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Drawbacks of Price-Shopping For Fillers?

Posted: 12:01 a.m. Sunday, May 5, 2019

By Anita Mandal, M.D.
Question: I was getting fillers from my plastic surgeon in Kentucky. Now that I’ve moved to Florida, there are so many doctors offering fillers at variable prices that it’s overwhelming. Since they are just fillers and don’t require the same expertise as a surgical facelift, doesn’t it make sense to see the doctor with better prices?

Answer: Believing that injectable filler treatments require less skill than facelift surgery is a faulty assumption. While basic line fillers for wrinkles may require a bit less skill than volumization, volume fillers are a mainstay and requiring greater understanding of the complex facial anatomy and deeper structures.

Before fillers, there were overpulled facelifts and too tight eyelids. With the advent of fillers, another dimension of “overdone” and “unnatural” has been added with overblown lips and puffy faces.
If your face is important to you, there is no substitute for good skill, regardless of whether it’s surgery or fillers. If you price shop for your face, you are more likely to get a result that matches the price you paid rather than a result that is based on quality. Cheap prices should be a red flag.

There are many reasons an injector might offer cheaply-priced injectables. Counterfeit injectables are readily available in the aesthetic industry. Companies offering counterfeit products entice injectors to buy their lower priced injectables which can then be passed onto patients interested in paying less. Since these products are not FDA approved, there is no guarantee that your Botox or filler contains a safe dose or if these products are not mixed with other toxic materials.

Inferiorly skilled injectors may also offer discounted fees to get patients in the door to build up their low volume. By the same token, injectors inexperienced with a given filler may offer discounted fees to compensate for their lack of experience in order to build up their volume. This approach is especially dangerous when used with specialty fillers like Bellafill, the 5 year filler, which requires a higher degree of injector skill than temporary fillers.

Injectors lacking qualifications, including those not board certified in facial plastic surgery or plastic surgery, could be another reason for offering lower prices. I’ve seen quite a few patients who needed their fillers redone after having treatments from doctors in other medical specialties with no formal training in facial anatomy. I once had a patient who was unhappy with Sculptra treatments performed by a neurologist. She saw the neurologist for migraines and was talked into having facial fillers while she was there.

Practices that use a non-doctor like a physician assistant or nurse practitioner may also offer lower prices. While occasionally one might find one with decent injector skill, the training of PA’s and NP’s does not come with the same focus on the complex and intricate facial anatomy.

A practice that is not busy enough may offer heavy discounts. I have had number of patients get Botox from a Groupon deal. Each of these patients shared that their Botox did not work. Upon learning what they paid for the “Groupon” Botox, it was clear the “Groupon” injector was not making any real net profit. Beware of Groupon practices luring you in with a deal on one procedure, with the intent of selling you other treatments in order for the injector to make a net profit.

Despite the endless warnings about Botox parties, it’s surprising how many patients continue to get treatments at parties. The enticement always seems to be that the fees were cheaper and the herd mentality of “my friends were doing it.” It’s important to question why an injector would perform injectables at a party when medical products are to be used by licensed professionals in a medical office setting. Such parties are in contradiction to the ethical and safety standards in patient care. A patient I recently saw had 2 years of intermittent facial swelling after having Restylane at a party by an unknown injector. To this day, there is no way to verify whether she, in fact, had Restylane or some non- approved filler.

Careful consultation with a Board Certified Facial Plastic Surgeon to determine your most suitable injectable options is the first step. If you care about your face, don’t nickel and dime yourself and risk ending up with an unnatural result.


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