Injectable fillers have come a long way in the past decade. While once viewed solely as a wrinkle treatment, fillers now have an expanded role to help add facial volume. A host of injectable compositions are now available to help lift, mold and contour almost any facial area.
The use of injectable fillers has spurned what some call a reinflation revolution. Recognizing that facial fat resorbs in most people as we age, the face becomes more shrunked in and in some people even gaunt in appearance. Fillers can be used either right under the skin and even down to the bone. Cheeks, around the eyes, nasolabial folds and the temples are commonly treated areas. A variety of injectable fillers are available to add this degree of facial volume from the more commonly used hyaluron-based types to Radiesse and Sculptra.
Even the nose changes as we age. The tip can droop and get flatter and the skin over the bone and cartilage in the upper nose gets thinner. Injectable fillers can be placed on top of the bone and cartilage to give the nose a more youthful look by filling in a low bridge and helping to push up the tip a bit. While a far cry from the results of a formal rhinoplasty, it can be very useful in the properly selected patient. In the unforegiving and relatively thinner tissues of the nose only the hyaluronic-based fillers should be used.
The lips are well known to age as well with thinning of the vermilion and the development of vertical lip lines. While injectable fillers are more commonly put into the pink part of the lips, there is always the risk if placing too much and creating the dreaded ‘duck look’. One filler technique to precent this problem is too fill in the skin around the lips, creating a shadowbox look that makes them look fuller but not ducky.
One issue that would expand the use of facial volumizing fillers even further would be a filler that not only lasts longer but is more malleable and can be shaped under the skin like putty. One such promising filler is Voluma, a spin-off of the Juvederm filler line. Not yet FDA-approved, it is thicker than any other hyaluron-based material. It can be injected against the bone and into the muscle to create an almost implant-like effect.
Dr. Barry Eppley
Indianapolis, Indiana