-by board-certified plastic surgeon Ashley N. Amalfi, MD
Let’s talk about fillers
In 2018, almost 16 million non-invasive procedures were performed in the United States, with Botox and filler injections topping the list. Dermal fillers involve the injection of a product, typically hyaluronic acid, into the face to restore or enhance the facial features.
As children, our faces have a more cherub-like appearance, and this facial volume is associated with youth. However as we age, we lose volume of both the bony structure as well as the fatty compartments of the face. Dermal fillers allow your doctor to directly address this loss of volume with a product that can build up the structure of the face and restore the volume that you desire.
Different products for different places
As these procedures grow in popularity, so do the number of products available for injection. Each of these products differs in its thickness and specific qualities. This is why it is critical to choose a board-certified plastic surgeon to fully evaluate your facial anatomy and choose a product and injection technique to give you the natural results you desire.
Non-invasive facial rejuvenation is truly an art form, and plastic surgeons rely on a variety of different products to achieve a desired look. For loss of structure and support, such as in the cheeks, forehead and temples, your doctor may choose a thicker product to provide the most support for your tissue. These injections are often performed deeply atop your bone for maximum effect. The perks of these deeper injections are that they are often less painful, cause less bruising, and last longer than other types of injections. Deep injections may last as long as 12 months, and newer products on the market may last up to two years. For my patients, once we have injected an area and my patient is very happy with their results, I will consider moving on to a longer-lasting product for subsequent injections to maximize the length of their results.
For lines and wrinkles closer to the skin, your doctor may choose a thinner product to fill in the contour and smooth the skin. These products may be metabolized more quickly and will last for 6-12 months. In areas of the face with more movement, such as the lips for example, the constant movement of muscles breaks down and dissolves the filler at a faster rate, so fillers tend to go away quicker in these more active areas.
What parts of my face can we treat with fillers?
Fillers can be used all over the face to treat a variety of areas. In the upper face, fillers can be used in the tear trough, or the deep groove and dark circle under the eye, to restore volume and reduce the look of dark circles and a tired appearance. Volume is often added to the cheeks and cheekbones with filler to improve the appearance of lower wrinkles and restore the youthful cheek appearance. Fillers can also be placed in the thin and deeper wrinkles of the lower face and around the mouth and jowls. These can create more fullness and reduce the appearance of sagging and aging in this location.
Some patients still have a lot of youthful volume but use dermal fillers for enhancement of certain features. The most common area that I treat with volume is the lips. A variety of different fillers can be used to give a range of results from a very subtle restoration to a more pronounced “Kylie Jenner” type look. Fillers are also being used for liquid rhinoplasty, a non-invasive technique used to improve the appearance and harmony of the nose with the facial anatomy. Deep fillers can be used to contour the face, creating a more defined jawline, chin or cheekbone to provide more structure and improve the shape of the face.
What can I expect?
Non-invasive procedures such as fillers are attractive because they are quick and have minimal downtime. Your entire visit will take place in under an hour. Following your injection, I usually recommend that patients avoid exercise for 24 hours and remain upright for the remainder of the day (no naps or downward dog poses!). The other perk to fillers is that results are immediate. Yes, you can peek in a mirror after your procedure and see instant results! Depending on the type and location of your filler, you may experience some discomfort during or after the injections, bruising, and swelling. I advise my patients not to schedule their procedure before a big social event just in case they have bruising after their injections.
What if I don’t like the results?
Most of our patients are thrilled with their results, but if you’re not completely happy, Hyaluronic Acid fillers are reversible. Your doctor can inject an enzyme that dissolves your filler until you are happy with your facial contour.
If you are interested in learning more about fillers and if they are right for you, call our office at 585.244.1000 to speak to a Patient Consultant.
Mckee, Daniel; Remington, Kent; Swift, Effective Rejuvenation with Hyaluronic Acid Fillers: Current Advanced Concepts . Plas and Recon Surg 143(6):1277e-1289e, June 2019.