Where is the best area to place fillers in the face for the most optimal result? (Photo)

Question

So in general where does the face age first? Undereyes? Cheeks? Jowels? And what area is the best area to place fillers and see the max result for the money. I keep hearing cheekbones will lift everything back up but i would think filling the cheekbones would take quite a lot of filler. Side question for liquid nose job some say radiesse some say no its too lumpy and use juviderm ? Which is best to disguise indent on bridge? Thanks so much in advance!

Nelson Lee Novick, MD · Answer

One of the primary age-related changes in the face is the shrinkage, shriveling and downward and inward descent of the cheek pads of the face (which are heart-shaped, convex fat pat pads that sit directly under the yes and sweep from the inner eyelid area to the crow's feet area and descend about half-way down the cheeks toward the angles of the mouth).  The results of this downward and inward descent are the formation of the smile lines, marionette lines, jowls along the jawline and hollowing and tear troughs below the eyes. Clearly then, since volume loss from the cheeks is at the root of the problem, volume replenishment with volumizing fillers can often very dramatically remedy the problem. So, this is where I typically start--i.e. by addressing the cheeks, which often leads to significant, immediate improvement. After that, any remaining problems under the eyes or residual nasolabial fold and marionette lines or jowls along the jawline may be addressed directly. In my Upper East Side Manhattan office, I typically address cheek volume replacement with a combination of Voluma XC and Radiesse. (In my Israel satellite office, where a far greater number of regulatory agency approved fillers and volumizers are available, I typically use Emervel Volume, Stylage XXL and Hyaluronica 3 for this purpose).For nonsurgical nose jobs, I use Perlane L combined with Radiesse in NY and Hyaluronica 3 and Restylane SQ in Israel.

Jason Emer, MD · Answer

Fine someone who will individualize your treatment plan and inject the best fillers for your goals.  As well, they should use cannulas to get results without swelling, bruising or pain.  Best, Dr. Emer.

Dana Goldberg, MD · Answer

There is no "one size fits all" approach to fillers and facial aging. Volumizing the cheeks gives a very youthful look, but it can take up to 4-6 syringes and still leave some need for softer fillers near the lips and tear troughs. In my opinion, the most economical approach for full correction would be to use Radiesse for the cheeks, nasal folds, and in the area in front of the jowl (maybe 3ml total). Then, something softer, like Restylane, could be used in the tear trough area and around the mouth. That could also be used for the nose (maybe 2ml total for all areas). A minimal approach would skip the cheeks and focus on the perioral area. Radiesse comes in a larger size (1.5ml) than Juvederm Voluma (1ml) and is less expensive in most offices, but unlike Voluma, Radiesse is not dissolvable if the effect is unsatisfactory or it looks lumpy (another reason to try a softer filler like Restylane before Radiesse for the nose). Both Radiesse and Voluma last over a year. Restylane lasts about 6 months. Good luck!

Naveen Somia, MBBS, PhD, FRACS · Answer

Thanks for your question.Every face ages differently, but the common ones are under eyes, cheek, and Jowl areas.I fill the Cheek and Jowl area first with a dense long acting filler for Structural support and longevity. Next I fill the Tear Troughs and nasolabial folds with a softer filler. I use Modelis and Belotero ( Esthelis) but you could use Voluma and Juvederm Ultra.You are looking at 4- 6 mls of fillersAll the best

Darryl J. Blinski, MD · Answer

Liquid facelift option using upto 4 Voluma for cheeks, 4 Juvederm for NL folds and lips and nose. Restylane silk for tear troughs + BOTOX! Fee for all these is 8,000 same as cost for mini FL/NL wih advanced PRP+stem cell injections ...

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