Using face fillers to reverse effects of lost fat and bone


As we age, we lose volume in our faces. Our faces literally deflate from loss of both fat and bone.

This accounts for the volume loss under the lower lids, leading to the "circles," loss of volume in the mid-cheek areas, smile lines, and virtually everywhere, including the bone under the upper lip, the jaw, and orbit - where our eyes get the sunken look from bone loss.

Re-volumizing reverses these deficient areas resulting in a more youthful appearance. Both men and women can benefit from fillers.

Where do "fillers" fit in? Fillers are products that can be injected into certain areas of the face to re-inflate deficient areas. These can be done during office visits in a few minutes, usually with no downtime other than some bruising.

The most popular fillers are made with hyaluronic acid. These are more natural and are reversible with an injection of the enzyme hyaluronidase. They can last from six months to two years and are priced accordingly.

There are some permanent fillers; however, these should be used with caution. If the patient doesn't like the result, it cannot be reversed.

Often an experienced injector will recommend more than one kind of filler, as each type might be better in certain areas of the face. This is called a "liquid facelift cocktail" and can be very effective because it utilizes the best characteristics of each product.

The Restylane family includes: Restylane Lyft, Refyne, and Defyne. A knowledgeable injector will know when to use one over the other.

Restylane Lyft is used for deeper wrinkles, such as the smile lines from the nose to the corner of the mouth, the nasolabial lines. It can also be used under the lower lids, however, the injector must be extremely careful in that area as the skin is very thin and lumps of product could be noticeable.

Restylane Refyne is used for superficial wrinkles, such as the wrinkles around the lips.

Defyne is great as a deep filler over bony areas.

The Juvederm family includes: Juvederm UP, Volbella for fine lines, Vollure for deeper injections, and Voluma, which lasts two years and longer. Like the Restylane's, the injector will choose the appropriate product.

Sculptra, another filler, is unique in that it last longer as it stimulates one's own collagen. It can be used most anywhere except the upper lip and eyelid areas. Sculptra is also being used in the buttock areas for a shapely derriere.

For lip volumization, Juvederm Ultra Plus or Restylane Refyne are good products, among others. Good injectors will allow the patient to choose the amount of product injected.

Fillers are a mainstay of plastic surgeons and their patients by providing a safe non-surgical procedure to make patients look as young as they feel. Just as with anything else, the injector's skill is most important.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. www.fingerand

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