When injected with HA fillers, do the fat pads in your cheek and jowls, etc. (malar pads, etc) re-position themselves?

Question

I'm confused as to whether or not HA fillers are able to actually re-position the fat pads in your face (if injected with them) or if they're only able to re-inflate them, since I know that, as you age, the fat pads but deflate AND move positions on the face. Please clarify.

Nelson Lee Novick, MD · Answer

With age, certain facial fat pads shrink and shrivel to become remnants of their former selves and also sink downward and inward (with gravity) to cause such problems as smile lines, marionette lines, and jowls along the jawline. When, for example, the heart-shaped fat pad that sits under the eyes shrinks and shrivels and goes southward and inward, it also leaves a "vacuum" in its wake below the eyes that gives rise to the tear troughs, hollows and bags that become so troublesome with time.When HA volumizing fillers (as well as calcium-based ones, such as Radiesse) are used to rejuvenate these areas, we are not repositioning the fat pads. Instead we are simply adding volume, lift and three dimensional projection to the deflated areas in order to restore and reconstitute their more youthful contours. Since volume replacement with volumizing fillers, unlike the simple filling of lines and folds, is as much art (more like sculpture) as science, it behooves prospective patients to be sure to seek out consultation and treatment at the hands of experienced and expert board certified aesthetic core physicians with years of experience, rather than inexperienced injectors who have learned at a two day seminar via a lecture how to simply fill smile lines with a filler.

Sheryl D. Clark, MD, FAAD · Answer

Dear 'brunette:'Yours is a very good question.  When you inject fillers, for the most part you are trying to replace volume exactly where it it has been lost, because of bone, and to a lesser extent, fat resorption.  When this volume is replaced, the fat pads can be lifted somewhat, although it is unlikely that they will resume their former positions.  The facial recontouring approach implicit to volume replacement will result in a natural and revitalized appearance, but will not make you look 25 years of age again -- nor, I would imagine, would you want it to?I hope this is helpful to you and would be happy to answer any other questions you might have.All the best, Dr. Clark

Joseph A. Eviatar, MD, FACS · Answer

Depending on your anatomy and the way the fillers are placed, they can both augment your natural volume as well as "lift" the fat pads which often sag a bit as we age.  Re inflation of the fat compartments can accomplish both, if performed correctly and if that is what you need.  Sculptra, a collagen stimulator, is especially good at this as it is usually injected (off label) into the various fat compartments to elevate and volumes them creating a natural appearing lift and rejuvenating the contours of the face.   That's why it's important to seek out a board certified injection specialist who understands the anatomy of the face and how to make the results look entirely natural, with the least amount of product.I hope that helps and best of luck!

Kevin Tehrani, MD, FACS · Answer

Re-volumizing is the main goal of dermal fillers. As one ages, the fat pads decrease in size showing more skin laxity. This may accentuate flaws in one's face like the deepening smile lines and dark circles around the eyes. Injecting dermal fillers can easily replace volume loss but also augment certain parts of the face with strategic injections if desired.

Steven Wallach, MD · Answer

The filler product enhances what you already have and can help elevate the fat pads a bit as they are injected into the given area.

When injected with HA fillers, do the fat pads in your cheek and jowls, etc. (malar pads, etc) re-position themselves?

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