Don’t Be Fooled Into Thinking Fillers Are Quick And Simple Treatments
Posted: 1:34 p.m. Monday, June 11, 2018
By Anita Mandal, M.D.
Question: I’m not ready for surgery but am interested in non-surgical facial rejuvenation. I have sunken cheeks, deep smile lines and hollows under my eyes. I’m just want a quick and easy filler treatment for these areas. Since a plastic surgeon will be more expensive and there are so many injectors these days, what’s wrong with going to another filler doctor?
Answer: Your areas of concern can sometimes be quite tricky to address. While deep smile lines can be successfully treated by a less experienced injector, some patients require layering of two different fillers which is more complex. Other patients may need volumization of their cheeks when loss of cheek fat is the main contributing factor in deep nasolabial folds. These anatomical variations in facial aging are often not recognized by the less savvy injector, in whose hands, the result can end up looking unnatural or overplumped.
Hollows under the eyes are best addressed by a highly experienced injector. Because of this area’s thin and delicate skin, injections should not be placed too superficially. Also, fewer filler options are available to effectively treat lower lid hollows. The anatomical relationship of the lower eyelid to the upper cheek must be carefully evaluated to determine whether injectable filler is even the right treatment option. In other words, it’s not a simple equation of using filler whenever you have a lower lid hollow since these hollows have variable causes. One must also consider if the hollowed appearance is an illusion caused by protrusion of fat from the eye socket. In some patients, multiple causes for a hollow eyelid must be addressed using a combination of filler, lasers and surgery.
Furthermore, volumization of hollow cheeks is often more complex than one may think. The cheek area consists of 5 to 6 facial aesthetic subunits. One key to successful results in this area lies in identifying the correct cheek subunits that contribute to the volume loss and require filling. Equally important, an expert injector can readily identify the subunits that should be left untreated to prevent an unnatural or overfilled appearance.
Choice of filler is also crucial and depends on the area and type of problem being treated. Bellafill, the 5-year filler, can be used to treat hollows of the cheeks and lower lids as well as deep smile lines. Temporary fillers such as Juvederm, Radiesse, Restylane or Sculptra are also used in some of these areas. However, with temporary fillers, a combination of different fillers is often needed since a single temporary filler can rarely address all of your concerns adequately.