Facial balancing (filler) recommendations, is Belotero the best? (Photos)

Hello, my name is Dr. Burko and I am a Plastic Surgeon at SY Aesthetics in NYC. Facial rejuvenation using fillers is a very customized and tailored approach to each individual patient. There are multiple products on the market that can be used for each injection site. Providers sometimes prefer certain products over others due to comfort level and experience. Most fillers typically maintain their results for approximately 9 months. The amount of filler used is also very subjective and I like to make the decision at the time of consultation and I tailor it as I am injecting.

Hi! Belotero is a GREAT choice when it comes to undereye fillers. The reason why we prefer to add Belotero to the undereye is because, since it is a clear gel, it will not cause a tyndall effect when placed superficially. It is a hydrophobic filler and does not absorb as much water as some other fillers can. Using a hydrophobic filler under the eyes is very important due to the delicate structures surrounding. For some added support, it is recommended to add filler to your cheeks as well in order to build a base for the undereye. I would start with about 2mL in the mid cheek and 1 syringe of Belotero to the undereye!

Thank you for sharing your questions and posting your photos. You should have your lower eyelid tear troughs filled by an experienced oculoplastic surgeon. This area has the best results with Restylane if injected properly. Good luck!

Your issue is one that I see practically every day in my practice. Appropriate projection of the upper cheek not only serves to create a more ideal oval, heart-shaped facial contour, but also serves as a major structural support for the under eye area. As such the use an appropriate volumizing filler, such as Voluma XC for this region properly injected can serve not only to enhance the cheeks and diminish the flatness you wish to address, but will also significantly improve the tear troughs and infraorbital hollows prominent in both the front-face and profile photos provided very likely without the need for any direct treatment of the under-eyes with Belotero. . This was precisely the case with the last patient I treated this afternoon who literally had these same two issues and was treated as above and exclaimed an immediate "Wow!" when she looked in the mirror right after treatment. In experienced hands, treatment takes about ten minutes and engenders little to no significant downtime. Just make sure to consult with an experienced, board certified cosmetic dermatologist injector. Best of luck.

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Thank you for your question. Improving the 3 dimensional projection of face is often best achieved with properly placed facial implants. Fillers don't lift, they fill and may have temporary improvement; however, these filler have their own weight and they will ultimately weigh down the tissue into which they are injected and will cause even more sagging. With regards to correcting the tear trough deformity, the brand of HA filler is not nearly as important as the skill and experience of the physician performing the injection.

You do have significant volume deficit of your mid face. This is easily filled with either a filler or fat. Be very careful, however, if you decide to use filler. Belatero is absolutely the wrong filler for this purpose. To properly correct your problem you need a heavy filler like Juvederm Voluma placed deep on the bone below the orbital ligament or on the muscles. Two syringes will probably treat the upper area. If you wish to increase the fullness of the mid malar area, then it will take at least two more syringes.