New Uses for Facial Fillers

AestheticsSure, we’ve all seen commercials featuring fillers for those smile lines, the “parentheses” of the face, and we’ve certainly all seen photos of Hollywood starlets who have added a little more volume to their lips. But can you do anything else with fillers?

Before we get to the fun stuff, it’s important to say that much of what we discuss in the next few lines is known as “non-FDA-approved uses” for fillers. That is to say, when the FDA approved these fillers, they approved them for injection into only certain areas (lips, cheeks and smile lines for example) because those were the areas that have been tested. With time, those of us with significant experience in injectables have expanded their use to other areas that need a little volume. This experience is vital—as cosmetic surgeons, we know where the muscles and soft tissues lie, what injections would have higher risks of complications, and into what tissue plane the least likelihood of risk would be.

Drooping brows: As we age, the tail of the eyebrow can start to droop towards the eyelid. This is in part because of bone loss to the rim of the eye socket, but also because of loss of collagen and movement of the fat pads around the eye. For very significant drooping, surgery may be the only option, but for those just noticing the problem, injection of some Restylane© or Juvederm© (both hyaluronic acid injectables) into this area can give some much needed lift and open the eye area dramatically. It may take more than one injection; some injectors like to use small volumes over 2-3 times, to get a gradual result, while others may inject 1-2 syringes at one time based on their personal preferences and the patients’ degree of volume loss.

Earlobes: Many patients with elongated ear piercings and loss of volume in the earlobe feel their ears make them look older than they really are. Placing a small amount of Restylane© or Juvederm© into the earlobe can support the ear piercing, allowing the patient to make their earrings more of a feature, and sometimes even wearing earrings a little more comfortable.

Temples: Another area often overlooked is the temples. Some patients have excellent cheekbones, and excellent midface volume, but the temples are hollow and sunken. Patients who are thin in the face in general tend to lose volume in this area quite significantly. Once the temples are volumized, the results can be quite exceptional, and allow the face to become more balanced. As we indicated earlier, this is a non-FDA approved area for injection, so experience with tissue planes and injectable types is crucial to obtaining good results. Many different types of injectable agents are used in this anatomic location. The choice will depend on your surgeon’s comfort level and preference, as well as your desire for the length of the result and extent of volume loss.

Radiesse® can be used in the temples as it lasts a long time and is injected deeply, in some cases, right on the bone. Sculptra® can also be used in the temples and is long-lasting as well, but requires some homework on the part of the patient as its main goal is to stimulate the patient’s own production of collagen, not to act as a filler in and of itself. And finally, Voluma®, which can also be injected in the temples, lasts just as long as Sculptra®, but doesn’t necessarily stimulate collagen production as its main purpose.

As experience with injections increases, and trends change, as they are likely to do, more and more uses for these versatile devices is sure to arise. As with all elective procedures, it’s crucial to feel comfortable with your injector. Experience is key, and complications can occur if the best product for a particular area isn’t used, or is used incorrectly.

Here, at the Emory Aesthetic Center, our cosmetic surgeons have extensive experience and can explain the treatment and side effects. We offer a full spectrum of options and will customize a plan that best fits your needs.

About Dr. Sethna

Anita Sethna, MDAnita Sethna, MD, understands that facial plastic and reconstructive surgery demand a marriage of science and artistry, and she enjoys using precision, skill, and vision to make her patients’ dreams reality. Dr. Sethna’s meticulous attention to detail and her passion for maintaining a natural look ensure optimum results for her patients. A dedicated teacher, Dr. Sethna is devoted to assisting residents in facial trauma or reconstructive cases at Grady Hospital. She relishes the opportunity to educate residents and medical students in all aspects of patient care. Dr. Sethna has a strong interest in several areas of facial plastic surgery research and has presented at national meetings on the importance of resident and fellow education in rhinoplasty techniques and adjunctive measures to decrease discomfort during cosmetic procedures.

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