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Dermal Fillers from A-Z

Dermal fillers are all the rage these days because of the incredible transformations we have seen so many models and celebrities go through. Dermal Fillers are an incredible method of reducing signs of aging by filling in areas of the face that have lost volume (as we age, our faces lose subcutaneous fat). Loss of facial fat means that the facial muscles don't have as much padding, so smile lines and crow's feet become more visible. There are of course other factors that come into play when it comes to aging - like the quality and thickness of your skin, sun exposure and genetics.

What we are also seeing more and more of is dermal fillers being used to contour the faces of people who don't have visible signs of aging. For example, you might want to define your cheekbones, or slightly contour your jawline or lift your eyebrows. One of the most popular forms of dermal fillers is lip plumping as well - which doesn't necessarily have anything to do with age (although our lips do lose volume as we age).

The point is, whether you feel like you are starting to develop unwanted wrinkles due to fat loss or you are looking to enhance certain facial features - dermal fillers can be used for a variety of beauty wants and needs.

As a board certified plastic surgeon who has participated in countless facial surgeries, as well as one of the first face transplants ever, I am considered an expert when it comes to the use of facial fillers - especially for tricky areas like around the eyes and the use of fat as a filler. Below are my answers to common questions about dermal fillers. I hope that they are helpful for you as you navigate the world of non-surgical enhancements!


Q: What are injectable dermal fillers?

A: Face fillers are a wonderful non invasive way of restoring volume and eliminating lines and wrinkles. As we age, we typically lose facial volume and injectable fillers can help restore the volume and augment areas of the face that we want to accentuate, like the jaw or the lips.


Q: Where on my face can I get filler injected? 

A: Facial fillers are most commonly used in the lips, cheeks, lower eyelids and nasolabial folds (otherwise known as laugh lines and smile lines found between the nose and corners of the mouth). Fillers can also be used to fill in small scars, and to augment the jaw line, and the temporal hollow.  Additionally, fillers can be used to correct or camouflage bumps on the nose.


Q: How many kinds of fillers are there?

A: Soft-tissue fillers, such as Restylane, Perlane, Juvederm, Sculptra or Radiesse can help fill in these facial lines and creases while creating a more aesthetically balanced and harmonious appearance. Fat can also be used as a filler and has the advantage of lasting permanently. 


Q: When should I start using facial filler?

​A: Filler can be used as soon as a patient sees a need for it.  Typically in the lips as early as 25, and other areas around 30.


Q: How quickly will I see results?

​A: Immediately.  Results will improve and soften over 5 to 7 days.


Q: Are the injections painful?

​A: The injections can be a little painful, but the use of numbing cream before or ice can improve that. Some patients experience bruising and swelling that may last a few days and can be improved with the use of ARNICA gel.


Q: How often should I come back for more injections?

A: The results usually last at least 6 months. But it is always good to come back for a little touch up around 6 months..


Q: Will I look like I'm making "duck face" - will it be obvious?

​A: I consider myself an expert at creating subtle, natural results. There usually is some initial swelling (sometimes slight bruising) so don't be alarmed if you look a bit more pouty than you were expecting to - the results only really settle in after about 5-7 days.


Q: What is the process of using my own fat as a filler?

A: Fat injections have a more complex process than soft tissue dermal fillers. First fat is harvested from an area of the patient's body with fat to spare (buttocks or hips for example), and then it is re-injected into areas of the face to enhance fullness, fill creases or build up shallow contours. About 50% of the fat injected will "survive" but it will last forever!


Q: If I use fat instead of synthetic filler and I don't like the results, what can I do?

A: It is extremely rare that a patient is not happy with the results of facial fat filler but if for whatever reason they would like to remove it, it is possible through a variety of simple methods.


Q: Is using fat as a filler much more expensive than soft tissue dermal fillers?

A: Using fat as a filler is more expensive than soft tissue dermal fillers as it involves a different and more involved procedure. That being said, fat filler is permanent so if you plan on using filler regularly, in the long run you will save money by making the initial investment.


Q: How do I choose where to go to get dermal fillers?

A: I highly recommend that you get any kind of injections done by a Board Certified plastic surgeon. You are always taking a risk when undergoing any kind of procedure, especially on the sensitive features of your face - so you want to mitigate those risks as much as possible by choosing someone who has the maximum amount of experience and knowledge of facial anatomy. Q: Is using fat as a filler much more expensive than fillers like Juvederm?


There you have it! If I didn't cover a question that you still have, feel free to comment below. Hopefully you feel like you have a solid understanding of what your dermal filler options are and whether they might be right for you.

Until next time,

~Dr. Alexes Hazen



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