The Real Deal on Fillers

In Dr. Lindsey Pennington, Health and Beauty by Lola Magazine

8 Things to Know if You are Thinking about Trying Dermal Fillers!

1. Results should look natural!

Highlighting certain facial features through injections goes back over 100 years. It fell out of favor after bad results from the use of things such as paraffin wax. It has certainly returned to favor this past decade due to increased regulation and great advances in technology. These days it’s almost always hyaluronic acid, regardless of the brand, being injected. Hyaluronic acid is naturally found in your existing skin and actually has been shown to stimulate the production of other naturally occurring complexes like collagen at the site of use. There are an increasing number of topical creams and serums with hyaluronic acid on the market for this effect.

When injected, these complexes are able to give your face the “lift” or increased volume that you may have noticed has been depleted or is slowly sliding down off of your cheeks with age. Or maybe you are one of the people were just born with smaller lips that you would like to be able to see when smiling or have more defined cheek bones.

I have some patients who do come in and request the “Kylie Jenner” look, but they are a very small minority. I would say 98 percent of my patients come to me because they want to look natural and refreshed. They are tired of being asked if they are tired.

2. More people have done it than you know, and even more will soon.

Worldwide, Botox and fillers are expected to grow between 10 and 15 percent a year for the next five years. By 2023, it is estimated people will spend over $10 billion to treat facial lines and wrinkles. Want to know the faster-growing market out of those two? It is the hyaluronic acid fillers.

People are much more open about the use of these procedures these days. If you have noticed a positive change in someone around you, if you privately ask them what they have gotten done, more times than not, they will tell you. Others are much more open about it and post it all over social media. You don’t even have to ask.

3. It is important who performs the procedure.

It is a procedure, and like all procedures, there can be a bad outcome associated with it and can be associated with risk when done poorly or unsafely. I would always choose a board-certified physician with plenty of experience.

There is also an art to it as well. You will not like the work of every artist. That is why it is important to go to someone whose work you have liked on friends or family or ask to look at before and after pictures. Many of the plastic surgeons will gladly post these pictures of consenting patients on their websites or social media pages. Start there.

4. You will very quickly know whether you made the right decision.

Unlike Botox that doesn’t start working for at least 3-4 days and takes up to 2 weeks for full effect, there is a lot of instant gratification involved with fillers. You can see the result instantly. Just like with any procedure there is risk of bruising and swelling after injection but is usually minimal. Most patients are able to apply makeup and go about the rest of their day or plans looking refreshed.

5. Results are NOT permanent.

What do you do if you absolutely hate the results from your injections?

Many people come see me unhappy with a previous provider’s work and want more filler placed to fix it. That’s almost never the right answer.

As mentioned earlier, hyaluronic acid is a naturally occurring complex in the body and as a result there is a naturally occurring enzyme that exists to break it down. We just inject this enzyme and give it a week, although most of the effect is immediate, to return you to baseline.

To recap, if you absolutely hate it, it can almost instantly be reversed with very little risk.

6. Results are NOT permanent.

Unfortunately, your own natural enzymes will slowly degrade the injected hyaluronic acid over time. Just like with Botox, maintenance is required. The good news is that the products are getting better and longer lasting. Where as 3 to 6 months was the typical lifespan of some of the earlier products, many of the ones used now can last up to 2 years. There are others in production that last even longer.

7. Different fillers have specific roles.

Although there are others, Allergan’s Juvederm line has the largest market share of any product line out there. It’s the one that I personally use as well. It comes with a great reward program called Brilliant Distinction that also includes multiple skincare products through SkinMedica. There are many reasons why I think it is currently the best.

There are five main products in the Juvederm line:

Juvederm ultrahas been around the longest and is the “work horse” of the fillers. It can last around 6-9 months, depending on where it’s placed. This can be used in the lips. This is a middle of the ground product when discussing firmness, one that you will feel in the lips and gives more volume to the lips and gives the patient more of a pout when used. It can also be used in nasal labial folds to fill in lines.

Juvederm ultra plus comes in a full syringe, also lasts around 9-12 months depending on placement. It can also be used in the lips — this is the firmest product that I will use in the lips and is for patients who are going for the “Kylie Jenner” lip look. This is a product you will be able to feel. Its also a great product for nasal labial folds in patients who have deeper lines, or to contour jaw lines.

Volbella comes in 1/2 or a full syringe. It’s a great product for people who are curious about lip filler but want to take it slow and have very natural results. It gives a subtle pout and dewiness to the lips. It’s a very soft product and is good for someone who doesn’t want too much of a change to their natural lips. It can also be used for superficial injecting for fine lines around the mouth that develop with aging, referred to as “smokers’ lines,” but they can occur in non-smokers as well. This product lasts over a year.

Vollure comes in a full syringe — this product is also on the softer side (when I refer to products as soft or firm, this means the thickness of the product). Soft products you can’t really feel in the lips and give a very subtle look — this is also used in the lips and gives a very natural result. It is good for someone who doesn’t want a huge difference in the lips but wants to soften and give a little bit of volume. This product I tend to use in my more mature patients who need volume added to their lips to help decrease wrinkles, but don’t want to look as though their lips are “done.” It’s a very dynamic product and can be used in the nasolabial folds and tear troughs as well. It’s one of my favorite products for the nasal labial fold area because it’s soft and moves well with your face. It can last up to 18 months.

Voluma comes in a full syringe. This is a filler that is used in the cheeks, tear troughs, and temple, and along the jaw line or chin. This product is firmer than any of the other fillers and really helps get a lift when placed underneath the soft tissues. Its fantastic for helping add accent to cheek bones to help thin out a round face or help lift due to sagging from facial aging. This product can last up to 2 years.

There are many other products on the market from other companies such as Galderma that makes the Restylane line of hyaluronic acid fillers. It is important to do your research and make sure whatever you choose to use is the best fit and safest for you.

8. Reasons not to get filler

I strongly discourage pregnant and breast-feeding moms from getting filler. There are no studies proving it harmful, but there are not going to be any studies proving it safe anytime soon either. That said, I personally know a few moms who have made that personal decision to continue with the procedure.

You should not receive fillers if you have an active sinus infection or skin infection on your face for risk of spreading it. There are some who also caution against going to the dentist or getting your teeth cleaned in the week before or following your injection. The concern is that they may inadvertently displace some of the hyaluronic acid or cause an increased risk of infection.

Probably the main reason though, is that some patients are just better candidates for a surgical correction of what bothers them, especially if that is loose skin. Fillers will not get you the results that you desire. Please see a board-certified surgeon to discuss the best option for you.

Dr. Pennington is a Facial Plastic and Reconstructive surgeon in Shreveport. She offers a full array of medical-grade skincare products and procedures at her office at 6030 Line Ave, Suite 110. She provides complimentary consults to discuss any issues from skin care to injectables all the way up to surgical consults. Call the office to schedule your complimentary consult today at (318) 216-5366 and follow her on Facebook or Instagram @penningtonfacialplastics to see before and after pictures of procedures she has performed.