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Category: Injectable Fillers

Fillers Gone Wild: How to Avoid an Overdone Look

Many of us have enjoyed the benefits of injectable dermal fillers, like Restylane®, JUVÉDERM®, and RADIESSE®, that fill in those pesky lines on the face—like the “11” creases in the middle of the forehead or the “parentheses” lines that run from the nose to the side of the mouth. However, the use of fillers has been extending to non-traditional areas of the face. When performed strategically by an experienced injector, filers can provide fantastic results. Conversely, when they are injected poorly, the results are less than satisfactory and sometimes even bizarre.

Close up portrait of cosmetologist hand in gloves holding syringe near young woman face-img-blog

The “duck lip” is showing up all too often, and it ruins the beautiful, natural cupid’s bow contour of the upper lip. Additionally, the cheeks are sometimes filled so much that they no longer look like a cute, rosy apple but more like a grapefruit (or even a cantaloupe!). And, the worst use of fillers now is the overfilling of the so-called “tear trough” (the dark circles or recesses under the eyes), which starts to make the recipient look more like a wretch who cried all night rather than a well-rested young woman. Unfortunately, these anomalies are becoming more frequent, and not just in Hollywood. They may be coming to (or already in) a town near you.

Choosing the Right Doctor and the Right Filler

A Practiced Practitioner

Don’t get me wrong, fillers are great! They can effectively rejuvenate these areas as well as many other areas of the face and hands, when needed. If the filler substance will fulfill the aesthetic goals and look natural, then I’m for it. But, all sorts of “practitioners” are offering fillers and BOTOX® Cosmetic nowadays. Specials abound on every billboard, mall window, and blast email. But, as I like to say, caveat emptor—buyer beware! Experience can really make a difference in the quality of treatment you receive, and practitioner experience should be a deciding factor when you choose who will be performing your filler procedure. There is such a thing as a practiced hand and an aesthetic eye, not to mention knowledge of the “golden proportions” of the face. For example, the lower lip is normally larger than the upper lip. There are some normal variations to this, of course, but not as many as I have seen lately.

Fillers are not all alike. Some are thicker or more cross-linked, which are better suited for deep volume filling, such as for the cheeks. Others are finer, softer, and more appropriate for fine lines or lip contours. Only a doctor well-versed in these finer points of fillers will know which is best for your specific needs, so please, choose your “practitioner” wisely.

A Filler to Fulfill Your Needs

Several new fillers have arrived on the scene that have varying “thicknesses.” You have probably heard of JUVÉDERM®, Restylane®, Sculptra® Aesthetic, and RADIESSE®. Now, there are several new fillers for your vocabulary: BELOTERO BALANCE®, additions to the Restylane® family of fillers (Silk, Defyne™, Refyne™, and Lyft™), as well as additions to the JUVÉDERM family of fillers (VOLLURE™ XC, VOLUMA® XC, and VOLBELLA® XC). This is all the more reason you need to choose an experienced injector! Which ones are good for lip plumping and filling those fine vertical lines above the lip and around the mouth? I would use BELOTERO or Restylane® Silk. I really like the way they plump the lip smoothly without creating a huge, unattractive blob. These products also do a nice job of filling fine lines superficially without producing the Tyndall effect: a bluish hue under the surface of the skin that looks like some eerie, latent abscess. Which filler should be used for bigger cheeks? For nasolabial folds? For re-contouring the jawline? (Jawline contouring is a fabulous procedure that can provide awesome results. I would use RADIESSE® for this.) So, get someone who knows!

Questions to Ask When Choosing Your Doctor

When you’re looking for a doctor to administer your filler treatments, it’s important to be thorough in your questioning. It’s always better to shop around and find another physician if you feel in any way uncomfortable or unsure. Don’t feel pressured to say yes to the first doctor you visit. Here are some questions that might be helpful to ask them:

Do you have before and after pictures I can look at?

It’s important to review the work of any doctor before you trust them with your face. Seeing before and after photos of other patients not only helps you see what you should expect, but it also gives you an idea of the skill level of the physician you are interested in.

Dr. Guy Fillers Infographic

How long can I expect my results to last?

Although it depends on the area being treated and the type of filler used, most results will last from four months to two years. It’s important that you be aware of how long your results will last so you can decide if you are willing to commit to having more treatments later on down the line if you want to maintain your results.

Are there complications or risks involved in the procedure? How are these handled?

While there are not many risks associated with dermal filler treatments, you should know what to be keeping an eye out for and what warrants a call or visit to your doctor. In general, you should be aware of the symptoms of an allergic reaction (pain and swelling that does not dissipate after a few days) and other poor reactions to the filler injections, such as asymmetry, excessive bruising, or lumps under the skin. You MUST call your doctor IMMEDIATELY if you have severe pain with skin blanching. Thankfully, this is rare.

Questions like these will help you be sure you know what you’re getting yourself into and that your doctor knows what they’re doing!

Trust Us With Your Face!

If you’d like to rejuvenate your appearance with non-surgical fillers, come in and give it a try. I promise it will not be the “extreme makeover” Hollywood look! And I promise I didn’t learn my injection techniques from some weekend course on fillers. Do yourself a favor and see a real plastic surgeon for these procedures. We know about facial proportions, how to wield a needle, and how to use sound, surgical judgment.

If you are interested in dermal fillers, contact our office today at (321) 727-1600 or fill out our online contact form to schedule a consultation with board-certified plastic surgeon Dr. Guy.

Facelifts vs. Fillers

Family functions, work events, and parties with friends during the holidays can be fun, but these festivities can take their toll on us both physically and mentally. We all want to look our best for the events we attend, and many people consider cosmetic procedures to give them that rested, youthful glow. Two popular solutions that can rejuvenate your face before the holidays are facelift surgery and injectable fillers. However, how do you know which is best for you? And when should you have your procedure or treatment done? There are many factors to consider when making your decision, and Dr. Guy is here to guide you throughout the process and answer any questions you may have.

Beautiful natural girl woman after cosmetic procedures

When planning a facial rejuvenation procedure, some factors you should consider are:

  • The specific concerns you’d like to address (e.g., wrinkles, sagging, etc.)
  • The invasiveness of the procedure (which often affects how long the recovery period is)
  • Any limitations you may have during recovery
  • How long your results will last

A personal consultation with Dr. Guy can help you find the treatment that will best fit your schedule and your specific concerns.


Injectable fillers (such as Restylane®, JUVÉDERM®, RADIESSE®, and Sculptra® Aesthetic) are temporary solutions to fine lines, wrinkles, and hollows in the face. These treatments are minimally invasive, and results can last anywhere from 2 to 18 months depending on what kind of filler is used. Your recovery time will be fairly short; you can return to your regular activities immediately but should avoid strenuous exercise for 24 to 48 hours. Due to mild swelling and bruising that may develop, you might want to schedule your treatment 7 to 10 days before an event to give yourself time to be completely healed and ready for your close-up!

If you are short on time and are looking for a quick fix, this type of treatment might be the right choice for you. However, fillers can only provide so much rejuvenation; at some point, a facelift will be the better choice to address more severe signs of aging.

Dr. Guy Fillers Before and After


If you have facial aging that requires a more in-depth approach, such as deep wrinkles around the mouth and sagging cheeks or jowls, Dr. Guy may recommend facelift surgery. There are several techniques available (such as a traditional facelift, mini facelift, or short-scar facelift), but recovery from any of these surgical procedures will be significantly longer than recovery from a non-surgical treatment. Results will become visible over several weeks, but complete recovery from facelift surgery can take up to 6 months. Because of this, it’s best to plan this surgery at least 6 months before an event to give yourself plenty of time to heal so you can show off your full results with confidence. Luckily, facelift results can last up to 10 years (depending on the type of lift done), so you shouldn’t have to worry about having anything redone for next year.

When some people think of facelift surgery, they might picture the over-stretched look that poorly done facelift procedures can present. While facelifts in the past may have not produced the most natural aesthetic, we now have a much better understanding of the underlying structures of the face and how the aging process works, which allows us to correct it with natural, beautiful results.

Dr. Guy Facelift Before and After 2

Facial Aging

As your face starts to show more signs of aging, you may start thinking about ways to slow down the process and keep yourself looking as young as you feel on the inside.

Img-blog-Fillers vs facelift infographic

The rate at which your face ages depends on several factors, including:

  • Your genetics
  • Your lifestyle choices (such as your diet and whether or not you smoke)
  • The amount of sun exposure you have had over your lifetime

So, what is the best age to get a facelift? When should you start considering one? While this is a very personal decision, there are a few guidelines you can follow.

Things to Consider

Most people who are interested in a facelift may think that they are too young, but the truth is that it is much more effective to turn the clock back 10 years when you are in your 40s or 50s than to wait until you are in your 60s.

Having a facelift done when you are in your 40s has several advantages:

  • Your skin is in a better condition in your 40s than when you are older, and so your recovery from a facelift will be easier.
  • You will also experience less bruising, and the incisions used are usually smaller.
  • Your results may not last as long if you wait until you are in your 60s due to the loss of skin elasticity.
  • Some doctors may recommend another facelift around 10 years after your initial procedure, but you may not feel you need one; it’s up to you.
  • You will always look younger than if you had never had a facelift done in the first place.

In reality, the main thing you should take into account when deciding to get a facelift is what you see in the mirror and not necessarily what your age is. Dr. Guy can help you determine whether or not you might be ready for a facelift based on your unique anatomy and needs, but if you are interested in having cosmetic surgery to help you look your best, it’s always best to start planning sooner rather than later.

Choosing the Procedure for You

The decision between fillers and facelift surgery (as well as the type of facelift surgery) depends on multiple factors, including the extent of correction needed. Dr. Guy offers several options for both facelift procedures and fillers, and she can help guide you to the decision that will help you look your best. With her attention to detail, she tailors each procedure to the individual to refresh and rejuvenate your appearance.

If you are interested in finding out about your options for facial rejuvenation, contact our office at (321) 727-1600 to schedule a consultation today!







I am a plastic surgeon.  That’s what I do.  That’s what I love.  But, let’s face it – not everyone is ready for plastic surgery.  And that’s fine.  Really, it is!  It’s fine because we have several alternatives to surgery, popularly known as “minimally invasive” treatments.  Fillers (like Restylane, Juvederm and Radiesse) and muscle relaxers (think Botox) are the most common.  They can’t do the same things as surgery can, but they can plump up lines, increase volume in hollow areas and relax wrinkles.  And they are office procedures with little to no downtime.  What’s not to like?  I actually LOVE doing these office procedures, too!  And at my office, I DO ALL THE INJECTIONS MYSELF!

Just How Much Can We Accomplish with Fillers?

Well, quite a bit, really.  But don’t just take my word for it.  Let’s look at some “real world” results to tell the tale.  Pictures are worth thousands of words, after all.  So, here are some case studies:

Case 1.

This is a busy lady who happens to be the top seller for the car dealership where she works.  Like many of us, no workie, no money!!!  So, she wanted a fairly “quick fix”.  She wanted something to turn back some time, especially after looking at a “selfie” she took.  I’ll show the selfie later.  Right now here are the pre and post treatment photos from the office.  She had two treatment sessions.

pre fillers 3-24-15 SMpost first fillers 3-26-15 SMpost second fillers 4-14-15 SM

At the first session, she had volumizing fillers to the cheeks and corners of the mouth and a softer type of filler to the lips.  She also had relaxers to the forehead and frown lines.  When she came back for photos (the second photo above) and a recheck two weeks later, we added just a little more relaxer to the forehead and filler to the forehead lines and a little more filler to below the corners of the mouth.  We also added some filler just below the right eyebrow, to help improve her eyebrow asymmetry.  The third photo was taken after that treatment.

And, because I know you’re curious, here is the “selfie” she took that spurred her on to action.  But I think her phone camera took unfair advantage of her!!  Some selfies are not meant to be shared, but she was so thrilled with her results, she wanted you all to see!!

selfie SM

Case 2.

This is a very successful businessman who wanted to look better.  Some commented that he looked angry, even when he sure didn’t FEEL angry.  And he’s a very sweet person and a really great guy!  With friends like that, who needs enemies, right?  But anyway, we had just the cure for him.

1 A pre fillers 11-20-2013 ED1 post fillers 1-21-2014 ED

He just had fillers to the nasolabial folds – those lines that run from the edge of the nose to the corners of the mouth – that’s it!  And “presto”!  The “angry” is gone and we have a still happy businessman, who also looks happy!

Case 3.

I have been doing hand treatments for a long time.  Only recently has Radiesse filler been FDA approved for volumizing the back of the hands and creating a more full and youthful appearance.  Check out my wonderful office patient-care coordinator, Janet – before and after her hand treatment.

pre radiesse, Janpost radiesse, Jan

Fun and Immediate Gratification!

These cases illustrate how much we can get out of fillers.  I had fun doing the procedures and the patients have fun with the immediate results.  Like I said, what’s not to like?


And it just so happens that we have already chosen our Fall Specials, some of which are for fillers and muscle relaxers!!

We are opening up the schedule on Friday afternoons to get in everyone who wants to have their quick Botox and Filler fixes in time for the holidays.  But…..you also get a punch card to go with your treatments.  For every one vial of filler or one session of Botox, you get a punch.  After 4 punches, the 5th treatment is half off.  Nice!!

Also, with a full facelift, get your hand filler treatments FREE!  Have a gorgeous neck and face AND don’t let your hands give you away.  You will really be all set for the holidays!

Please call the office for details at 321-727-1600 or inquire on our website at www.drguyplasticsurgery.com.  Ask about our other Fall specials, too.  We love our work, and it shows!!