Correcting The Overfilled Face

We have all seen it, the woman or man with abnormally plump features, with lips that look like a rubber duck, or a face that looks like a bloated fish. They may be turning heads, but it is for all the wrong reasons.

How does this happen? First, it takes two to tango. On one hand you have a patient pushing for less lines or wrinkles and a fuller face, thinking plumper is younger. On the other hand you have a provider (who may or may not be a legitimate plastic surgeon or dermatologist) willing to over-fill the face in an attempt to make the patient happy, or due to their own skewed vision of beauty.

The real question is how does anyone think this makes them more beautiful or younger looking? Well, it often starts with a small amount of filler tastefully done, resulting in a fresher look that the patient immediately notices and likes. This may be a small amount to the nasolabial folds to decrease the appearance of the laugh/ smile lines, or filler below the eyes to fill the “tear trough” making one look less tired, or a small amount to the cheeks to provide a small lift and volume augmentation.

This instant gratification has a funny effect on some people. They get used to the new look, and start thinking if a little is good, then more will be better. When it comes to fillers this is absolutely not true. At the heart of the matter is becoming focused on just one part of the face and forgetting how the face looks as a whole.

Examples of what Dr. Patel has seen:

1- A patient who has the nasolabial lines filled at another clinic returns to her doctor and says “well there is still a fold” and insists on having it filled until the fold is gone. This doctor complies in an effort to please the patient, and accomplishes her goal of erasing the crease entirely. What happens after?

Her friends start asking if she is okay, since her face is a puffed up version of what she used to be, with a heaviness to the lower face making the whole face look distorted. Her smile only accentuates this abnormality since the cheeks no longer move like they used to, and it looks like her lips are trying to part two mountains.

Finally in a photograph she sees that it looks odd, and feels embarrassed that she got so distracted about this one crease that she distorted the whole face. She was surprised and embarassed by the compliments she was receiving as it disappeared.

2- A patient who went to another clinic for Botox was told she should have filler placed underneath the eyes to make her look less tired. The assessment may have been correct. However, the problem was that the nurse who had injected it had chosen the wrong type of filler for this area, and injected it into the wrong location.

She was left with puffy bluish tinted pillows along her lower lids, making her look way more tired than before, and with “bags” that she did not have before. She required multiple rounds of injection with hyaluronidase and steroid to correct the problem, and still is not quite the same.

3- A patient who had a lot of loose skin and sagging tissues of the face due to aging, who was seen by a dermatologist who recommended a “non-surgical facelift”, or fillers in place of surgery. She was injected with seven syringes of filler and dissatisfied that she looked plump and bizarre, rather than just old. Ultimately the patient let the filler wear off and was given the option of selective filler to look a little better while age-appropriate with volume, or having a facelift to truly reposition the tissue and get rid of the extra skin.

Does this mean fillers are bad and should be avoided? Absolutely not. In the right hands and the right patient, the results of filler injection can be phenomenal. A patient can look significantly better without anyone knowing why, or knowing they even had any fillers.

The trick to making someone more beautiful with fillers requires the following:

-having an eye for beauty

-knowing the anatomy of the face and how it changes with age

-understanding the “ideal” proportions of features, yet still making sure to customize to the individual

-knowing how adjusting one part of the face changes the overall harmony and look of the face

-knowing how to maintain the natural movements of the face

-being educated on the different options of fillers, and knowing what to put where for the best result

-knowing the risks of each type of filler and how to prevent them

-having technical skill and finesse with injection techniques

-knowing how to fix a problem if it occurs

So, when you see Groupons or local spas offering these services, ask yourself if you are confident the provider has the above qualities. This is your face after all. When done poorly, fillers make a person either look bizarre or look older. Worse still, occasionally complications from filler can be severe, including things like loss of skin on the face, or loss of vision.

It is important to note that even fully trained and qualified providers can have patients experience problems, yet the difference is they know how to manage those problems. Any office providing fillers should have hyaluronidase, an enzyme used to dissolve any hyaluronic acid based filler, in the office or readily available.

Generally speaking fillers are safe, non-invasive, and can produce excellent results.  The fillers Dr. Patel uses in her practice include Restylane, Juvederm, Belotero, and Perlane. The treatment plan can include simultaneous treatment of multiple areas, or can be done step-wise for the patient new to fillers or patients on a tighter budget.  Dr. Patel provides complimentary cosmetic consultations to discuss your  goals and come up with a comprehensive plan for rejuvenation.

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