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How To Get Natural Results from Injectable Fillers

Posted: 6:00 a.m. Sunday, April 29, 2018

By Anita Mandal, M.D.
Question: I really need filler in several areas of my aging face, but I’m afraid to look unnatural like so many of the women I see. Is there a way that I can get natural looking results from injectable fillers?

Answer: I use several important approaches to give my patients as natural of a result as possible. The type of technique used depends on the facial area being treated with injectable fillers.

When it comes to the nasolabial folds (NLF) or the smile lines that run from the nostrils to the mouth corner, a NLF typically comes with a mild depression which is normal. I focus on softening the fold rather than completely flattening it in order to restore a youthful yet natural looking facial contour. Too often, patients want the folds eliminated and this can result in a flattened face with unnatural contours.

In patients with droopy mouth corners and/or marionette lines, conservative use of filler by lifting a droopy mouth corner combined with filling of the residual marionette or “puppet” lines will reduce the chances of a heavy appearing lower face and give a more natural appearance. Many injectors mistakenly overfill this area which can accentuate sagging jowls and the lower facial heaviness that occurs with age.

Another common mistake is to overfill hollow cheeks but ignore hollow or narrow temples. As aging progresses, volume loss often occurs in both the cheeks as well as the temples. Many injectors place filler in the cheeks but overlook the temples. This aesthetic error often creates a unnatural diamond shaped appearance to the face. The cheeks should typically not be wider than the temples. An upside down triangular facial contour with temples slightly wider than the cheeks is closer to an optimal facial contour.

In patients with hollows under the eyes, injection errors occur when the hollows are overfilled with extension of filler into the upper cheek. I always fill hollow lower lids separately from hollow cheeks and then connect the two facial areas by feathering at lower lid/cheek area junction to restore a natural facial contour.

While it is important to seek an expert injector experienced in the technical aspects of advanced facial injections, it is equally important to seek an injector who has a strong aesthetic eye for detail and understands what is needed to give a natural appearance. Seeking a Board Certified Facial Plastic Surgeon who is not only an expert injector but also has an artistic eye is the first step in helping you to achieve the most natural results in facial contouring.


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