Thank you for your question.
You submitted your question with two photos and you state that you, several months ago,
underwent a filler correction with Juvederm in the cheeks, the lips as well as in the
smile lines.
And you state that you’re happy with the cheeks and the lips but with the smile lines,
you are not so happy.
And your doctor stated to you that they don’t really like doing the smile lines.
Now you’re concerned about doing under eye hollows and you have perceived or became aware
that in salons near you, different brands of fillers are offered.
So your question essentially is about changing brands or whether to stick to one brand.
Well, I can share with you my personal philosophy about fillers and placement as well as this
ongoing perception about brand identities that are relevant to correction of different
issues of the face.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
I have literally been a part of the evolution of the use of fillers since the very early
days where there was only the collagen, Zyderm and Zyplast.
And since then, I’ve certainly become very well-known for the use of fillers particularly
in the Juvederm and Restylane families.
And I can give you, basically, an overall understanding of how I approach these areas
and how I suggest you to do moving forward.
So to begin with, I think it’s very important for everyone who’s interested in having
fillers done to make some specific distinctions.
Essentially fillers, like pharmaceuticals, are produced and promoted by multibillion
dollar companies.
And it’s in their interest to create consumer demand for their products.
But the product is not worth anything unless it is placed properly by a skilled practitioner.
And so, when you think about the differentiation of the United States and other areas of the
world, the menu of fillers varies.
And yet, there are many skilled practitioners able to get consistent results with limited
numbers or with large number of fillers.
So how is that possible?
Well, I’ll tell you that, as far as the brands are concerned, there is a spectrum
of the behaviors and particular characteristics of the fillers of the Juvederm family as well
as the Restylane family which are both hyaluronic acid fillers.
And there are differentiations based on their relative thickness, their elasticity, their
longevity.
And based on your doctor’s comfort level and familiarity, doctors choose what they
prefer.
Now that being said, I think that what you can reasonably conclude about your experience
with your doctor in terms of the cheeks and the lips, the smile lines, is that specifically
with the smile lines, the nasolabial folds, this is an area that I think most doctors,
either would confess that the nasolabial fold is not as so easy to treat.
It has to do with the anatomic nature of that area.
And rarely can you get a 100% correction because you’re treating a line as opposed to structure.
And speaking of structure, in our practice, we do a procedure called structural volumizing.
And so in people who have issues with the nasolabial folds, very often when I restore
volume by placing the filler at the bone level to improve the cheeks in a way that is more
directly integrated with the bone structure, then the nasolabial fold doesn’t look as
prominent or as deep and that is the art of sculpting of creating this balance.
That being said, separating that from the different fillers, I would say that if you
are really interested in getting consistency, then you should identify a practitioner who
is skilled in using different fillers and is able to establish for you the outcomes
that you are looking for, at least, close to achieving.
I would dissuade you from going to what sounds like salons like hair salons versus medispas.
A lot of times, these places don’t have either doctors, at least in the United States,
don’t have physicians who are present or their model is more of a volume discounting
model.
And very often, patients just bounce from one to another instead of finding the right
doctor who can offer them the solutions and the long-term relationship that really, ultimately
is more productive and results in better consistency as well as in the end, is actually more cost
effective instead of bargain shopping which happens certainly in the US.
With that being understood, I would say, differentiate the product away from the practitioner and
the method of placement.
That technique and the practitioner’s style are very important.
And especially when it comes to treating the area that you’re concerned about, the under
eye hollow area, getting that area just right and having the best result is really an art.
And I think that you will find that if you find the right doctor who can help you with
all those areas that you’ll want to stick to the doctor as opposed to chasing the brands.
The brand does not produce the result.
It’s the doctor who performs the procedure.
And the art of this is for the doctor to choose the right products that are suited for each
area based on their experience.
And so certainly, it’s a balance.
And of course, doctors don’t promote the way the companies do but at least the consumers
become aware of what’s available and certainly, there is a value there.
So either go back to the doctor that you already had the experience with or look for a doctor
who you feel to be comfortable with doing all these different procedures.
And that way, you can at least go to someone for some consistency and get consistent results.
So I hope that was helpful, I wish you the best of luck and thank you for your question.