Why You Shouldn’t Be Afraid of Fillers, Per a Dermatologist
The general category of fillers in aesthetics has not had a great few months. From filler scans to speculation-based stories of celebs who’ve dissolved them, it seems like a whole lot of people have something bad to say about the treatment.
“Yes, filler phobia is real—and, yes, there is a point where enough is enough,” Phoenix, AZ dermatologist Dr. Karan Lal succinctly says. “But it’s mainly because we often see bad work and overfilled faces.”
While he isn’t placing blame on the term, Dr. Lal is also quick to say the concept of “facial balancing” has skewed people’s views of reality.
“And, yes, filler does stick around for a long time—longer than we expected,” he is quick to admit, adding that that can offer an upside: “But we can use that to our advantage. Not only does filler add volume to the face, but it is biostimulatory and helps your body build collagen in sites of injection,” Dr. Lal explains, while offering this breakdown of what to consider:
Different Types of Filler, According to a Dermatologist
Simply put, there are many different types of fillers, and none of them are a one-size-fits-all solution. “There are hyaluronic acid fillers, which can be divided into Vycross or Non-Vycross,” Dr. Lal says. “Vycross products like Juvéderm Voluma, Volbella and Volux are highly cross-linked, which makes it harder for your body to break down it down and allows it to last longer in the skin.”
Both Vycross and non-Vycross fillers are cross-linked, but Vycross fillers incorporate technology that blends high- and low-molecular-weight hyaluronic acid. “There is some concern that Vycross products are associated with delayed onset nodules. And I have seen them, but we are not sure how or why they happen,” says Dr. Lal. “We’re also not sure of who they will happen to. If someone has a chronic inflammatory disease, I typically avoid Vycross products. But I love Vycross when possible because they provide the best longevity in my practice.”
The RHA collection of fillers is also unique in that it is very close in composition to your natural body’s hyaluronic acid, explains Dr. Lal. “I personally don’t use RHA in my practice, but it is a great product for those that want a softer look.”
And then, there is the Restylane line of products, which has multiple profiles. “They have Kysse for lips, Contour for cheeks, Eyelight for undereyes, etc.,” says Dr. Lal. “These, too, are hyaluronic acid products, and all have unique properties. Restylane has NASHA products that are meant to provide structure, like Restylane Lyft, and they are minimally modified in their creation process. OBT technology by Restylane, like Kysse, is meant for mobile areas so the filler moves with the tissue and within the tissue. This avoids lumps and bumps.”
There are also non-HA fillers, like Sculptra (a biostimulator that helps with natural collagen production), that can last even longer.
“Next up, we have Radiesse, a calcium-hydroxylapatite filler,” says Dr. Lal. “This is great for providing structure and is a strong biostimulator. This is great for the jawline and cheeks. I personally don’t use this in my practice because there is no dissolving agent to correct an issue should it occur.”
Lastly, there is Bellafill, which is FDA-approved for acne scars. “This is a strong biostimulator. But it requires skin testing first to make sure people aren’t allergic as it has bovine collagen in it,” Dr. Lal explains, adding that the most important fact to remember is this: “Hyaluronic acid fillers can be dissolved if people are unhappy with the results.”
What to Consider When Getting Filler, According to a Dermatologist
When it comes to fillers, Dr. Lal says it is imperative to remember a few things:
“No one needs a yearly touch-up, and I’d go so far as to say you should avoid such practices,” he says. “Do what makes you happy and within reason. And be mindful of the person injecting you. If they look like they are over-injected, you may end up looking like that, too.”
Do not fall into syringe-buying traps, Dr. Lal warns. “Filler placement, when done appropriately, knowing the anatomy can provide excellent results. I seldom do more than two syringes at one visit. This is not how everyone practices, nor is it the ideal way, but it’s my way. It also depends on the type of correction and concerns.”
Filler doesn’t provide facelift results, so do not fall for the “liquid facelift” marketing and have realistic exceptions. “We are adding volume and lifting skin, which is very different from ‘facial lifting,’” says Dr. Lal.
Choose your injector wisely. There are risks associated with filler use, including lumps, bumps, infection, blindness, stroke and death of the skin. “Injecting filler into a blood vessel can lead to serious damage including blindness and stroke,” Dr. Lal warns.
