21 Sep 2023 | by Leonard Miller, MD, FACS, FRCS
Injectable filler is certainly one of the most popular procedures in my practice as well as the entire field of plastic surgery. According to the latest statistics from the American Society of Plastic Surgeons (ASPS), over 2 1/2 million patients received soft tissue fillers in 2018. And I think we can expect to see this number continue to rise. The reason is simple: dermal fillers are a safe, fast and easy way to turn-back-the-clock without any downtime.
I love fillers for their versatility and effectiveness. Coming up with the right treatment plan or “recipe” for your individual anatomy and needs allows me to be both creative, as there is no “one size fits all” when it comes to injectable filler, and technical, as this is a procedure where expertise is crucial for delivering a natural looking result. Due to their incredible popularity, however, there are a lot of providers out there offering fillers who shouldn’t. So, I thought it would be nice, as a fillers expert, to map out what I feel are the 5 questions you should absolutely ask before getting injectable filler.
View more microneedling before and after pictures
What Is Your Expertise & Training?
As mentioned, a dermal fillers procedure may be non-surgical, but it is not simple so you always need to make certain that your provider has not only undergone the proper training for each filler, but continues to stay up-to-date on the latest techniques through continuing education. Here at the Boston Center for Plastic Surgery, every injectable filler procedure is performed by either a Board-Certified Plastic Surgeon or a Board-Certified Cosmetic Dermatologist. While an injector does not have to be Board-Certified to be good, this certification is an easy way to ensure that your provider has undergone the necessary training and education.
The other thing that you want to ask about is experience. As with any art form, the more you practice, the better you get. So, it’s important to ask not only how many years the provider has been performing fillers, but also how many injectable filler procedures he or she does a week.
Which Fillers Do You Offer?
Not every provider carries every filler as there are a number of fillers manufacturers, such as Juvéderm or Restylane, with more coming to the market this year. Furthermore, each of these manufacturers offers an entire line of different fillers. I provide my Boston area patients with a full range of dermal filler options because each variation works in a slightly different way. This is where expertise really comes into play. I have decades of experience with dermal fillers so I understand the subtle ins and outs of each variation. This allows me to customize an injectable filler procedure to your unique anatomy and needs. As no two patients are the same, this is critical for delivering a truly “wow” result and avoid complications or an unacceptable result.
In general, the difference between the various filler options comes down to the size or weight of the filler molecules themselves. There are 4 basic fillers for rejuvenating the face. These include:
- Very soft, thin gel fillers for fine lines & wrinkles (Belotero, Juvéderm Ultra, Restylane Silk)
- Soft cohesive, slightly denser gel fillers for lips & under the eyes (Restylane)
- Slightly firm gel fillers for nasolabial folds & scars (Restylane Defyne)
- Firmer, thicker gel fillers for the cheeks & jawline (Juvéderm Voluma)
Is it a HA Filler?
I only use HA or hyaluronic acid based fillers. However, some providers do offer fillers with non-absorbable elements. It is important to understand the benefits of HA fillers. First, hyaluronic acid is a naturally occurring substance in the human body so there is less risk of an adverse allergic reaction. Second, HA fillers are reversible. An enzyme can be used to dissolve an HA filler that is:
- Bumpy
- Puffy
- Incorrectly placed
- Not your desired aesthetic
The best way to prevent getting a dermal fillers result that you don’t like, however, is to see a really skilled injector.
How Long Will My Results Last?
A question that most patients don’t need to be reminded to ask is: How long will my results last? However, it’s important to pay attention to your provider’s answer. No filler lasts forever. If your provider isn’t honest about this, buyer beware. Furthermore, any estimate of the length of time that a injectable filler result will last is just that — an estimate as everyone’s body processes fillers differently. In general, an injectable filler that is thicker or heavier last longer. Results with Juvéderm Voluma, for example, can last up to 2 years while those with a thinner filler, such as Juvéderm Ultra, which may only last 6 months to a year.
What Kind of Facial Rejuvenation Result Can I Expect?
The degree of facial rejuvenation that you can expect from your dermal fillers procedure is going to depend entirely on your provider and your anatomy. It takes a combination of skill and artistry to deliver a non-surgical facelift like result with an injectable filler. It also takes a provider who will be honest with you about whether or not your anatomy and needs are a good match for dermal fillers on their own or if it will need to be combined with another procedure such as:
- Botox
- Laser skin resurfacing
- Micro-Renewal
- Chemical peel
I pride myself on always be honest with my patients. My goal is to help you feel like the best version of yourself. My results are subtle and natural-looking so no one will know that you’ve had anything done unless you decide to tell them. As far as I’m concerned, this is the best possible fillers result.
To find out more about injectable filler at the Boston Center for Plastic Surgery, contact us today or call (617) 735- 8735 to schedule a consultation.
