are there ways to make fillers last longer people are sometimes hesitant
about having cosmetic filler treatment because they worry that the results may
not last as long as they would like another reason for hesitation is fear of
ending up with exaggerated looking cheeks particularly after seeing people
in the media with pillowy or doughy looking faces I'll discuss how cosmetic
fillers can be placed in a way that's not performed by most doctors I apply
this method every day in my practice and achieve long-lasting and natural results
for my patients I'm Dr. Amiya Prasad I'm a Board-
certified cosmetic surgeon and Fellowship-trained oculofacial plastic
and reconstructive surgeon I've been in practice in New York City and Long
Island for over 25 years I routinely perform facial cosmetic surgery such as
facelifts and the surgical placement of facial implants this surgery based skill
set has been instrumental in my ability to place cosmetic fillers at the deeper
bone level I call this deep placement of filler Structural Volumizing as it adds
structure and definition to the face not just volume the advantage is that you
look natural not overfilled or doughy as a cosmetic eyelid surgery specialist I
believe in having a natural aesthetic in my approach to upper and lower eyelid
surgery I also routinely perform filler treatments for the eyelids lips and nose
these areas are subject to different variables that affect longevity which I
will elaborate about further to begin with when we talk about types
of cosmetic fillers I prefer using hyaluronic acid fillers such as from the
Restylane and Juvederm family of fillers hyaluronic acid exists naturally in the
body so these fillers are safely metabolized over time this is in
contrast to permanent and semi-permanent fillers which can become very complex to
manage in the event of a complication such as an infection or foreign body
reaction there are three variables which impact the metabolization of hyaluronic
acid fillers the physical characteristics like the elasticity and
viscosity the effects of facial movement and the presence or absence of the
enzyme hyaluronidase in a particular anatomic location
generally speaking thicker and more viscous hyaluronic acid fillers last
longer than softer and less viscous hyaluronic acid fillers I place thicker
fillers in facial areas where there tends to be little to no movement such
as the cheeks jawline and chin a thicker filler such as a Juvederm Voluma can
last in these areas for up to two years I find that softer fillers are better
for areas where there's more movement such as the lips when placed in an area
such as the lips softer fillers typically last about six months to a
year the placement technique used for softer
fillers in delicate areas such as around the eyes and lips is critically
important to achieve an aesthetic appearance with maximal longevity in my
experience this is best achieved using techniques where there is minimal
inflammation and minimal swelling the hyaluronic acid which naturally exists
in your skin plays a vital role in the support and hydration of your
skin as part of your body's natural metabolic processes the enzyme
hyaluronidase breaks down hyaluronic acid in the skin as new hyaluronic acid
is produced this means that hyaluronic acid placed during a procedure can also
be affected by the hyaluronidase which exists naturally in
your skin since hyaluronidase is not present in
the space between the bone and the overlying muscle hyaluronic acid filler
placed in the space does not break down in the same way as it would in the skin
as I mentioned earlier a major issue associated with conventionally placed
cheek filler is too frequently seen unnatural results like the people
walking around with soft and pillowy looking faces this doughy look is due to
filler being placed in the fat or soft tissue level which is not strong enough
to hold the filler in the intended shape it was originally placed the filler
weighs down the face or migrates to make the face look bloated by performing the
technique I use called Structural Volumizing for deeper filler placement
I'm able to achieve facial definition and more natural-looking results for my
patients this method of placing filler at the foundational bone level allows a
hyaluronic acid to essentially be stabilized by the bone and the overlying
muscle layer my patients look more defined and natural without the risk of
filler migration or their face looking soft or bloated when Structural
Volumizing is performed for the cheekbones chin jawline and jaw angle
it's referred to as the Y Lift the Y Lift is often referred to as a
non-surgical facelift I found that my experience performing
facelift surgery as well as surgical implants has been invaluable in my
approach to performing Structural Volumizing as a surgeon I'm able to feel
the levels I'm placing the filler in and be certain about the anatomy of where I
am in fact I've often observed many well-intended doctors mistakenly
believing that by contacting the bone with the needle while performing filler
placement that they're placing the fillers at the bone level in actuality
the fillers are placing is being placed at the soft tissue level or just below
the skin Structural Volumizing not only allows for enhanced filler longevity and
better definition but it can also have a lifting effect as we get older and
facial volume decreases due to bone muscle and fat loss this shrinking of
facial structure leaves less support for the skin as a consequence there appears
to be a perception of the skin sagging or stretching when volume is added at
the bone level to rebuild facial structure
a skin lifting effect often results Structural Volumizing does not replace a
facelift for people whose skin soft tissue and underlying muscles need
lifting tightening and repositioning however for a lot of my patients in
their 40s 50s and 60s with facial volume loss that is more
significant than the skin is soft tissue sagging structural volumizing or why
lift can look as if they had a facelift one of the characteristics of Structural
Volumizing is that there is very little use of needles in comparison to
conventional filler placement in fact the precision placement of filler is
done not with needles but rather blunt tip cannulas this strategic application
of blunt tip cannulas means that there is typically minimal to
no bruising swelling or discomfort I often see patients who come in
requesting a facelift assuming that they have sagging skin and jowls they're
often surprised to learn that what is commonly referred to as jowls may
actually be the result of volume loss at the mandibular notch making the area
appear to be sagging by restoring volume to the jawline particularly in the
mandibular notch area you can achieve a continuous contour and better defined
jawline your profile can be enhanced by improving your chin projection without
placing a chin implant sunken cheeks can be made more full and youthful looking
with a better definition and structure that simply isn't possible with more
traditional filler placement techniques it's important to understand that
youthful faces are not just full but also defined and balanced while results
can resemble a facelift the actual procedure to treat the jawline chin and
the cheeks can be done in about 20 minutes
patients can look pretty good right after the treatment and can even return
to work afterwards which is why some patients come in during their lunch hour
I routinely see my patients after two weeks to see how they look after
everything has settled oftentimes doctors try to overcome the limitations
of hyaluronic acid fillers placed in the traditional fashion by choosing or
selecting semi-permanent or permanent fillers which generally tend to be
thicker as mentioned earlier should there be any
complication such as infection these fillers need to be surgically removed
with structural volumizing my patients get better definition
the safety of reversibility unique to hyaluronic acid fillers should the need
arise to have to dissolve hyaluronic acid the enzyme hyaluronidase sold under
brand names such as Vitrase or Hylenex can be used to safely dissolve the
hyaluronic acid without needing to perform surgery by combining
longer-lasting and thicker hyaluronic acid fillers with advanced
techniques such as Structural Volumizing I'm helping my patients look their best
at any age my approach to maximizing safety with
longevity and reversibility has helped my patients enjoy a more youthful look
for much longer periods of time than had been previously possible with
traditional approaches to the application of hyaluronic acid fillers I
hope you found this information helpful thank you for your question
you