Customized Dermal Filler Treatments: Achieving Natural Results

Customized Dermal Filler Treatments: Achieving Natural Results

Dermal fillers are materials that are injected into or below the skin to make improvements in people’s appearances, however they do a lot more than just fill and correct volume loss. Fillers come in different forms: soft and firm, and in the right combination and amounts can contour the face and provide changes that are long-lasting and natural-looking. The magic however is not in the cosmetic filler treatment plan, but more importantly in the eyes and hands of the provider. Fillers are based on science, results however are an art form.

The key concept is that the skin on our face is supported by soft tissues (fat), intermediate firmness tissue (muscle, collagen and elastin) and mainly  supported by the firm tissues of our bones and teeth.  There is a balance in our face with these supportive tissues that is associated with a youthful, healthy and rested appearance. Too much soft tissue can lead to a bloated, puffy and stretched skin appearance, whereas too little support from our bones and teeth can lead to a sunken appearance, where our skin drapes and folds. The harmony is in achieving an aesthetic mixture of fillers  with the correct balance of this soft, intermediate and firm tissue in the correct areas in the face. 

Where a filler combination can be used during a dermal filler treatment? 

  • Under eye bags: With the EyeRise™ technique, the patented procedure by Dr. Stephen Bracci, combines small amounts of hyaluronic acid soft filler (Belotero) in the tear trough area with deeper, more structured support from Radiesse (calcium hydroxylapatite) in the upper part of the midface. By combining the best elements of soft fillers in the area closest to the eye and the advantages of a firmer lifting  and support from Radiesse beneath this area – the under eye can appear lifted rested, and most importantly natural. Treating this area with either filler alone would not achieve this synergistic effect. 
  • Areas around the mouth and nasal labial folds (smile lines): Typically benefits from a combination of soft Hyaluronic acid facial fillers closest to the mouth – in  the lips themselves, the upper lip fine lines (wrinkles above lips)  and the upper part of the marrronet area (corners of mouth),  and then treating the nasolabial folds and remainder of the Marinette area with a more structured firmer filler such as Radiesse – to achieve the balance of using both soft tissue and firm tissue replacements. 

Often new injectors or spa models of injectors relay mainly or solely on the softer hyaluronic acid type of fillers – brands such as Restylane, Juvederm, Voluma, Belotero, Versa, RH are examples – typically relying on certain areas of the face, lips, nasal folds, mid face cheeks 

The hyaluronic acid (soft tissue filler) fillers are water retainers – in the right application such as lips, in the lines in the skin itself and in small amount under the eyes can achieve brilliant results. However when soft hyaluronic acid fillers are used excessively as commonly placed  in the cheeks or nasolabial folds often results in a round, puffy, heavier, and bloated appearance.

Sculptra (poly-L-lactic-acid) is a great stimulator of collagen which is an intermediate firm tissue strength filler – provides lifting, volume, and support – without water retention and puffiness, however Sculptra does not produce the defining effects of Radiesse.

Radiesse (calcium, hydroxyl appetite), is generally a most useful versatile filler in my practice as it provides firm bony lifting and support, while also bio stimulating intermediate firm tissues of collagen and elastin. Moreover Radiesse also provides regenerative effects of stimulating new blood vessels called angiogenesis.

Who would benefit from a customized dermal filler treatment? 

Bodybuilders who may have gained a significant amount of muscle including increased facial muscle size, who have lost weight rapidly and stripped or lost nearly all soft tissue facial fat before competition – can appear drawn without any soft tissue 

Older people who have lost a significant amount of teeth and  or bone, especially when very thin, can have a sagging sunken skin appearance as the skin drapes differently. Fillers can help to rejuvenate their specific needs and give a more youthful appearance. An analogy is a tablecloth over a table – if a table cloth is placed over a small table (likened to bone and teeth loss) it will drape and fold to the floor.

Who should be cautious in receiving too much soft fillers?

On the other hand, younger people with specific aesthetic goals who want to appear different or enhanced may seek out rounds of soft hyaluronic acid fillers which can accumulate – may tip the balance to too much soft tissue in the face  – appearing bloated, puffy, or to have gained weight. The better approach may be to receive a combination of soft, and also firm fillers such as Radiesse to aid in contouring and definition to the face . 

How Can I Schedule a Consultation for a Customized Treatment Plan? 

To schedule a customized facial filler treatment or to discuss your specific concerns regarding injectable facial rejuvenation at VERVE Medical Cosmetics, call us at (212) 888-3003 or fill out this form and schedule a consultation online. 

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