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Male Voice: Fillers can be used not only to reduce the depth of wrinkles and lines, but to restore the volume which is lost in our faces naturally as a result of the aging process. As we age, we develop wrinkles and lines. It's never a good idea to totally eliminate wrinkles and lines because then you just don't look natural. Fillers can be used to reduce the depth of wrinkles and lines, but more importantly can be used to restore the volume which we lose in our temples, in our cheeks, and around our mouth as a part of the aging process.

As we get older our faces deflate, our cheeks become hollower and flatter, hollow dark circles appear underneath our eyes, the lips become thinner and often form wrinkles. If you've ever noticed people who are heavy, even if they're in their '60s or '70s, their faces often look youthful, and the other side of that is if you look at people with very low body fat content who may be marathon runners or athletes, they maybe young, but often if you look carefully at their faces, they don't look that young. So, volume is a key component to looking youthful.

The two major categories of fillers are those that are permanent and those that are not. I don't recommend the use of permanent fillers except in unusual circumstances. The fillers that we have which are permanent can only be modified by a surgery and therefore, we use them very, very carefully. On the other hand, fillers which can be modified are very, very attractive in a lot of ways, you can add a little bit more, you can modify the filler, you can shape it, you can smooth it and if need be for whatever reason, you can take it away.

The hyaluronic acids such as Juvederm, Restylane, and Perlane are fillers that we use in the cheeks, the lips, around the mouth, under the eyes, and lots of other places with beautiful results in a very natural subtle way. It shouldn't be apparent if fillers have been injected in an appropriate manner. We'll sometimes use a combination of different fillers at any given setting. For example, a drug called Sculptra is very often used to treat the cheeks and the temples, but we might want to use a different drug such as Restylane, or Perlane, or Juvederm in the cheeks or the mid face or the lips.

If it's recommended to you that you have different products injected, it's because certain products work well in some areas while other products are preferred in different regions. Fillers are administered in the office. There's no anesthesia required from the standpoint of IVs or general anesthetic. Usually topical numbing creams are administered and occasionally patients will take something to help them relax a little bit before being treated.

From a practical perspective, you should probably give yourself a few days of recovery period after undergoing a large filler injection. But if you need only a small amount to touch up something here or there, you can resume your normal activities typically right away. When it comes to replacing facial volume, old photographs are helpful to determine what has changed most in your face.

Injectable Fillers 101

Dr. Brian Biesman goes in depth to discuss several aspects of injectable fillers, such as what they are, what brand names are often used, what areas of the face or body are often injected, and what patients can expect for discomfort and downtime.