• FillersFillers – To continue my posts on treatments that are truly effective in helping all of us win the fight against aging, today I want to discuss fillers. Specifically, why we use them, what they are made of and where they work the best. For those of us in the injectable industry it is easy to forget many people do not know the difference between botulinum toxin (Botox) and filler. In short, botulinum toxin inhibits muscle function wherever it is injected and where you do not have muscle function, you do not get creases. Filler on the other hand, does just what it sounds like it does, it fills.

    As we age we all begin to lose volume. The next time you see a 20 year-old woman, pay close attention to her cheeks. You will notice they are FULL of volume. It is hard to tell where her lower eyelids stop and her cheeks start. In our thirties the signs of aging begin and into our forties and fifties those signs accelerate. We end up with significantly less cheek volume. We begin to develop grooves separating our lower eyelids from our cheeks and or smile lines seem to get deeper and deeper. Appropriate use of fillers helps replace this lost volume and restore or maintain a more youthful facial appearance.

    The vast majority of filler today is made of synthetic hyaluronic acid. Our skin naturally produces hyaluronic acid and our skin cells use it as a scaffolding. This makes it an excellent filler because the immune system does not recognize it as foreign. The various fillers include Voluma, Volbella, Juvederm Ultra, Juvederm Ultra Plus, Vollure and many more. They last anywhere from nine months to two years and consist of varying thicknesses. It is easy to imagine a softer filler would be needed if one is trying to increase lip volume while a thicker filler may be needed if one is trying to add significant volume to the cheeks.

    Generally, fillers work best in the lower two-thirds of the face. This includes the cheeks and around the mouth. It is excellent at adding subtle volume to the lips. I would absolutely advise using an experienced injector. Over-filling the face and lips looks fake and a common mistake for inexperienced injectors to make and even some experienced injectors.

    If you are considering filler injections and are not sure where to go let me make it easy for you. Call our office and come see us. We have a relaxed, low pressure environment and we will make it safe but fun. However, if you live too far away or cannot come to Flower Mound Plastic Surgery & Aesthetic Spa, then start by choosing a board-certified plastic surgeon (NOT A COSMETIC SURGEON – there is a huge difference) who does his or her own injecting and has a lot of experience doing it. Next, look at the staff at the medspa or clinic you are considering. If they all look over-filled and fake, then know that is probably how they inject. Conversely, if the staff looks natural, it’s probably a safer bet.


    Drew Sanderson, MD
    Board Certified in Plastic Surgery