Davis

Cheek fillers aren’t as commonplace as lip injections, tummy tucks, or breast augmentations, but that could be about to change.

Facial fillers make up the fastest-growing segment of minimally-invasive cosmetic procedures. More than 2.6 million treatments were performed last year, according to the American Society of Plastic Surgery. So they’re already widely accepted.

But, for the most part, the cheeks have been excluded from that movement—until recently. Plastic surgeons have long considered the cheekbones to be the most underappreciated feature on the face, and perhaps the entire body. When you realize just how much of the face’s surface area they comprise, not to mention the fact that they’re the heart of the face’s bone structure, a subtle tweak can completely change the face’s architecture.

That sentiment finally seems to be gaining traction as more and more get comfortable with facial fillers. So, how do they work? Read on.

It’s a highly customizable

A high-viscosity hyaluronic acid gel—Juvéderm Voluma is a popular choice— is used to temporarily plump and fill cheekbones that have lost volume due to age, or to create better symmetry. (The human face is naturally asymmetrical, though it’s hard to detect with the naked eye.)

With the right placement—because so much depends on the placement of the injections, it’s critical to seek out a plastic surgeon who’s not only board-certified but who also has an artist’s eye and skill—the filler will help lift and elevate the middle of the face, all while creating a softer, more youthful appearance for the upper portion of the face.

It’s a highly customizable procedure. The aim is really to accentuate the individual’s own facial beauty, not to create some version of universally ideal cheekbones. Someone with a thin face may want plumper cheeks. While someone with a round face may prefer a more angular look.

Immediate results

You’ll discuss your goals with your plastic surgeon. At which point, they’ll take careful measurements of your face to determine just how much filler you’ll need. It’ll take a few minutes for the topical numbing cream to take effect. And the injections themselves should take five to 10 minutes.

How long the filler will last varies from person to person because individual metabolic rates play a big part in it. But it generally takes between a year and a year-and-a-half for it to completely dissolve.

For those who prefer their new look over their natural appearance, you can add more filler after nine or 10 months, which will maintain the same level of structure.

There’s likely to be some mild swelling for a couple of days after the injections, but the recovery, otherwise, is virtually nonexistent. Even more, the results are immediate. Your features will look sharper, but the change will be subtle enough that no one could pinpoint the difference unless you point it out.

Until only recently, rhinoplasty was the only means to make a nose smaller, straighter, or smoother. The surgery’s effective and the results, permanent, but it requires anesthesia and considerable healing time because of the bruising and swelling.

With the rise of injectable fillers, a second option emerged a few years ago: the nonsurgical nose job. It’s an off-label use for fillers that’s capable of transforming your entire profile in under 15 minutes. Using the same hyaluronic acid gels used for lips and cheeks, a board-certified plastic surgeon can correct the nose’s contour and even make it appear smaller.

Sounds almost too good to be true, right? It’s not. But it’s still important to know exactly what you’re asking for. So, to help with that, here’s a primer that covers all the essential details about the procedure.

Who’s a good candidate?

It’s someone who has a pronounced bump on their nose. By filling the area around the bump, the plastic surgeon can create the illusion of a perfectly straight nose. Filler can also lift up a droopy tip and correct a slightly crooked nose.

A plastic surgeon can also make it appear smaller, even though they’re actually adding volume to the nose. And that’s because they’re creating symmetry. (The human face is naturally asymmetrical, or imbalanced, though it’s more noticeable in some.)

How long does it last?

It depends on the cosmetic filler that’s used. Often, plastic surgeons will start a patient off with a temporary filler, such as Voluma, which is natural-looking and lasts for up to a year-and-a-half. If they’re happy with the results, they’ll move on to a permanent filler, like Bellafill, once the temporary one dissolves.

The Voluma requires one 15-minute session, while the Bellafill, a collagen-based injectable that’s typically used to treat acne scars, takes three separate sessions, though the final result will last for years. Another important distinction: The temporary fillers, because they’re made from hyaluronic acid, can be dissolved if you don’t like the result. The Bellafill cannot.

Why is an experienced surgeon important?

All injections come with some amount of risk for swelling, bruising, and bleeding. But the nose is an especially delicate area of the face because its blood supply is quite weak. Put too much filler into the tip or a nostril and it can cut off the blood supply.

Important as it is to be aware of such complications, take it with a grain of salt because they’re rare—as long as the procedure is performed by a board-certified plastic surgeon with extensive experience in facial fillers, and nonsurgical nose jobs in particular. This isn’t a procedure you want to shop around for the deepest discount.

In the right hands, the nonsurgical nose job is nearly painless. (Some topical cream to numb the area and ice afterward helps.) It’s a true “lunchtime procedure.” You may be a little red or bruised for a few days, but even that can be helped with a laser treatment.

Forehead wrinkles are a sensitive subject for many of us because they’re often at the top of our list of complaints about ourselves. But a range of treatments are available to help regain natural-looking, smooth, tight skin on our foreheads.

Botox injections are the most common and effective way to alleviate forehead wrinkles. More on that in a moment. First: How is it that our foreheads become billboards for our age?

There’s no simple answer because there are lots of factors that can cause forehead wrinkles, ranging from the repeated use of certain muscles in your face to a loss in skin elasticity that comes with aging. Perhaps the most common culprit is the frontalis muscle, which elevates the eyebrows and causes the forehead to wrinkle in the process.

But even if you’re someone who’s preferred subtle facial expressions, age inevitably catches up with all of us. As our skin laxity lessens, fine lines and wrinkles begin to form. And the forehead, if only because of its prominent placement, is usually the first place we notice them.

What does Botox do, exactly?

Botox burst onto the scene in 2002, when it was approved by the FDA as a safe and temporary solution for smoothing wrinkles. It continues to be the most popular nonsurgical wrinkle treatment, even as the injectables market has grown exponentially in recent years. Last year alone, nearly 7.5 million Botox procedures were performed in the United States, a 3% increase over 2017.

So, how does it work, exactly? Where forehead wrinkles are concerned, it stops the targeted muscles from working, which, in turn, gets rid of the creases. You’ll notice the muscles slowly freeze up within a day or two of the injections. The full, line-smoothing effects will appear after a week. And they typically last for three to four months before gradually wearing off.

There aren’t any other treatments thus far that have been shown to extend the effects of Botox, but there are things you can do to complement the treatment and enhance the results. Wearing sunscreen and taking care of yourself is a start. An ultrasound treatment will help further tighten the skin on the forehead for a greater duration, and a brow lift, which entails small incisions along the hairline, will help create a smoother look overall.

Start sooner rather than later

A couple of other things to keep in mind. First, the number of injections varies from person to person. And, side effects are rare, but when they do occur, they’re usually the result of the injection process. So, seek out a board-certified plastic surgeon who has extensive experience in cosmetic injectables.

Also, Botox is most effective as a preventative treatment. While the mid-twenties may sound premature for considering any kind of facial cosmetic treatment, that’s when traces of lines begin appearing on the forehead. If you wait to treat forehead wrinkles after they’re apparent, it becomes more difficult to achieve ideal results.

Concealer isn’t cutting it anymore. You’ve spent more on eye cream than you’re comfortable admitting. And you’re meticulous about drinking enough water and not skimping on sleep. Yet there they are, practically unfazed by all of it: those dark circles under your eyes.

Before we go any further, it’s time for a dose of reality: None of that was ever going to improve your dark circles. And that’s because the reason behind their presence is mostly genetic. The cosmetics industry will have you believe they have everything to do with your sleep habits and coffee consumption, but they really have more to do with the composition of your skin and the way light reflects off your orbital bone.

That doesn’t mean, however, that there’s nothing that can be done about them.

What the under-eye filler does

Dark circles become more prominent as we age. Doctors refer to them as tear troughs. The skin around our eyes is thinner and paler and lacks the proper fat restores, so the indentations grow a little deeper, giving the eyes a more tired appearance.

While that may sound like a fairly intricate (and irreversible) concern, it’s actually fairly easy to remedy—with the right know-how and technique. All it takes is a small layer of precisely placed hyaluronic acid gel to lift the delicate skin up and away from the blood vessels under your eyes.

Hyaluronic acid is a natural part of the skin’s dermis, but it diminishes as we age, which causes the undesired hollowing effect under the eyes. The hyaluronic acid in fillers helps pull water to the site of the injection, creating a plumper under-eye.

What to expect

The procedure can be a liberating experience if you find yourself increasingly reluctant to leave the house without cover-up. At a certain point, no amount of cover-up is going to disguise a hollow. But, within a day or two of having an under-eye filler, your eye area will appear noticeably brighter.

And the effect should last anywhere from six months to a year, depending on how quickly you metabolize the filler and the type that was used.

As I mentioned, the application of the injections is critical. The filler needs to be placed quite deep so it isn’t visible under the delicate under-eye skin. (A topical numbing agent can be applied beforehand to ease any discomfort, and it’s a very small needle, so the injections are virtually painless.) Which makes finding a board-certified plastic surgeon with lots of experience with the procedure all the more important.

If the idea of getting an injection around your eye is still too daunting, lasers can also help with dark circles, especially if they’re caused by visible blood vessels. Your plastic surgeon will help you determine the best course of treatment by pinpointing the root cause of your dark circles.