montreal, Quebec, dermal filler injections, along with BOTOX/Dysport have become very popular in recent years since they offer non-surgical improvements with no down time.

Younger patients

Fillers are used in younger patients to enhance the volume of certain regions, such as the lips, the cheeks or in the tear trough (the hollow under the eyes). Younger patients also use dermal fillers in our Montreal office to soften deep facial grooves or folds to provide a more balanced and attractive facial appearance.

Older patients

In older patients, fillers are used to provide a more youthful appearance. One of the features of facial aging is the loss of volume, mainly fat, under the skin. Fillers are used to fill hollowed areas, thereby recuperating the volume lost and restoring a more youthful appearance. Common areas where fillers are used in older patients include the nasolabial folds, the marionette lines (between the corners of the mouth and the chin), the tear troughs under the eyes, the hollowed temples which confer a “skeletal” look, and other areas where folds, wrinkles and creases contribute to the aged face.

Other facial areas are better addressed with Botox® / Dysport®, and other skin rejuvenation methods. Therefore, for an optimal result, Dr. Samaha recommends an individualized approach, tailored to the patient’s needs. This may include the use of Botox® / Dysport® alone in specific areas, skin fillers alone, or a combination of both. A discussion at the time of consultation will help determine the best approach, unique to the patient.

Dr. Samaha approaches filler injections in the same way as he does surgery: He views the face as a whole using an artistic eye to create the harmony that is inherent to beauty. (see Art and Sculpture)

Dr. Mark Samaha

Meet Dr. Mark Samaha

A double board-certified otolaryngologist whose practice focuses exclusively on facial plastic surgery, Dr. Samaha is highly qualified in facial aesthetics. Learn more about our physician and how he's carefully refined his skills to sculpt your beautiful face.

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Beautiful lips are defined by their shape, curve, and volume. These can vary for each face and still look beautiful. The goal is to create full lips that have a natural shape. Simply adding volume without taking shape and curvature into account is a common mistake that leads to unnatural, frequently oversized lips. Fillers in the lips are performed for all ages. For younger women, a fuller, curvy lip is usually the goal. For more mature ladies, restoring the volume lost in the lip and re-creating a lost curve is usually the goal.

For some patients, due to the anatomy of their lips, fillers provide a limited result. In those patients, a lip lift may be the optimal treatment to enhance their lips by showing more lip and exposing the lower part of their upper teeth, which is a sign of femininity and beauty.

The quantity of fillers usually needed for maximum benefit to the lips is one syringe


There are two principal areas in the cheeks that benefit from fillers: the area of the cheekbones and lower down in the cheeks. Each area needs to be contoured for the best esthetic result, according to the patient’s anatomy.  For most people, the goal is to create a highlight of the cheekbone oriented toward the temple. The common mistake is to fill the cheekbone too high, giving an artificial “plastic” appearance.

Fillers in the cheeks are performed for all ages.

Quantity of fillers usually needed for maximum benefit: 1-2 syringes each side

Side-by-side diagram of non-treated vs treated areas (female)

Tear trough

The tear troughs are one of the areas where fillers yield quite possibly the most rewarding result. The goal is to fill the hollows under the eyes that appear dark under the effect of shadowing. When this hollowness is filled, it eliminates the tired and sleep-deprived appearance.

Filler injections in the tear troughs are also the most delicate and require the most finesse. Many practitioners do not perform fillers in this area as it tends to be more specialized and require more skill. Our clinic receives referrals from many practitioners as we have developed a reputation of excellence particularly in this area.

Injections in the tear trough are performed for all ages. In some patients, the sleep-deprived look can even be present from early childhood.

The quantity of fillers usually needed for a maximum benefit in the tear troughs is 0.5-1 syringe on each side.

Nasolabial folds

The nasolabial folds are the folds between the nose and the corners of the mouth. This is a common area for fillers, in both younger and older patients. The filling and camouflaging of those folds softens the expression and enhances youthfulness.

Quantity of fillers usually needed for maximum benefit: 1 syringe each side

Marionette Lines

The marionette lines are folds that form between the corner of the mouth and the chin. They tend to be present in older patients. If performed artistically, the corners of the mouth can be slightly lifted to eliminate a sad appearance, in addition to eliminating the wrinkles. Fillers can be used in this area alone or in conjunction with other rejuvenation surgery, most notably a facelift.


Using fillers on the nose, also known as nonsurgical rhinoplasty is highly specialized but extremely effective for certain patients. Patients who are not candidates for surgery or who do not wish to undergo surgery can greatly benefit from this treatment.

The filler needs to be properly dosed and placed with precision to achieve the best results. Therefore, in addition to an artistic eye, detailed knowledge of the anatomy is essential for a successful result. Dr Samaha’s expertise and exclusive focus on facial surgery provides him with the knowledge of the anatomy of the different facial regions and the experience in treating this area.

Quantity of fillers usually needed for maximum benefit: 0.5-1 syringe


Restoring our patients’ youthful beauty is our top priority. While signs of aging are certainly most obvious on the face, ignoring aged hands can create a disharmony and betray one’s age. Therefore, we feel that rejuvenating the hands is an integral part of a comprehensive approach which aims to make our patients look overall as youthful as they feel.

The hands age in two main ways: loss of volume and brown spots. Brown spots can be addressed with creams and IPL, while fillers can replace the lost volume and restore the youthfulness of the hands.

Quantity of fillers usually needed for maximum benefit: 1-2 syringes.

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In the right hands with the proper eye and skill, in addition to the correct dosage, fillers can provide a beautiful, natural improvement. As with any treatment, it is not the instrument or product that provides the result but rather the person providing the treatment. Poor placement or dosage of fillers frequently leads to a poor result or insufficient improvement. An artistic, skilled, and experienced injector is essential for a beautiful result.


The injections take a few minutes depending on the number of areas being treated.


There is very little pain associated with these injections. If necessary, the area is numbed with a local anesthetic cream to minimize discomfort prior to injecting the filler.


The longevity of filler substances depends on the particular substance used, the area being enhanced and the patient’s skin characteristics. In an area where motion is frequent, such as the lips, the result will last a little less than in a non-mobile area such as the tear trough. For most areas the result will last over a year. In certain areas, such as the tear troughs or nose, it lasts approximately 1.5 years.


Dr. Samaha performs filler injections as an office visit. Patients may carry on their daily activities after their visit. There may be some mild swelling and bruising after the injections for 24-48 hours.


Fat injections, also known as Fat Transfer is another method of adding volume to specific facial areas. It consists of suctioning fat from the abdomen, knees, or thighs, processing it to remove oil, blood and liquid and injecting the purified fat into specific facial areas. As with every technique, it has its advantages and drawbacks. The main advantage is its longevity. Its main drawback is its unpredictability as the amount of fat that the face accepts and therefore remains long-term, is unpredictable. This means that some patients may require revision or repeat fat injection treatment because the first procedure did not provide long lasting effect.

We look forward to introducing you to the possibilities of dermal fillers. Request your consultation online or call us at (514) 731-2525. Dr. Samaha attracts patients from Quebec City, Laval, and Gatineau.

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