When you read the title, don’t hate on me just yet. I don’t fear wrinkles nor do I think patients should either. It’s just a catchy hook to get you to read on. Worked, didn’t it?
Ok, ok, so I am that dermatologist. The one that makes some recommendations to my patients, that I have yet to try myself. Why? Partly due to my busy schedule, but mostly, if I’m being honest, out of fear. Yes, I fear some of the very things that I tell my patients to do. One of them is spray tans. I haven’t taken the plunge because I do wonder if I’ll resemble an Oompa Loompa after it’s done. But just so you know—I’ll be getting a spray tan in the next month or two. I’ll be sure to let you know how it goes. But the other one is something I do in clinic and refer to my colleagues for all the time….…FILLER.
The fear stems from having to correct filler misplaced or seeing so many people overdone, including colleagues I haven’t seen in a while and been shocked by their filled appearance. I’ve also been blessed with a full face since childhood, great for surprising others with my true age but also something I was self-conscious about and never confident with until my 40s. So, like most fears, rooted a little irrationally, but I do plan to conquer it in the future too. The timeline is just looser.
When I’m talking filler, I’m specifically talking about dermal fillers. They typically work one of two ways—by providing immediate volume replacement or by stimulating natural collagen production. The first type of filler might sound familiar–hyaluronic acid (Juvederm®, Restylane®, RHA Collection®, Bellotero®). You probably know about hyaluronic acid (HA) because you’ve seen it or used it as a serum or in a moisturizer before. HA is naturally occurring in the body and helps with skin hydration and plumpness and joints. HA filler usually lasts around 6-12 months.
Fillers like calcium hydroxylapatite (CaHA) (Radiesse®) and poly-L-lactic acid (Sculptra®) are considered biostimulators. They stimulate natural collagen production, which can lead to long-lasting corrections over time. Like HA, CaHA is also a naturally occurring substance in the body, found mostly in your bones and teeth. Poly-L-lactic acid (PLLA) fillers are synthetically derived but for some of you health care folks, poly-L lactic might sound familiar too. It’s a suture material. So, if you’ve ever had stitches before, you might have had PLLA. Both CaHA and PLLA can last up to two years.
Another collagen builder is polymethyl methacrylate (PMMA; (Bellafill®). PMMA containing filler has Polymethyl methacrylate microspheres, which are suspended in a smooth, naturally occurring collagen gel. As your body breaks down the gel, the PMMA spheres are left behind to help provide a framework for collagen to form. It is ideal for injecting the nasolabial folds, which are the parentheses around the mouth and can last up to 5 years in the skin.
Something you might not know–you can also use your own fat as a filler as well. You can do what’s called a fat transfer and remove fat from one part of your body to another area. Sounds incredible right? Too much to get into now but a teaser for later.
What’s essential for filler is that you see a skilled injector so that you can have a conversation about your own personal goals, expectations, filler types and side effects. Do I plan to pull the trigger? Yes, I do plan to try it. Even full faces start to lose volume. My problem area is the chin, where I can see a little dimpling that would be nice to correct. My lips? Maybe. I do have the upper lip that disappears when you smile. Stay tuned.
Trotter’s Take: Filler shouldn’t be feared and in the hands of a skilled injector, the results can be a natural enhancement that can complement other cosmetic procedures.
Want to ease your own fears about filler? Then calm down with Dr. Lisa Akintilo with her expert advice on fillers and what to expect.
