Aesthetic Treatments

Everything You Always Wanted to Know About Fillers — But Didn’t Know Who to Ask

Cheryl Kramer Kaye
Woman touching face

Stocksy United / Leandro Crespi

It could be a beauty proverb: As we gain wisdom, we lose volume. The fat, bone, and collagen in our faces that make us look young and plump wane over time. But with the help of injections of dermal fillers, you can correct that loss temporarily: cheekbones get volume and contour, lips get plumper, deep wrinkles get smoother almost instantly. And if you’ve been thinking about trying fillers, consider this proverb: Why put off until tomorrow what you can inject today? (Well, close enough. Remember to check with your doctor first to find out if it’s right for you!)

What’s the difference between injectable wrinkle reducers and fillers?

Injectable wrinkle reducers and fillers are both injected into the face to improve the appearance of wrinkles temporarily, but they work in different ways and on different types of lines. Injectable wrinkle reducers “reduce muscle activity so the moderate to severe wrinkles that come from frowning, squinting, raising your eyebrows, or endless other expressions are visibly smoother,” explains Ellen Marmur, MD, founder and director of Marmur Medical in NYC.

Injectable hyaluronic acid (HA) fillers, on the other hand, don’t affect the muscles, but literally fill in the areas where volume has been lost. Explains Joshua Zeichner, MD, director of cosmetic and clinical research for the department of dermatology at The Mount Sinai Hospital in New York, “Think of them like adding air to a deflated tire.”

What’s actually in fillers?

“Generally,” says Marmur, “fillers are made of molecules that attract water, like little sponges.” Hyaluronic acid (HA), which is a substance naturally found in our skin and joints, is the most popular ingredient in fillers because it works. HA has been FDA approved as a soft-tissue filler for 15 years and has an excellent safety profile; it’s absorbed gradually by your body until it eventually disappears.

Other common ingredients, says Zeichner, are calcium hydroxyapatite, a calcium-based product, and polylactic acid, an ingredient that’s similar to what is used in absorbable sutures for surgical wounds. Like most treatments, there are side effects, so talk to your doctor about whether fillers are right for you.

Why are there so many different fillers out there?

Rarely will a doctor use just one filler all over the face. Dr. Marmur gives us the perfect analogy for the reason: Having different fillers to work with “is like having a range of spices or herbs—each contributes something different to the end result.”

In more technical terms, “each filler has its own unique properties and may be best suited for a particular part of the face or special need,” says Zeichner. “Some last longer than others, some are more dense while others are more dilute, some are firmer while others are softer, some offer more plumping, while others offer more lifting.”

Where in my face can I have fillers injected?

Many of the most Googled faces on the internet have had fillers. Can you guess where they’ve likely had filler done?

Zeichner weighs in: “Fillers are most commonly used in the cheeks, smile lines, lips, and around the mouth,” the areas where fillers are approved for use by the FDA.

Does it hurt?

Typically, says Zeichner, “patients usually sit in the office for about a half an hour before the procedure with numbing cream on their face” so the injections hurt less.

Also, most of the fillers contain numbing ingredients in them, so you don’t feel much after the first injection into any given area. Some redness, bruising, and swelling is normal the first few days after the procedure, so don’t plan to have fillers just a day or two before a big event. “Depending on where the product is used, you may feel some pain or tenderness when you smile for a few days after,” says Zeichner.

How long do fillers last?

Movement tends to make fillers dissolve faster, so “in areas like the lower face, where there is a lot of movement, fillers may last around six months, while in other areas they may last upwards of 1 to 2 years,” says Zeichner.

There’s good news: The newest generation of hyaluronic acid filler formulations tend to last the longest because they contain newer cross-linking technologies that make them more resistant to degrading.  

How much do fillers (gulp!) cost?

The cost depends on where in the country you live, the area being filled, and the product being used. Fillers are measured in “syringes,” with prices ranging anywhere from $450-$1,500 per syringe. For some treatments, one syringe will be enough, but typically, two or more syringes are used.

What happens if I don’t like the way I look with fillers?

We’ve all watched The Real Housewives of Everywhere and have seen how overdone fillers can make you look puffy-faced and fat-lipped. But rest assured. Adding small amounts through the measured syringes allows for results that do not look overdone. This brings us to something very important — be sure to talk to the provider about what you want during your initial consultation.

If you do your research (like you are right now!) and go to a trusted doctor with experience and training in facial injection procedures, you’ll likely look more than just fine. Thinking about a consultation?Chat with a trained aesthetic specialist to find providers near you!

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