Cosmetic Plastic Surgery Articles

Facial fillers have become the driving force in plastic surgery’s most recent popularity surge. Hyaluronic acid (HA) fillers, like Restylane and Juvéderm; neurotoxins, like Botox and Jeuveau (newtox); and fat-melting Kybella have worked their way into the mainstream vocabulary and changed the face of cosmetic surgery, angling it more toward minimally-invasive procedures that yield natural-looking results.

And practitioners of all kinds—with varying degrees of training and experience—are capitalizing on the demand. As breezy as our attitude’s become about filler injections, the ability of the injector still matters.

Facial fillers are generally very safe and effective when injected by a board-certified plastic surgeon who has an intimate knowledge of the human anatomy. But that’s really just our starting point. Before you dip a toe in the rejuvenating waters of facial fillers, there are a few other things you should know.

What’s in a name?

While the term facial fillers is thrown around pretty nonchalantly by beauty sites, it’s actually an umbrella term that encompasses a nuanced range of injectables. For starters, the majority are made of HA, a safe sugar found naturally in the human body, while a few are made from other materials.

Radiesse contains the mineral calcium hydroxyapatite, which is found in our bones and teeth. Sculptra uses poly-L-lactic acid, the same biodegradable component that’s used in absorbable stitches. Bellafill suspends non-biodegradable acrylic beads in cow-derived collagen and is far longer lasting—it’s considered safe and effective for up to five years—than most other facial fillers.

HA fillers act kind of like place holders, substituting for depleted collagen and fat. But these others are known as biostimulatory fillers. Basically, their primary purpose is to spark the growth of your own collagen for longer-lasting fullness and lift. (HAs have also been shown to increase collagen and elastin production over time, but to a lesser extent.)

And even within the HA fillers, there’s a lot of diversity. The gels vary by density, viscosity (or flow), elasticity, lift-ability (or stiffness), and longevity. These traits determine their roles. Robust fillers like Restylane Lyft and Juvéderm Voluma can help restore volume and projection to the cheeks while lifting the lower face. While lighter HAs, like Juvéderm Voluma, are a more appropriate fit for the small lines that can appear across the upper lip.

Depending on the formula, some will break down faster or swell up more. These are all things that will factor into your plastic surgeon’s consideration when selecting the right filler for you and your features.

Facial fillers aren’t blanket treatments

Chances are, you were turned on to facial fillers by a post about a celebrity or maybe even a close friend who was more than happy to brag about her treatment. While there’s no harm in that, of course, it’s important that you enter your consultation with a plastic surgeon with an open mind.

Facial fillers really are an individualized treatment. Your friend may look great with Juvéderm Volbella in her lips, but it’s not a given that it’s appropriate for your needs, goals, and anatomy, too.

Not to mention, plastic surgery is as much an art as it is a science. In other words, you could consult with a handful of doctors, and each one would likely suggest a different solution—because there’s always more than one. Choose a plastic surgeon based on their education, experience, and aesthetic. And then trust in their ability.

Botox treatments (and the like) were the most popular cosmetic procedure performed in 2018. But that’s been a recurring headline for the last few years. The nearly 7.5 million treatments represented a 3% jump over 2017 and an astounding 845% increase since 2000, according to the American Society of Plastic Surgeons.

Plastic surgery has become far less stigmatized over that span, and minimally-invasive procedures, like Botox injections, have grown the most dramatically as a result of the accessibility and interest that followed. Today, Botox is not only an effective means to minimize the early signs of aging, it’s also become popular as a preventative measure.

When should I start Botox treatments? It’s not unusual for a plastic surgeon to suggest the mid-twenties. We develop wrinkles because, as skin loses its elasticity with age, it can’t effectively bounce back from the countless facial expressions we make every day. Botox relaxes the facial muscles and prevents them from constricting and wrinkling the overlying skin.

Say you furrow your brow when you read from a screen. We’re essentially retraining your face to no longer do that and, in turn, lowering the chances that you’ll develop those dreaded wrinkles between your eyebrows. So, the earlier you begin getting Botox, the better, in most cases.

But I prefer to gauge a starting point by need rather than age because there are a couple more pressing factors that need to be considered, including the amount of sun you’ve been exposed to over your lifetime and your skin tone.

Caucasian women who’ve protected themselves fairly well can usually hold off until 35 or 40. For women with darker skin tones, it’s more like 40 or 45.

The benefit of a little wiggle room

The next natural question is, how far apart should you space your follow-up botox treatments?

The effects of Botox generally begin to wear off after three or four months, but that can vary from person to person. And, ideally, you don’t want to wait until the effects have completely worn off, around six months. What that really means is that the targeted muscle has regained its strength.

You’ll have a better long-term result if you schedule your follow-ups before you reach that point, because Botox has a cumulative effect. With each round of injections, the targeted muscle becomes progressively weaker and eventually atrophies. As that happens, it’ll also allow you to space your treatments a little further apart each time.

Consistency is what matters most

Another reason not to set your Google calendar reminder for three-month intervals is that there are a few other variables at play, too. For one, if you’re very physically active, you may need to schedule your follow-ups a bit sooner.

Also, some muscles, like the one behind those dueling wrinkles between your eyebrows, are stronger than others. So they’re going to require more frequent treatments. So, too, will wrinkles that are relatively fully formed.

Whatever schedule you settle on with your plastic surgeon, commit to it. Much as you may like the initial results of a Botox treatment, they’ll get even better over time—as long as you remain attentive to your follow-ups.