Fillers May Very Well be the Best Thing Since Sliced Bread

Fillers May Very Well be the Best Thing Since Sliced Bread
Fillers May Very Well be the Best Thing Since Sliced Bread (Real patient of Dr. Farhad Rafizadeh)

It’s no secret that injectables are as mainstream as makeup in 2016 — there’s no more stigma or shame associated with visiting a doctor for a little something here or there, but while Botox and similar neurotoxins were the way to go in past years, fillers are certainly the way of the future.

“A youthful face is V-shaped, with wide prominent cheek bones and a narrow jaw that closes in on the chin,” explains board-certified plastic surgeon and ASAPS member, Ulysses Scarpidis, MD. “With age, the V starts to look more like an O as the cheeks narrow and our jowls grow. Eventually the youthful V turns upside down to reveal the aged face with narrow, empty cheeks and a fuller lower face, jowls and neck.”

What’s to blame for all this? Well, a lot of things from gravity to bone loss— but one of the most easily addressed is the slow and steady loss of collagen over time. Collagen is the wonderful little plumper our body naturally distributes to youthful skin, and simply put, the older we get, the less we make and distribute.

“Our collagen and superficial fat melts while the deeper fat pockets lose support and start to sag as we age. These changes, coupled with weight gain due to a slower metabolism, result in the expansion of the lower face. As we age further, bone loss to the bony ridge that supports our eyebrows, causes the brow to slide down the bone slope ever so slightly. This slight brow droop is most noticed by the saggy upper eyelids that haunt many women as they try to apply mascara and further manifests in a tired, sleepy look. The chin resorbs as does the jaw line, blunting the transition between the face and the neck. This is especially noticeable in men who yearn for that chiseled, youthful look.”

Well, that’s depressing… until you realize that fillers can prop most of those issues right back up.

“A few patients, blessed with great genes and cheekbones may never notice significant volume loss until they are well into their 40’s. However, most of my patients start to notice changes in the early to mid- 30’s. Oftentimes, these patients require the subtlest hint of filler under their eyes to maintain their youthful look. In general, less is more when you start early. The goal is to always look refreshed and the best for your age, rather than the old cliché of trying to look 10 years younger.”

As a 32 year old woman, I’ll be the first to tell you a little under-eye filler is the closest thing to magic I’ve ever experienced. You can see my under-eye filling journey, here

Fillers, although they’re good for most aging faces in general, can be used in different ways— and there are even differences between the way a doctor would inject a woman’s face vs a man’s.

“Masculine facial features differ from women in several ways. Men have more pronounced, chiseled jaw lines and prouder chins than women, while women have more pronounced cheek bones that create a more pronounced ogee curve. When replenishing volume to the face, these differences must be respected and preserved.”

So which fillers are right for you? It really depends on the specifics of the way your particular face is aging. Eyes are treated differently from smile lines, and cheek plumping certainly isn’t the same business as enhancing one’s pout.

“Under eye skin is thin to begin with, magnifying even the smallest of changes. I reserve the thinnest, most natural looking fillers, such as Belotero, for the under eye area. Thicker, more form stable fillers, such as Radiesse, are best for re-establishing bony volume loss, such as when sculpting the jaw line or remolding the cheek. Juvederm Voluma and Restylane Lyft are bulky fillers best suited to restore larger volume deficits, which also aid in rotating the face up.”

Depending on the brand, style, and placement of fillers they can last anywhere from 6 months to 2 years, and are relatively affordable when compared with surgeries and other permanent measures.

“Hyaluronic acid based fillers can last between 6 months and 2 years, depending on the number of crosslinks between proteins. Sculptra, a medicine that is injected under the skin to stimulate your own cells to produce collagen, may last longer. A patient’s own fat can last for years, which sometimes makes it an ideal choice especially for the price conscious patient.”

Dr. Scarpidis also suggests combining facial lasers and resurfacing treatments with fillers to maximize the benefits of plump, radiant skin with dewy, soft skin. The combination can quickly shave years off a patient’s overall look. He also stresses that visiting a top plastic surgeon is the best way to ensure great, lasting results.

To find a board-certified plastic surgeon in your area, use the Find-A-Surgeon search tool.

About the Author

Bryce Gruber is the founder of TheLuxurySpot (, lover of all varieties of waterfront real estate and chocolate, mom to 3 high energy little ones, and a morning news host. When she's not traveling across the globe in pursuit of the best falafel or ice cream she's reading medical journals for fun. She lives, writes, and plays in New York City on ordinary days.