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Should A Gynecologist Do Fillers?

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

By Anita Mandal, M.D.
Question: My gynecologist offers Botox, laser and fillers. Her prices are better than other doctors. She’s not a plastic surgeon, but it’s not like she’s doing facelifts. Why would I get filler treatments from a plastic surgeon when it’s so convenient to go to my gynecologist?

Answer: Needless to say, important differences exist between gynecologists and plastic surgeons. A Facial Plastic Surgeon’s education and training, from the outset, is focused on the face. If you don’t mind having filler treatments from a doctor whose scope of training and education has been focused to a very different area of the body, that is your choice.

Non-plastic surgeons can and do take training courses on filler injection techniques. However, the focus of injectable fillers has shifted from simple line filling to facial volumization to create youthful contours. The skill level required for facial volumization is much higher. In fact, not even all plastic surgeons necessarily have the proper skill set for quality facial volumization.
How well does your gynecologist understand the intricate facial anatomy, specifically of deep facial structures, that changes with age? It’s takes a facial plastic surgeon many years of training to acquire such a level of knowledge. If it were easy, any doctor without formal training could become certified in facial plastic surgery.

This in-depth understanding of aging face anatomy and how it affects facial function is especially important when using injectable fillers to volumize the face. It’s much easier to fill in nasolabial smile lines or marionette lines. But when you have deep nasolabial lines, how does your gynecologist know when this is due to malar volume loss of the cheeks rather than deepening of the line itself?

Failure to identify the true cause of aging can result in treatment of the wrong part of the face with worsening of one’s appearance and/or an unnatural look. Will your gynecologist recognize when treatment is beyond their skill level and it’s time to refer you to an advanced injector?

If you have hollow lower eyelids, does your gynecologist know when to inject filler directly into the lower lid hollows vs. simultaneously treat the volume loss in your cheeks to avoid an unnaturally overfilled lower eyelid? Does your gynecologist know when to advise surgery vs. Botox or fillers vs. a combination of surgery and fillers?

If your lips are too thin, does your gynecologist understand lip anatomy well enough to know when to volumize the lips themselves, when to treat the lip vermilion border and when to treat both? Does your gynecologist understand which of the 5 different types of Restylane restore lip volume, lip definition and soften lip wrinkles?

If your gynecologist fills your sunken cheeks, does he or she know when simultaneous temple volume loss must also be treated to restore facial balance?

Does your gynecologist understand the various subunits of the cheeks? How does your gynecologist know to volumize the lateral malar cheek, the submalar cheek, the pre-aurucilar cheek, the medial cheek or more than one cheek subunit? Does your gynecologist know that the lateral malar subunit is the most common area of cheek volume loss and sets the mid-facial framework?

Is your gynecologist well- versed on the pros and cons of temporary fillers, Bellafill – the 5 year filler, stem cell fillers and fat grafts in order to make the optimal recommendations for you? Or will your gynecologist primarily offer what he or she carries on the shelf?

Consider these questions when deciding on an injector. Too many patients fail to recognize the value of a specialist until it’s too late. Hiding a mistake on your face can be challenging. If you value your face, don’t price-shop or cut corners. Seek a Board Certified Facial Plastic Surgeon who understands the complex facial anatomy of aging and is also an expert injector.


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