I am interested in fillers but scared the results may backfire due to horror stories I have read?

Question

I am interested in fillers to fill in under my eyes (looks hallow) and for folds around my mouth/nose. I have read some horror stories about fillers gone wrong..... Is there a specific type of filler that I should use for these areas and is there a way to determine if the person injecting is skilled enough? Thanks, Grace

David Shafer, MD, FACS · Answer

It is important to do your research before having dermal filler treatments.  Make sure your injector is experienced and check their credentials.  Any doctor can buy the product, so be careful.  However not every doctor has the same training.  Some doctors inject a few patients a week, while others, like myself, inject hundreds of patients a month, teach filling techniques locally and nationally and have extensive experience with and have in their office all the dermal fillers available.  There are several different fillers to choose from.  As a first time patient, I would suggest an HA filler.  The reason is that HA fillers are reversible or can be "melted" if you don't like the result.  There are other nice fillers like Radiesse and Sculptra made of different materials, but these cannot be removed, so I reserve these for patients that already have experience with fillers.  For the HA fillers, you could chose from Restylane, Perlane, Juvederm or Belotero.  The Juvederm brand has Ultra, Ultra Plus and now Voluma.  Which filler to choose really depends on the area you are having treated and I would leave this choice up to your injector - assuming they are experienced.  Without seeing you in person or even pictures, it difficult to give you more specific advice.  When you have your evaluation, don't be surprised if the injector suggests having injections in areas that are not specifically in the areas that you are concerned about.  For instance, many patients point to their nasolabial creases (folds around their mouth and nose), however, having the injection along your cheek bone instead can help lift the skin around your mouth and make those creases smoother while maintaining a more natural result than having too many injections around the month leading to a puffy look.  Another consideration is that you may also benefit from a neuromodulator such as Botox, Dysport or Xeomin around your eyes and/or forehead as well as the dermal filler treatment.  Often doing a Botox Cosmetic treatment at the same time can help improve the overall aesthetic of your face and maintain the most natural result.  Taking a global approach to your face instead of a pinpoint treatments helps maintain an overall balance and facial harmony.  Good Luck.

John J. Martin, Jr., MD · Answer

Most complications from fillers occur from injecting the wrong type of filler into an area, or from poor technique.  You should first know that if your physician uses an HA filler - hyaluronic acid - filler, there is an enzyme called hylauronidase that can be injected which will dissolve the filler.  So if for some reason you don't like the way you look after an HA filler, you can reverse it and go back to your original look.  The HA fillers include:  restylane, perlane, Juvederm and belotero.   There are differences in the HA and some fillers are better suited for certain areas.  Any experienced injector should know this. Long-term or permanent fillers are much riskier. They have a higher incidence of nodule formation, and should not be used in certain areas - for example in the tear trough.  So to stay out of trouble - use an HA filler!  If you like the look, you can use a longer term fill in the future, or fat.

Steven Wallach, MD · Answer

Yes, there are some horror stories. Often by unqualified injectors. Best to find out their credentials before having the procedure done.

I am interested in fillers but scared the results may backfire due to horror stories I have read?

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I am interested in fillers but scared the results may backfire due to horror stories I have read?

Answers (3)

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Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.