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Avoiding An Unnatural Look From Injectable Fillers?

Posted: 6:00 a.m. Sunday, Oct. 2, 2016

By Anita Mandal, M.D.
Question: I want fillers for my deep smile lines and cheek hollows, but I went to a med spa a few years ago and looked like a monkey after Juvederm injections. It took a full year for my face to look normal again. I’d rather look aged than unnatural. How can I avoid the unnatural look from fillers?

Answer: First and foremost, credentials should not be overlooked. It’s important to seek a board certified Facial Plastic Surgeon. However, these days, being a board certified plastic surgeon isn’t enough. Many surgeons primarily do surgery and have small injectable filler practices. A surgeon who specializes in the face and has a practice equally balanced between surgery, injectable fillers and minimal-invasive procedures can offer you a well-rounded approach to facial rejuvenation. Thirdly, it’s essential that your surgeon have a strong aesthetic eye if you desire a natural result. Credentials and technical skill mean nothing without aesthetic expertise.

Natural looking nasolabial smile lines typically require more filler in the deeper wedges near the nostrils and tapering of filler as one extends it laterally towards the mouth corners. This avoids the overfilled “monkey” look.

Droopy mouth corners should be lifted with filler first to reduce the appearance of marionette or “puppet” lines. If the deep lines are filled before the mouth corners are lifted, the jowls can appear heavier with an unnatural appearance.

When the cheeks are hollow, one must identify which cheek subunit’s should be filled and which should be avoided. Too often, filling is done under the cheek bone rather than on top of the outer malar cheek subunit. This can result in a heavy lower face exacerbating aged jowls and distorting the facial appearance.

When dark or hollow circles under the eyes exist, the surgeon must identify whether hollowing is only due to volume loss along the eye socket or in combination with volume loss of the upper cheek. Too often, failure to identify the exact cause results in an unnatural, overfilled midface.

Establishing facial proportion and balance should be the priority over addressing an isolated concern such as hollow cheeks or deep smile lines. Such an approach helps restore a more natural, youthful face.

When it comes to your face, you can shop around for the best price, but skill, experience and an aesthetic eye are priceless!

Look 9 Years Younger In 90 Minutes

25 Minutes: SculpSure, the new standard in permanent, non-invasive fat reduction with skin tightening: abdomen, flanks, back, hips, thighs, arms and chest.

40 Minutes: Infini RF, the Non-Surgical Facelift to tighten sagging jowls, neck and soften wrinkles with no downtime.

90 Minutes: Bellafill, a filler that lasts five years. Dr. Mandal is BellaDiamond which represents the top 1 percent of Bellafill injectors in the country.


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