Purpose of Dermal Fillers is to restore or correct certain areas of the face when volume loss becomes apparent. In the face they can be injected virtually every where by an expert physician. Each area of the face has its own anatomy and the injections should follow specific rules that comply with the anatomy and physiology of the specific region that needs to be treated. Also, the injector has to establish a goal of the specific treatment and on this base discuss the modality, the different materials that can be used, the quantity, the costs and eventual risks and possible complications.
Non-surgical ‘eye-job’ with natural fillers offer long lasting results and a significant improvement of your eyes, erasing signs of fatigue and ageing:
Recent articles has shown that 80% of the patients seeking an aesthetic improvement of their face with a non-surgical treatment expressed a major interest in rejuvenating the appearance of their eyes.
The same study proved that the area that most patients noticed to have shown the first signs of aging were the eyes. That’s why it is important the role of a physician dedicated the the aesthetic of the eyes only, the oculoplastic surgeon!
The area of the face that most often I inject are the lower eyelids with the goal of correcting the ‘tear trough’ deformity, dark circles and lower lid bags. Also the eyebrows can be injected laterally, giving a more full appearance and a lift effect to the tail of the brow. The cheek with the malar eminence is the second most injected site in my practice, alone or in conjunction with the lower eyelid. Restoring the proper volume in the cheeks/malar region will restore the natural V-shape of a youthful face, corrects the lower eyelid/cheek transition reforming high cheekbone.
And all this is achieved with a simple injection, invisible signs with an effect lasting as long as more than 1 year, depending on the product and amount of filler injected. Finally the nasolabial folds, the jaw area and the chin area can all be effectively injected at the same time.
Dermal fillers materials
Now days all the marketed products are all re-absorbable and therefore temporary fillers. They can be made with hyaluronic acid or calcium hydrossiapatite; there are many brands, but I use only the ones that are FDA approved and that have the longest reports of patient safety and satisfaction. Botulinum toxin and fillers can be used together to treat different areas of the face with excellent compatibility. Can botulin toxin and fillers substitute surgery? Botulin toxin and fillers are a complement to surgery. Patients not ready for surgery can use these treatments as an initial procedure to attain rejuvenation.
Treatment: all treatments are performed in the office with minimal downtime and is painless. Occasionally, a small ecchimosis of the treated area may require ice packs and a minimal make up for the first 48 hours. Volume replacement techniques are becoming increasingly popular for the correction of periocular volume defects. Volume defects in the periocular region are typically localized between the inferior eyelid and the cheek, but can also occur in the superior sulcus.
The naso-jugal groove medially, also known as ‘tear trough’ deformity can extend laterally to the arcus marginalis forming the so called ‘hollow’. Infraorbital hollows can have a constitutional basis and as such be present since adolescence or can occur with aging, affecting young adults and middle aged patients. The presence of infraorbital hollows is often associated with lower lid ‘bags’ and/or ‘dark circles’ and the various combination of these defects gives a sad, tired look to the entire face. As oculoplastic surgeons we are the first doctors consulted by these patients and we should possess as many tools as possible to address these problems.
Each patient should be treated with individualized choice of material including hyaluronic acid, Radiesse or lipofilling (fat grafting harvested from the patient himself) based on the patients desires, expectations, fears clinical indications.
Possibly due to the white color of the material which allows to improve the dark circles at the same time, my personal preference is Radiesse in young patients and fat grafting for middle aged patients which require some associated surgical procedure.
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