So just as an introduction, if you’re wondering is Botox a facial filler, the answer is no, basically, there are two main types of injectable treatments today: neurotoxins like Botox and Dysport, and facial fillers neurotoxins are used to basically weaken muscles that create wrinkles muscles like the glabella.
I’ve had a little bit of Botox here in the past, which has caused me not to be able to create those deep 11 signs that I could in the past, forehead wrinkles as well as crow’s, feet wrinkles. These are typically best treated with a neurotoxin like Botox or like Dysport.
Fillers are used to fill in lines or wrinkles or plump areas up and the way I describe it to my patients. It’s like liquid skin. You inject it into areas that you want to plump up now. The original filler was collagen and back gosh.
Now, a couple decades ago, collagen was very popular as a way to fill in lines, while the newest fillers are typically hyaluronic acid based, and these are much better than the old collagen, because they last longer and they are reversible.
Okay, and so if you inject the the hyaluronic acid substance into let’s, say a part that you don’t like or you get a lump from it or god forbid. It goes into a blood vessel. You can inject hyaluronidase, which is basically an antidote to it that will melt it away and that’s.
A super important reason why, if you’re gonna get facial injectables go with a hyaluronic acid based injectable, with one exception, and I’ll. Go over that here in just a little bit, because the hyaluronic acid fillers are going to be these safest.
So what I’m gonna do on this. Video is just go from the top down okay because they get so many questions of okay. What do I fill my name’s, Lily billfolds, with what’s best for the cheeks? What’s best for the temples every doctor has their own opinion and I’m, not going to tell you that my opinion is the best for everybody, but I’ll.
Give you my opinion in this video so that you know that if you’re gonna have an injection. What I recommend talk with your doctor and see if, if that doctor recommends the same thing, so once again, if you’re looking at forehead wrinkles, if you’re, looking at wrinkles of the glabella or the crow’s, Feet Botox is the way to go.
Okay, this port is an alternative version by the makers of Restylane. That’s, a very good treatment as well, but that’s. What I would recommend first for those lines, and hopefully coming out very soon, is the newest botas competitor called cheveux.
Jabo is something that has been in the pipeline for many many years, and I’m, really excited for that to come out and by the time you watch this video it might be out and might be rocking and rolling people may be really enjoying Their results from Chivo, but as of this video, Botox and Dysport right now are what is available for these lines up through here, as we go down the face.
Okay, super common question: what do I do to fill in my under eye hollows? We get this question all the time, so I am God all of my boxes here of all the different fillers that we do here at UN plastic surgery.
So I’m gonna go over what I recommend for these specific areas so that you know what is best for you. So if you’re looking at under eye hollows, the filler that I recommend for that is Restylane L, okay, wrestling L is wrestling with lidocaine.
This is once again a hyaluronic acid filler. If you’re, injecting under under the eyes. Ideally, you want your doctor to inject small amounts. Usually if you have one syringe of wrestling, a one cc syringe that’s more than enough to fill the under eye hollows.
So like point, four CCS on each side is usually enough for most people. The risk of getting the under eyes filled is lumpiness okay, so you have to be very careful there. Fillers, I don’t recommend under the eyes.
This is the one if you go for anything, go with the traditional wrestling L for the under eyes and, like I said, the reason why I recommend that is because it has a lower risk of lumpiness, unlike some of the other fillers that may absorb, moisture and Pump up after you inject it rusting L does seem to stay about what you see.
So what you see is gonna be what you’re gonna get and unlike, if you inject it into the lips, if you inject it under the eyes, it can get pretty darn good lunge evety. Some people get over a year when it’s injected under the eyes all right.
Well, how about let’s, go up a little bit. Actually, I forgot the temples. This is an area that a lot of people forget about when they’re looking at injectable fillers, but the temples are an area that really can thin in so many of us as we get older and it’s, an area that A lot of us don’t really realize I get so many people that come in to see me and they say yeah there’s.
Something about my face. I feel like my face is too thin, but I don’t know where to fill, and quite often it’s, temporal wasting where this area gets thinner and thinner and thinner. So what I recommend for that – which is the easiest, is Sculptra now I mentioned earlier that hyaluronic acid fillers are the ones that I typically recommend for most of my patients.
The only non hyaluronic acid filler that I recommend is Sculptra Sculptra is poly L, lactic acid. As you can see – and this is basically it’s like a powder that you mix with water, you inject that mixture into areas of the face and what it does is for a day or two that water may stick around and then the water Dissolves away and the Sculptra powder that’s left under the surface, will interact with the surrounding tissues, to increase the collagen content and to gradually fill that area out the negative with Sculptra is.
It does typically take two to three treatments for maximal effect. The positive of Sculptra, though, as it results, can last two years or even longer, and for those people who really want a very gradual change, Sculptra can get that for you.
The reason why an ideal sculptor in general is safe compared to some of the other non hyaluronic acid fillers is because it’s injected in a bear, a dilute fashion. Okay, it’s kind of like if you’re mixing, kool-aid kool-aid mixing that is, is still a liquid okay and even if it’s accidentally injected into a blood vessel, the risk of it clogging that blood vessel is Lower than if you get some of these other thicker fillers that are in XLE injected, so if you’re, looking at the temples sculpture is a very good treatment.
Literally it’s, one poke, and what we do is we make a 1 poke, go all the way down to the bone. Believe it or not, don’t worry. It won’t, go into your brain because there’s bone in the way, and we inject it buried deep right on top of the bone below the muscle in the temple area and that helps to gradually fill that area out.
Now you could consider a different type of a filler Restylane, like I mentioned earlier, that could also be used in the temple area. You could also use a filler like a standard Juvederm and where is it driven or multiple us? This can also be used in the temple area as well.
I’m, not as big of a fan with the hyaluronic acid fillers in the temple, just because there’s, a big blood vessel that comes right through that area, and I just don’t want there to be any Chance that we could accidentally inject the filler into that blood vessel, and so for that reason for the temple for most my patients, I recommend Sculptra once again, we’ll need, though, typically three treatments to get maximal effect, sometimes more, sometimes less all right.
What about the cheeks? The cheeks, are a very popular area to inject. I love injecting the cheeks because one of the areas of our face that loses volume really the main area, in my opinion, that lose volume that can really benefit from it as we get older, are the cheeks and when I first started my practice back in 2004, The only real good filler we had at that time was fat and I did a lot of fat grafting in the first ten years of my practice, but now that we’ve gotten a number of injectable fillers that are FDA approved for the cheeks.
I’m, doing a lot less fat grafting than before. Now the my top choice, typically for injecting the cheeks is Juvederm voluma. Now Juvederm voluma is a nice in that it’s very similar to regular Juvederm.
It has a different type of a cross-linking pattern to it, and the great thing about Juvederm voluma is that it lasts a long time. You can get upwards of two years, usually a year and a half to two years with Juvederm voluma.
So the voluma is what I typically recommend for plumping up the cheeks, because you get such good longevity from it. The negative of voluma it’s, a bit more expensive than the other fillers, and some people who are a bit on a budget may opt for the wrestling virgin, which is wrestling.
Lift wrestling lifts is another very good filler. It is FDA approved for the mid-face, basically to plump up the cheeks. The benefit of wrestling lifts, / voluma, is that it is less expensive. The negative is, I don’t think it lasts quite as long.
So if you’re thinking about having your cheeks injected and you’re, not sure that you’re gonna, like it maybe best to go with G wrestling lifts as a way to try it out. If you like it, and you want something longer-lasting, then you may want to try graduating to the Illuma a final option.
If you don’t want to spend a lot of money at one time here’s. My green drink is Sculptra. Sculpture is a great filler for the cheeks as well. This I use quite often in the cheeks for people who say look.
I don’t, have the budget to spend on let’s, say two syringes of voluma or two syringes of lift, but I can spend less each time and come back a couple of times to do Sculptra. So you can definitely use sculptor for the cheeks.
I think it’s, a very good filler for the cheeks it just takes longer. So, typically, you need once again three treatments, maybe more maybe less we space those out every really six to eight weeks or so, and so for those people who are okay with a gradual filling out, then Sculptra is a way to have that done.
You spend less each time, maybe instead of spending $ 2,000 in one shot, you spend 500, but you do it three or four times so that’s. Another option all right as we go our way down as we go down the face: nasolabial folds.
These are the most popular areas to inject the nasolabial folds. Are these static lines that go from the corner of that of the nose to the corner of the mouth, and the majority of injectable fillers are FDA approved for that area, but not all of them are the best for that area.
So let me show you what I recommend. Excuse me for the nasolabial folds Juvederm Ultra Plus. This is a workhorse for the nasolabial folds, and the reason why I like this is because it has good longevity.
It can last a good year, or so it’s, a very nice and easy injection, and it’s very moldable. So you can massage it at the time of the treatment to reduce any, let’s, say potential lumps and that type of thing a great filler.
You can use Juvederm, Ultra Plus in so many different parts of the face. The only place that I recommend you definitely not have it injected is under the eyes, but otherwise you can use it off-label technically for the cheeks for the lips and that type of thing too, but what I recommend as far as nasolabial folds.
This is a great filler for that Juvederm recently-released val Bella giambo Bella another great filler for the nasolabial folds. I would use Bal Bella in a patient where the folds aren’t quite as deep.
I would use ultra plus in a patient where the folds are deeper. Okay, because I do believe that Juvederm Ultra Plus has a bit more of a lifting capacity, then of all Bella. All Bella’s, a bit of a softer injection.
So somebody where the folds a little bit softer, they want something a little more moldable, a little less stiff. Then ball Bella may be a better option, but if you’ve got a deep nasolabial fold.
You want to consider Ultra Plus well. What else can you use rustling define? This is why the newest wrestling products, a very, very popular product in our office, rustling, define, was originally used in Europe and still is under a different name called Emmer Bell, and what this is specifically made to actually inject into parts of the face that move, because The filler will actually move with the parts of the face, one of the things that a lot of people are concerned.
If they have injectable fillers, is getting let’s, say stiff appearance afterwards, you know. So if you have the nasolabial folds down it. Looking and feeling stiff and fillers like wrestling define and its cousin or brother or sister refined, are used basically to inject into those areas and allow those areas to still look and feel soft and mobile.
So this is another great one for the nasolabial folds kind out. My top choice, if the folds are really really deep, but if they’re, not that deep, this or bow lure, I think, are fairly similar products.
I like both of them a lot if it’s, a stiff fold, though, if it’s, a real deep one, then once again, Ultra Plus is good, and then I should also mention you can use wrestling lift in the nasolabial folds.
As well, so if you’ve got deep folds wrestling lift is a great filler for those deep folds as well all right how about the lips? The lips are super popular to inject and unfortunately, people are having them injected too much, as you can probably see in photos and videos from people out in Hollywood.
So there are a lot of fillers once again that you can use for the lips. Let me show you the workhorses Juvederm Ultra Plus we use this and lips all the time. This gives a really nice pumping effect to the lips and it lasts a good amount of time 6 to 12 months or so typically the neck and the positive.
This once again, it’s, a powerful lifter, so you can really fill the lips out nicely mmm. It does a really good job with outlining the lips and it lasts quite a bit of time. The negative is, you may get a little more of a dramatic result with this okay.
So if you’re, looking for a softer result, you can consider Juvederm ba bella. Juvederm vol bella is a softer filler, that is FDA approved for injection around the lips, and so this is a much softer filler similar to like a velour.
But this one’s made specifically for the lips last anywhere from 6 to 12 months as well. Once can give me a bit of a soft look. Are you looking for a real pouty, more of a dramatic appearance? This may not be the best one for it, but if you’re, looking for just a modest kind of a soft change and filling out, then ball Bella, maybe a good one.
For you, another one is Restylane silk. This also is FDA approved for the lips and is a great filler for filling out the lips and another one is Restylane. Refine rustling refine is the cousin brother sister, whatever you wan na call it wrestling define.
This does not quite have the lifting ability of define it is softer. It is once again mobile a really nice filler for the lips. The only question is: does deep does refine and ball Bella, which are the two really soft fillers? Do they last as long as Juvederm, Ultra Plus or wrestling define? Maybe not.
We do see some patients where they do seem to disappear a little bit more quickly. That may be a bit of the negative of going with the softer less one skin dramatic, powerful lifters. For the lips, so you got a lot of options for the lips honestly with the lips you can do.
You can do once again: silk, you could do Juvederm Ultra Plus, you could do Restylane, refine and vol Bella. Those are all very reasonable options for the lips. If you’re gonna, have it done really talk with your plastic surgeon or your dermatologist to get their opinion on what would work best for your lips and a lot of it comes down to what your expectations are? Alright? Well, what else we’ve got fine lines around the mouth.
These are really really hard to treat because in so many people these smokers lines are so fine that it’s hard to get a filler in actual needle to inject and fill them. But if they’re deep enough, then what I recommend for those types of lines are wrestling refine: okay, cuz it’s very soft.
You can inject it into these tiny little wrinkles another one that’s really good. For that is ball Bella, okay, once again, very fine, fine filler! If it’s slightly deeper, then I find wrestling. Silk is another option as well.
So those are the three that I would do for the lines around the lips would be Restylane silk. Once again, Juvederm val Bella and Restylane wreaths, five and then marionette lines or another area very commonly treated it’ll, be the same things that I would recommend for that is we do for the lines around the mouth so once again, it would be The wrestling silk, the Juvederm Val Bella and the wrestling refined, depending on how deep those lines are.
Sometimes you may need something a little bit stronger, in which case the wrestling define is usually what I recommend for that, or you could even consider a Juvederm voluma again a softer filler. I’ll, feel that is more moldable.
It tends to move with the surrounding facial structures. Finally, I’ve had a lot of people that have come in to have their chin injected. Once again, when I started my practice back in 2004, I did a lot of chin implants.
We did fit fat to the cheeks chin implants to fill out the chin, and nowadays I’m – doing a lot less of that, because we can do injectable, fillers so very commonly. I use a filler like wrestling lifts for the actual chin and it’s, a good filler, we inject it.
I inject it right on top of the bone, underneath the muscle to enhance the chin and it’s, a very, very nice treatment for that um. So these are the variety of different fillers for all the parts of the face.
I hope this has been helpful for you remember if you’re going to have fillers what I recommend dr. Ewing, the holistic Beauty doc recommends is a highly Roenick acid filler. Overall, the only non hyaluronic acid filler other than fat that I recommend is Sculptra and I think sculpture is great for the temples and for the cheeks do not inject it around the mouth.
However, okay cheeks and temples Sculptra and the cheek hollows sculptor, I think, works very very nicely a couple other things to keep in mind. The number one complication we want to avoid is intravascular injection of the filler that’s.
Why? You do really want to be choosy on who does this, even if they use a hyaluronic acid filler, the worst thing that can happen? Is it’s accidentally injected into a blood vessel, and there are blood vessels that go all up like that into our face that can cause horrible horrible complications ranging from scarring believe it or not – even blindness so having a inject injectable, an injector.
That is very experienced that has the backing or is a board-certified plastic surgeon or dermatologist is super important, make sure it’s. A hyaluronic acid filler make sure they have hyaluronidase available.
Hyaluronidase is the antidote there’s, no point in having an antidote available and not having it there. Okay, because a lot of times you want to have this injected right away. If that complication happens, so ask your doctor: do you have highly Ronna dates available? If something you know if something bad happens, and then finally, one thing that recommend for all my patients whenever possible, is that we use a cannula.
Cannulas are long, blunt needles that we inject the fillers with it costs us a little extra it’s, not a guarantee that you won’t get into a blood vessel with it, but it lowers a risk of that happening, and so All of my injectors here at yps myself, we we use cannulas whenever possible, which is probably realistically 80 plus percent of the time.
Sometimes you get a little line here or the mouth lines you can get that with a cannula, but in most areas like the cheeks like the cheek hollows like even the lips, we can inject most of that with a cannula for optimal safety.