Injectable Fillers

Facelift procedures are usually performed on patients beginning in their upper forties and fifties. In younger patients, other procedures such as Botox and injectable fillers are more common. Surgical procedures such as submental liposuction are also helpful in younger patients.

Injectable fillers can be used to provide minor contour chances to the nose, but I do not feel that fillers are an alternative to rhinoplasty surgery. Fillers are helpful in enhancing small depressed areas of the nose.

It sounds like your daughter may have a deviated nasal septum causing the nostril asymmetry. Furthermore, she may have had nasal trauma in the past or was born with a crooked nose. Minor nasal corrections can be adjusted with injectables to fill subtle contours. Judging by the way you describe her nose, this definitely sounds like a surgical case. The good news is that many times, medical insurance will cover correction of her nasal abnormalities, especially if it is causing nasal airway obstruction.

Fillers are a good nonsurgical option for periorbital rejuvenation. They are particularly good for filling the groove between the lower eyelid and the cheek. For fine lines around the eyes, particularly in the crow’s feet region, I prefer Botox injection. The fillers that I use most are Juvederm and Restylane, and both of these products last an average of ten months.

Hyperdynamic lines of the forehead and periorbital regions usually respond better to Botox injection rather than an injectable filler. Sometimes, however, patients who have deep wrinkles, especially in the brows, respond well to a combination of Botox and a filler. Because of your youthful age, I suspect that Botox alone will best suit you.

I almost exclusively inject hyaluronic acid fillers in my practice. The most common brand that I use is Juvederm. I like this filler because it is soft and natural feeling, does not tend to form lumps beneath the skin, is completely absorbable and not permanent. There are reports of patients having allergic reactions to injectable fillers, but I have not personally seen it occur.

I almost exclusively use injectable hyaluronic acid (HA) fillers in the face.  There are several products available which work well.  This is composed of a naturally occurring substance found in the skin and is not made from animal products.  Although mentioned as a potential risk, I have never seen an allergic reaction to this product after injection.  There are studies which suggest that this type of filler stimulates collagen formation which is desirable in long-term reduction of wrinkles.  This is an absorbable filler that lasts approximately 10 months.  I know of no long term deleterious effects after injection of HA fillers.

I most commonly treat these lines around the lips and mouth with an injectable filler.  This usually lasts 10-12 months, although some studies suggest that fillers stimulate new collagen formation and can provide a longer result.  It takes approximately 5-10 minutes in the office setting.  For deeper lines of the lips and face, sometimes dermabrasion or laser resurfacing is the better option.

Short answer, I just say no to bigger lips.  Many patients forget what they originally looked like before entering the world of injectable fillers.  I tend to be very conservative with injecting lips and often show patients their original photographs before repeating injections.  I almost always avoid injecting the entire length of the lip, sparing the lip area at the corner of the mouth.  This can maintain a natural transition of the upper and lower lip and not create a “fish lip” appearance.

I exclusively inject fillers composed of hyaluronic acid (HA).  This is a naturally occurring substance in the skin and not made from animal products.  They are produced in varying viscosities.  For example, a smaller particle sized filler would be a good choice for small lip lines, and a larger particle sized filler would be a good choice for a deep nasolabial fold.  Also, HA fillers are not permanent and provide a natural soft enhancement.