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Posted: 6:00 a.m. Sunday, Apr. 12, 2019

By Anita Mandal, M.D.
Question: I had a facelift in my early 60?s that I was quite happy with. Now, it’s been 10 years and I seem to be hollowing in my cheeks with prominent smile lines and droopy mouth corners. The hollows under my eyes also make me look tired, and my temples are sunken-in. I know I need fillers, but how many different fillers do I need to treat all of these areas?

Answer: It all comes down to whether you want a temporary filler or a long-term filler. The various temporary filler options include Voluma, Juvederm, Restylane, Radiesse and Sculptra. Long-term fillers include Bellafill – the 5-year filler, fat grafts and stem cell fillers.

If you want a temporary filler, you will likely need a variety of different fillers to treat all of your areas of concern. For example, Voluma is used for the cheeks, but should not ideally be placed in the hollows under the eyes. As another example, Sculptra can be injected in the cheeks and temples, but Restylane is a better choice for the lower lid hollows.

If you’re looking for a long- term filler, Bellafill, which is highly safe and also lasts five years, can be placed in the temples, cheeks, nasolabial folds, mouth corners, and lower lid hollows. In my 6 years of using Bellafill and having done over 3,000 syringes, its versatility of use in many different facial areas is one of Bellafill’s greatest benefits.

While fat grafting is also a long-term option, the downside is that only 50% of injected fat is typically retained with each treatment, requiring a series of treatments for optimal correction. Additionally, fat grafting is more of an invasive procedure compared to injectable filler treatments and thinner patients tend to have a limited supply of fat.

While stem cell fillers can be a wonderful option for treating all of your areas of concern, once you get into a certain age range, stem cell quality can diminish. Also, since the stem cells are harvested from adipose tissue, supply is limited in thinner patients who have minimal fat stores.
When it comes to facial volumization, I offer a broad range of temporary and long-term fillers. Bellafill is, however, the most commonly requested volumization filler in my practice due to its high safety profile, long-term results, cost-effectiveness and natural appearance. Bellafill cannot be used in the lips nor is it an optimal choice for very fine lines.

A thorough consultation with a Board-Certified Facial Plastic Surgeon is the first step in determining your optimal rejuvenation needs. Of course, one must have realistic expectations as medicine and surgery are not an exact science and results can vary from one patient to another.


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