Filler 101

While Botox (and similar neuromodulator) treatments have become fairly commonplace, the idea of injectable fillers may still be a bit of a mystery to some. People may be wary of filler and looking “done” with an image in their mind of an overfilled celebrity. The reality is that filler injections, when done by the right person, should deliver subtle enhancements and harmonization of facial features. 

Hyaluronic acid (HA) based fillers are most frequently used. Common brands include Juvederm, Restylane, etc. HA is a natural substance found in our skin. HA filler is a gel-like substance that can be injected into the area of concern at different depths to help soften a line or fold, lift tissues, or enhance a feature. Over time the filler will gradually be absorbed by your body. The results from filler can be seen immediately and generally last 6-18 months. There are a wide variety of HA filler options, with different thickness or viscosity, intended for different purposes. An advantage of HA fillers is that they can be dissolved with an enzyme called hyaluronidase if needed.

The range of different formulations of filler provides the injector with the ability to select the appropriate product to achieve a specific outcome. Fillers can be used to provide treatments ranging from general facial contouring to lip enhancement to filling under eye hollows to “liquid rhinoplasty.” There is even a class of fillers referred to as biostimulators, like Sculptra or Radiesse, where the injected product encourages the body to produce collagen.

Filler injections are generally quite safe but as with any procedure there are risks, and the risks with filler are greater than those with Botox. Bruising, redness and swelling may occur. Inadvertent injection of filler into a blood vessel can lead to more serious complications including loss of blood supply to the skin or eye. This is one reason why it is extremely important to see a qualified injector who understands facial anatomy as well as how to manage complications should they arise. With strategically placed filler, and when safety and natural looking outcomes are top of mind, we can have great results with filler treatments.

Skin Care at Every Age

Healthy skin habits start at a young age, as my son Jacob has shared in his videos. As every dermatologist will tell you, the most important thing for all ages is to protect your skin from sun damage! Beyond that there are obviously different concerns that tend to arise at different points in our life and while everyone’s skin is unique I wanted to share some general tips for skin health as you age.

For those of you in your 20s if you haven’t already established a skin care routine now is the time. Prevention is key at this age. A gentle cleanser, moisturizer and sunscreen are the key elements. You may also want to consider an exfoliating product to help turn over the skin cells. Many people in their 20s may still be dealing with acne as well so if you are having flare-ups and don’t have a treatment that works well for you, be sure to talk to a dermatologist. While most people at this age haven’t started to develop wrinkles, I do see some younger patients for “preventative botox” as there is evidence that use of neuromodulators can actually prevent the formation of wrinkles down the road.

In your 30s is when you will likely start to notice more changes to your skin. For the most part, the routine you established in your 20s is still relevant (especially the sunscreen part - seriously, wear it every day!) Loss of collagen is a big one and this is the perfect time to introduce retinoids to your skincare routine. Hyaluronic acid is another ingredient that I recommend to help hydrate the skin and soften the appearance of fine lines. In terms of in-office treatments, depending on the condition of your skin you may consider starting laser or light-based treatments to help even out the skin tone and stimulate collagen.

For most people the 40s is when you start to see more signs of aging. Women in this age group may experience the onset of peri-menopause and the increased hormonal activity can wreak havoc on your skin. Adult acne may even be a problem and I often encourage the use of a retinoid for both anti-aging and acne concerns.  It’s a great time to incorporate an antioxidant like topical vitamin C into your routine as well.  

50s and beyond - yes I know there are a lot of years beyond the 50’s and everyone’s skin is unique at every age but especially as we age our needs differ. Unfortunately I’m running out of space for this post, but in brief, with age the skin dries out so hydration and a good emollient is key. In addition to the above, incorporating a growth factor could also be considered!  At this age and beyond one of the biggest problems is volume loss. Hyaluronic acid based fillers like Juvederm or Restylane can be helpful to lift the tissue, soften the folds and minimize the appearance of the jowls and sagging skin.  

No matter your age it is important to develop a treatment plan that is right for you and work with a doctor who can help to evolve that plan as you age to keep you looking and feeling vibrant!