The Art Of Fillers

The art of using fillers properly is based on science and understanding the aging process.

Instead of chasing wrinkles, fillers should be used to reverse the signs of aging: deflation and descent. As we age, we lose facial volume. Facial bones recede, and facial fat deflates and descends. Just think of a baby's face - so full and rounded. Compare it to a face of an older person. Thinned out and droopy. So the 'anatomic' approach to facial fillers is not to fill wrinkles, but to add volume where it used to be, to recreate the facial fullness that creates a more youthful look. When the face loses volume, skin starts to sag, and the shape of the face is changed. So adding volume to the cheeks helps to restore the youthful cheeks, supports and lifts the facial skin minimizing nasolabial (smile) lines and jowls.

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However, there is a limit to what fillers can do. They are effective in younger patients. As patients get older, as their bones recede more and they lose more facial fat, more filler is required. Over time, so much filler is required to help fill in the loose skin that 1) it becomes prohibitively expensive (each syringe of Juvederm can go for $600-900) and 2) the volume required creates an unnatural facial fullness that is far from attractive.

The art of fillers is also recognizing when fillers no longer work and surgical options such as a facelift should be discussed.