Why we place a small amount of filler in the mid face before we treat the folds.

At MODE Aesthetics and Wellness, a medical spa in Scottsdale, AZ, a filler plan for a face that reads tired or heavy usually starts in the mid face, not in the folds. We restore support where the deeper cheek fat has thinned with age, add a touch in the lips so every feature stays in proportion, and look at the under eye and the nasolabial folds again at the follow up before anything goes into them.

In May, Marisa Dulin, MSN, FNP-C, our co-owner, nurse practitioner, and lead injector, shared the before and after above: one patient, a small amount of hyaluronic acid filler through the mid face and lips. This post is the thinking behind it, in her words where they are hers, and from the published anatomy where it is not.

Why does the mid face change with age?

Facial volume loss with age is not only skin. The deep fat compartments of the mid face lose volume and shift position over time, a pattern that has been measured on facial CT scans in both cross sectional and eleven year longitudinal studies. That deep fat loss, and its drift downward, is described in the anatomy literature as one of the things that hollows the cheek contour and, in turn, makes the tear trough and the nasolabial fold look more pronounced.

Put simply, as the deeper support of the mid face deflates, the tissue above it has less to rest on. The under eye area can look hollow or heavy and the nasolabial folds can look deeper even though the fold itself has not gained anything. It is the same facial volume loss we see in the temples and cheeks, and it is one of the nine concerns we plan for.

Why put filler in the cheeks when what bothers you is the under eye or the folds?

“By supporting the mid face, we can help lift and soften the under-eye area and reduce heaviness through the nasolabial folds.”

Marisa Dulin, MSN, FNP-C, on Instagram, May 2026

That is Marisa’s description of the plan she shared, and it follows the anatomy above: if the fold looks deeper because the support above it thinned, the first place to work is that support. Our approach to dermal filler is restraint first. The goal is anatomical proportion, a cheek that looks like your cheek and a lip that reads as yours. We build gradually across visits when needed, and we would rather under dose than over correct. The mid face, the cheeks, the under eye, the nasolabial folds, and the lips are all areas we treat, so the question at a consultation is never whether we can place product in a fold. It is where a small amount does the most for the whole face.

“It’s not about adding, it’s about blending. Bridging each feature so everything flows seamlessly together.”

Marisa Dulin, MSN, FNP-C, on Instagram, May 2026

Why a touch in the lips?

In the plan Marisa shared, the lips were part of the mid face work, not a separate treatment. In her words, a touch in the lips “keeps everything balanced and in harmony.” The aim is proportion with the rest of the face rather than size, which is why lip filler at MODE is planned in the same consultation as the cheeks, and typically takes one half to one syringe.

How much filler is a small amount?

Less than most people expect. On our dermal filler page we give the ranges we typically plan around: lips one half to one syringe, cheeks one to two syringes per side, and a full face rebalance three to six syringes spread across multiple visits. Your nurse injector maps this at a complimentary injectables consultation, which takes 45 to 60 minutes and ends with a written plan and quote you take home. Because mid face filler sits close to the tear trough and the nasolabial fold, candidacy and technique are decided at that consultation for your own facial structure, including which product within the Juvederm and Restylane families fits your anatomy.

How long does mid face and lip filler last?

How long a result lasts depends on the specific hyaluronic acid formulation and the technique used, so duration is discussed at your consultation rather than promised as a fixed timeframe. Published studies on individual products, such as the trials of Juvederm Vollure XC for nasolabial folds, look at safety and correction over time for that one filler rather than setting a single number for every cheek or lip product. The typical ranges we quote are on our dermal filler page, and every filler treatment includes a complimentary follow up about six weeks later, once swelling has fully resolved, to assess whether any refinement is needed.

Is mid face filler reversible?

Yes. Because these fillers are hyaluronic acid, they can be dissolved with an injectable enzyme called hyaluronidase if a result needs to be adjusted or undone. At MODE, filler correction and dissolution is its own service, $200, for filler that is misplaced, overdone, or has migrated, whether it was placed with us or elsewhere. We treat it as a correction, not only an emergency measure.

Who places mid face filler at MODE in Scottsdale?

Dermal filler at MODE Aesthetics and Wellness is placed by two people: Marisa Dulin, MSN, FNP-C, our co-owner, nurse practitioner, and lead injector, and Torey Varner, RN, our nurse injector, who also trains other licensed professionals in injection technique. Our office is at 7420 E Pinnacle Peak Rd, Suite 120, on the Pinnacle Peak corridor in North Scottsdale. We see patients from DC Ranch, Silverleaf, Whisper Rock, Grayhawk, Troon, and McDowell Mountain Ranch, from Paradise Valley, and from across Scottsdale.

The areas we treat and what the six week follow up covers are on our dermal filler page, and Marisa Dulin’s bio covers her training and the injectables practice she leads at MODE.

The clinical references behind this article, each claim cited to its source, are published as a companion authority reference.

Sources

• Aging changes of the midfacial fat compartments: a computed tomographic study (Plastic and Reconstructive Surgery, 2012)
• Deep cheek fat volumes and midfacial aging (Aesthetic Surgery Journal, 2020)
• Facial aging: a quantitative analysis of midface volume changes over 11 years (Plastic and Reconstructive Surgery, 2021)
• Anatomical based filler injection techniques: anteromedial, buccal, and lateral cheek hollow (Aesthetic Plastic Surgery, 2025)
• Juvederm Vollure XC is safe and effective for correcting nasolabial folds: results from a randomized controlled study (SKIN, 2017)
• Juvederm Vollure XC is safe and effective for long term correction of nasolabial folds: results from a multicenter, randomized, controlled study (SKIN, 2017)

Originally shared on the practice’s Instagram. The before and after shows one patient; individual results vary, and treatment plans are set at a consultation.