Have you ever seen someone you know, or maybe even on television, and think “something seems different about their face but I can’t put my finger on it.”
More than likely this person has received a neuromodulator or dermal filler to enhance the aesthetic aspect of the face.
Cosmetic injection techniques have come a long way in a short amount of time. We can now use neuromodulators (Botox) and dermal fillers to not only reverse natural signs of aging, but to enhance and contour a younger face.
For example, I get routine injections of Botox and dermal filler to maintain a pleasingly (to myself) aesthetic look. A few places I love to get dermal filler injected are my cheeks, brows, and chin. I have a Hawaiian heritage and exhibit these flat facial traits of the brow, nasal bridge, and cheeks. I prefer when these areas are augmented and provide contour. The augmentations are ever so subtle and do not change my overall appearance, but do cut down on the amount of makeup I wear by providing the contouring effect.
I previously posted about Botox including what it is and where it can be injected in the face. CLICK HERE to read more about Botox.
What Are Dermal Fillers?
Currently, dermal fillers can be composed of hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, polymethylmethacrylate, or autologous fat.
Each filler is indicated for a specific patient type when discussing ultimate goals and deemed by your injector upon assessment.
I will discuss hyaluronic acid (HA) fillers in this post as these are the fillers I mostly work with. Hyaluronic acid is naturally produced in the body with the primary function of water retention and hydration. As a filler the HA is in the form of a gel-like substance and works to replace or augment an area.
Who gets it?
I tend to separate filler patients into two categories: volume replacement and/or volume enhancement.
Volume Replacement
We have fat pads strategically placed throughout our face, which provides structure and shape. As we age the fat pads are displaced by gravity. The youthful appearance of the face can be restored by replacing the volume loss. The most common areas that age the face through volume depletion are the temples, cheeks, and nasolabial folds.
Volume Enhancement
Previously we only thought of dermal fillers for the aging face, but as cosmetic injectables have evolved we are able to use dermal fillers to contour and enhance a younger population. I, myself, fall into this category of patients. Cosmetic injectors are beginning to see more patients in their 20s and 30s in the office. Most are wanting an ever so plump pout of the lip, excluding the dreaded “duck lip” appearance, of course. A number will ask for a cheek augmentation to provide a beautiful cheek bone, creating the contour we all watch makeup artists perform on YouTube. These two areas are not the only requests from the younger patient population. I will break down each area of the face below.
Areas Commonly Injected In The Face (Not all inclusive)
Temples to restore a sunken appearance.
Tear Troughs to improve dark circles under the eyes (See post on dark circles HERE)
Nasolabial Fold to reverse the static line that runs from the corner of your nose to the corner of the mouth.
Lips to replenish volume depletion as we age or augment for a fuller looking pout.
Chin to elongate the face and balance proportion.
Jawline to frame the face.
The forehead and brows can be injected to replace lost volume or further contour, although these areas are high risk and should be sought out with caution through your consultation.
Complications
What do I mean by high risk? Anytime you consult with an injector for dermal filler, they need to make you aware of the risks. Not to scare you, but to educate you. The main risk is vascular occlusion. This means if the filler product were to get into a vessel (vein or artery) it could do one of two things. It could cause necrosis, or death, of the surrounding tissue due to lack of blood flow or it could, in the worst case, cause blindness.
Yes, I said blindness. And all the consent forms you sign prior to getting the injections tell you this.
Necrosis and blindness are very rare and your injector should practice safe injecting techniques to avoid these potential complications.
I am not telling you these things to scare you, but you need to be educated and informed. You need to ask your injector about these things and be confident they will inject safely.
Dermal fillers can work wonders through facial enhancement, although it is not the equivalent to plastic surgery. If you are wanting a drastic change, you may need to consider a surgical consult.
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Great article. just to add These skin fillers can be “particularly effective at smoothing delicate frown and smile lines, as well as the fine creases around the eyes.” Cons: “Without ongoing treatments, the injected collagen is gradually absorbed by the body and your face returns to its original appearance of the skin surface.
Thanks Kate! Although, I do favor Botox to treat fine lines around the eyes. The fine lines are a result of habitual contraction of the orbicularis oculi when smiling and if the contraction is not lessened, the fine lines will remain. When dermal filler is injected in the periorbital area improvement is seen in elasticity although if used as the primary method to correct fine lines you may end up with an over augmentated appearance. Similarly in the perioral area, I prefer to ensure facial structures such as the cheeks are optimally filled thus requiring less product in the nasolabial or milolabial folds and avoidance of the dreaded “bull dog face.” Lastly, dermal filler is comprised of hyaluronic acid, not collagen. While it is optimal to receive annual evaluation for the need to touch up injected areas, I find that they do not return to baseline as research shows collagen stimulation and growth through injection of dermal fillers.