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Contouring vs. plumping with fillers

Posted:10:06 a.m. Monday, May 5, 2014

By Anita Mandal, M.D.

Question: I have very hollow cheeks and temples and am told that I need injectable fillers. I see so many plumped and unnatural faces. Even some of the richest movie stars look fake. Is there a filler that will make me look natural and refreshed?

Answer: It is unusual for the filler, itself, to cause an over-plumped or unnatural look. More often, substandard injection technique and/or an inadequate understanding of the areas to be injected, on the part of the injector, is the cause.
Precise knowledge of which areas to inject and which to avoid, especially in the upper face which often requires more volume filling than the lower face, is key to a natural result. Unlike two dimensional facial wrinkles and grooves, the upper face should be analyzed in three dimensions to best identify the specific subsections to treat.
The goal with injectable fillers in the cheek, temple and forehead is creation of specific contours to add definition to the face. Injecting a filler to give generalized facial volume rather than only treating specific subunits can often give an over-plumped or “fat” looking face.
A facial plastic surgeon who understands facial anatomy and performs a high volume of filler treatments for specialized areas is the first step. Overfilling can be avoided with proper injection technique and detailed knowledge, on the part of the surgeon, of 3 dimensional facial anatomy.

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