Any suggestions for face fillers? (photos)

Hi - I'm very dissatisfied with my face. I'm only 32 years old but I feel like I'm aging very quickly. I'd like to get restylane under my eyes to fill in the horrible dark circles that I've had all my life plus botox for my forehead. I also feel like my cheeks sag a lot so not sure how that could get corrected with fillers. Help! What would you suggest to make my face look more youthful!

Doctor Answers 12

Aging face

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Thank your for your question.  A more youthful face has volume with gentle curves.  Multiple modalities are available to reach this goal, including fillers, neurotoxin and laser.  I suggest a formal evaluation with a board certified dermatologist or plastic surgeon experienced in facial rejuvenation.  Good luck

Hollow cheeks and dark circles under the eyes

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Thanks for your photo.  I would recommend Voluma to your cheeks and Restylane to your tear troughs.  You will likely need 3-5 syringes of Voluma and 2 syringes of Restylane depending on your profile views.

Good luck!

Any suggestions for face fillers?

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  • Hi, based upon the attached photos, the cheeks are very flat making the face appear a bit elongated. I don't see a profile view, but I also suspect that the chin is weak which can amke the mid face area appear relatively top-heavy. The under eye issues are worsened by the lack of cheek fullness anteriorly (in the front). Based upon the aesthetic factors discussed in my book on face and body beauty dermal fillers can be used to shape and feminize your face. You may wish to consider the following procedures or treatments:
  • Cheek Augmentation wirth a dermal filler for fuller, more round cheeks anteriorly.  I prefer using Perlane for this and it typically requires 2 syringes, one to shape each cheek.
  • Cheek Implants for a permanent cheek enhancement.
  • Cin Augmentation with a dermal filler.  I prefer using either Perlane or Radiesse for this.
  • Chin Implant for a permenent enhancement of the chin.
  • Upper Lip Augmentation with a dermal filler using either Restylane or Juvederm.
Hope this helps.

Any suggestions for face fillers?

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Restylane® and Belotero® are great fillers for filling under eye hollows, and Juvederm Voluma® is great for lifting, volumizing and enhancing cheek shape.

Manjula Jegasothy, MD
Miami Dermatologist

Facial Fillers

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Thank you for sharing your photograph.  A combination of a small amount of Botox on your forehead, Juvederm Voluma for your cheeks, and Restylane under your eyes would greatly improve the areas of concern.  The key is to consult a board certified dermatologist with experience with these cosmetic injections for the most natural looking results.

Any suggestions for face fillers?

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Thank you for your question. As we age, our bodies naturally lose collagen over time, but there are many external factors that affect the rate at which we lose collagen such as: excessive sun exposure, poor skin care regimen, and poor diet which are all essential elements that make up for your skin’s healthy complexion. Hyaluronic acid fillers and injectables do a wonderful job to volumize and lift the face to give you a rested and refreshed look. Botox is a popular injectable that many patients request due to its ability to lift and rejuvenate the eyes, and also relaxes fine lines and wrinkles. In fact, many patients in their late twenties use Botox as a “preventative wrinkle” treatment to help paralyze overactive facial muscles that cause fine lines and wrinkles to prevent the early onset of aging.

Hyaluronic acid fillers are also a great choice to rejuvenate the eyes and lift the cheeks. Restylane, a naturally occurring molecule in the skin, is injected underneath the eyes to provide instant volume in the skin. This is a quick, non-invasive procedure that is often considered a “lunchtime procedure” and the results last for one year. In my practice, we use cannulas to avoid the bruising. No needles are used. Fillers provide natural looking results that help rejuvenize your skin. Voluma is another hyaluronic acid filler that is FDA approved to lift the cheeks and the results can last up to two years. A board certified Dermatologist can inject these fillers to provide a natural aesthetic outcome.

You may want to consider Ultherapy if you are interested in long term results. Ultherapy is a non-invasive treatment that uses advanced ultrasound technology to target the deep layers of the skin to tighten sagging skin of the jawline and naturally lift the cheeks and brows. This is a commonly requested treatment in the office. Patients love this procedure because it provides natural results that stimulates the growth of your own collagen. The results with one treatment last approximately three years.

Ariel Ostad, MD
New York Dermatologic Surgeon
4.3 out of 5 stars 17 reviews

Skin Rejuvenation

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The best treatment for skin rejuvenation and prevention depends upon an individual’s skin type, age, ethnicity, sun exposure, and overall health. I recommend  a healthy lifestyle: a diet high in fruits, vegetables, nuts, legumes and fish; eight to ten hours of sleep nightly; limiting alcohol intake other than the occasional glass of red wine; and regular exercise. An important step for all skin types is sun protection including the use of daily sunscreen, sun hats and sunglasses, all of which help prevent aging and sunburns. When it comes to rejuvenating and prevention treatments, a combination of treatments are available including cosmeceuticals (skin care products including ZO® Skin Health or ZO® Medical, Skinceuticals® or Glo-Minerals®), neurotoxins (Botox®, Xeomin®), dermal fillers (Restylane®, Juvederm®, Esthelis®, Belotero®, Emervel®, Radiesse®), and skin resurfacing procedures (advanced laser resurfacing or OBAGI® controlled depth chemical peel).  These are advanced techniques so be sure to get an experienced dermatologist or plastic surgeon consultation for recommendations and treatment options.

Go slow and make wise choices.

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There are several things that may help you.  The problem is that there are more than enough doctors who will want to inject you anywhere and everywhere with anything they've got.  This could create problems.  You would benefit from a comprehensive evaluation and an understanding of what algorithm to follow.  What would happen if you injected the Restylane to the tear trough (which I think is a bad idea) first.  What if you improved the volume of the cheeks first and see how that changed things?  What product would be best without risking looking weird or swollen?  I would advise you to see a board certified plastic surgeon, who could give you carefully considered options.  Good luck!

Non-surgical facial firming and filling or Surgical facial volume lifting

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Dear elopez83:

Various options for "facelifting", minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below.

Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material.

Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a "facelift".

Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed.

The most popular of the fillersRestylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting "cousin "Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial ("parentheses") and marionette folds, the brow ("number 11") lines and fill and lift the cheeks and lateral brow or chin.Voluma is the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!.

Non-surgical facial contouring is possible with fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin as well.

Scuptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent.

Botox and Dysporttoo have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles!

Dr. Obagi's new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin.

IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation.

Thank you for sharing this photo with us. Based on this photo, I believe you would benefit from:
  • projecting facial fillers such as Voluma, Perlane, fat in the deep cheek compartments and / or evaluation for a mid-face lift. A Mid-Face Lift would carry the soft tissues of the cheek directly upwardly to fill the cheek with the fat and other loose tissue of the jowl, reduce the nasojugal fold, nasolabial fold, elevate the corners of the mouth and possible soften the marionette fold. 
  • ZO Obagi Skin Health will provide exfoliation, cell regeneration, luster and firmness to your skin
  • mild added fullness to your upper lip vermillion 

Please consider any of these and other procedures and their combinations with a proper examination by a Board Certified Plastic Surgeon or ENT Facial Surgeon who performs all of these options so you will not receive a biased approach because he or she are limited in their skills.

Facial fillers

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I think that you need to be seen in person to determine what could be best for you.  Facial fillers are excellent choices for the right individual.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.