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.
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.
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.