Filler injection is a popular ambulatory procedure and is often used for restoring soft tissue volume or augmenting bony deficiencies. They are often performed in combination with botulinum toxin injection for synergistic results. There is a wide range of fillers with various different characteristics to suit each individual’s unique anatomy and help them meet their aesthetic goals.
Aging of the face brings about the most significant difference to an individual’s perceived age. There is thinning and laxity of the skin, formation of fine wrinkles. There is also deflation, descent and loss of the cheek prominence. Facial grooves and bulges form after the third decade: these include the tear trough deformity, mid-cheek groove, nasolabial folds (laugh lines), jowls and marionette lines. The lower eyelid, cheek and lower face appear to be one single unit in youth. With advancing age, these subunits of the face gradually become distinct and separate and are delineated by bulges and grooves. These changes may appear as sad, angry or tired-looking to others, and may adversely affect body image.
In other individuals, there may be underdevelopment of the nasal bone and chin. The nasal bridge may appear low and flat, contributing to an apparent widening of the distance between the eyes. The chin may be vertically short (microgenia), lacking forward projection (retrogenia), or a combination of both. Underdeveloped nasal bone and chin often diminish one’s masculine image and many affected individuals seek their correction.
Facial aging is a complex multi-factorial process involving the skin, subcutaneous fat, the facial muscle (SMAS) layer and the facial skeleton. These include:
These changes result in the formation of facial bulges and grooves including the tear trough deformity, midcheek grooves, laugh lines, jowls and marionette lines.
Underdeveloped nasal bone and chin manifest following the completion of puberty and are heritable traits that are common in Asian men.
Age-related skin thinning and laxity of the skin occurs more significantly in women than in men due to their inherent difference in skin thickness. Skin is thinner in women than in men. The predominant mechanisms of aging in men are fat loss and deflation, and laxity of the SMAS (muscle) layer. Because men have heavier soft tissue and require the use of firmer fillers in higher volumes to achieve a significant lift as compared with women. Intimate understanding of the differences in anatomy and aging mechanisms between both genders and administering gender-specific treatment delivers attractive, optimal and bespoke outcomes.
The fundamental question really is, “What are my aesthetic goals?” Individuals are unique in their desires and inherent anatomy. The choice of filler is based on the most appropriate product suited to achieve the expected result. Picasso Plastic Surgery carries a large range of fillers with different characteristics that will help individuals meet their aesthetic goals.
We frequently see or hear of people who look unnatural following aesthetic treatments. This is often due to practitioners who attempt to reverse all the signs of aging by using revolumization techniques alone, resulting in an overfilled “pillow face”. Filler injection does not reverse skin and muscle laxity or ligament lengthening. Choice of the incorrect filler type will also result in irregularities that become more prominent when an individual animates the face.
Attaining bespoke and natural-looking results that retain an individual’s expressivity is frequently possible and requires accurate assessment, appropriate product choice, precise administration by an experienced practitioner.
Delivering effective and safe treatments are the cornerstones of our philosophy at Picasso Plastic Surgery. Safe filler injection requires an experienced practitioner with intimate knowledge of the anatomy, precise technical execution, appropriate product choice and adopting relevant preventive measures to prevent complications. Picasso Plastic Surgery uses only products obtained from licensed distributors.
Ideal individuals who may consider filler injection include those with good quality skin and mild to moderate degrees of facial deflation and/or minor degrees of bony deficiency.
Dr Yeo is an experienced botulinum toxin and filler injector and is a trainer for several botulinum toxin and filler product lines. He frequently delivers lectures and conducts workshops on effective and safe filler administration in the Asia Pacific region. Picasso Plastic Surgery carries a large range of fillers that will help individual achieve their varied aesthetic goals. Near-painless injections are possible at Picasso Plastic Surgery with the use of a proprietary pain distraction device at the time of injection.
The effects of filler injection may be observed immediately following the procedure. Depending on the anatomical region injected, most fillers will be resorbed in 6 – 9 months and repeat treatment is required to maintain the result.
Individuals are advised to avoid vigorous massage or rubbing to the treatment area for 2 hours following the filler injection to minimize the potential for bruising. Individuals may resume their usual activities immediately following the procedure.