Patients often worry that fillers will make their faces rounder. The effect of fillers depends on how they are used. A skilled injector needs to be able to 1) assess your needs and 2) create a plan that will give you a good result. The variability among skill levels is dramatic, so make sure you go to someone with experience. My goal is to make your face look younger, while retaining a natural appearance. In a patient that is showing signs of aging, achieving this goal often depends on creating a more oval shape. A youthful face is a series of unbroken curves: the curve from the forehead down to the cheekbone, the curve of the cheek, the curve of the jaw. In the aging face, the curves are disrupted, with areas of fullness (jowls, nasolabial folds, under-eye bags) interrupted by areas of loss (marionette lines, tear troughs). A skilled injector can use fillers to lift the face creating more volume on the top half. We also aim to soften the transitions between areas of fullness and areas of loss. The goal is to create a surface that reflects light (and decreases shadows). At the same time, we must keep in mind that the skull is shrinking while the envelope of the skin is enlarging. The goal of softening folds and wrinkles has to be secondary to maintaining a natural appearance. We have other tools in addition to Voluma to help us get the effect that we desire: energy-based devices such as ultherapy to tighten the skin and underlying layers; sculptra is a wonderful product that helps rebuild the foundation of the face.