The Surgeon Minute

Facial Fillers: Not Just for the Mid-Face

Facial Fillers: Not Just for the Mid-Face

Fillers have completely transformed the world of facial rejuvenation. They are such an integral part of every plastic surgeon’s arsenal for “turning back the clock” that it is hard to imagine life without them. In fact, according to the latest statistics from the American Society of Plastic Surgeons (ASPS), there were over 2.6 million filler procedures performed in the last year alone.

It would be remiss to forget that plastic surgery is a specialty of innovation. While fillers were created to add volume to the mid-face, cutting-edge surgeons are utilizing fillers in new and interesting ways to rejuvenate the face as well as the body. Dr. Louis Bucky, a board certified plastic surgeon in Philadelphia, discusses how he has found solutions to issues presented by his patients through injectable fillers.

Liquid Rhinoplasty: A New Use for Fillers

“It’s probably been about 15 years since we started using fillers for facial rejuvenation,” explains Dr. Bucky. During that time, plastic surgeons have become more experienced, and the fillers themselves have become more sophisticated. There is now a wide array of fillers of different compositions. This variety is allowing surgeons to effectively use fillers in areas other than the nasolabial folds and mid-face.

Non-surgical nose surgery.

The “liquid rhinoplasty” is one such area, or non-surgical nose surgery using filler. In the right patient, a couple droplets of filler can achieve results that once were only available via surgery. Potential non-surgical nose fixes include:

  • smooth out any irregularities on the bridge of the nose
  • raise the nasal bridge
  • hide a dorsal hump
  • make the nose appear straighter

In a liquid rhinoplasty, instead of taking your bump down, the surgeon fills out the recesses so that your nose looks straight. It only takes about 2 minutes with very little bruising. Although not ideal for everyone, it’s exciting to be able to offer patients a non-surgical option for improving the look of the nose.

Fillers on the Periphery of the Face

When we look in the mirror, we tend to be focused on what is directly in front of us. This is one of the many reasons why the mid-face and nasolabial folds are such hot spots for patients seeking facial rejuvenation. And yet, a youthful looking face is a proportional face; it is always important to consider the face as whole. This includes the periphery of the face.

Fillers on the periphery of the face.

In very fit patients, the temples will often get “thin.” This atrophy can really age a patient. Filling in the temple area with some filler can lift the look of the eyes as well as the entire face.

For a good plastic surgeon, it is no longer just about filling the front of the face. “We should frame the face from the side, the jawline. We’ve even doing fillers and fat to the neck. It makes a big difference,” says Dr. Bucky.

Lift Drooping Earlobes with Fillers

As a busy facelift surgeon, Dr. Bucky is seeing more and more patients coming in worried about their ears. Women in particular complain about their hanging or drooping earlobes, a product of decades of earring wear. They feel as if their ears are “floppy” or have simple lost tone. It may even make them feel self-conscious and old when they look in the mirror.

Fillers in the earlobes.

Calling aging earlobes “droopy” is a bit of misnomer. As with the face, breasts and buttocks, the sagging or droop is not really an issue of gravity: it’s caused by a loss of volume. The earlobes are “hanging” due to deflation. Adding some filler in the appropriate places on the earlobe is a wonderful, quick solution.

Other Areas that Benefit From Fillers

Others areas that can benefit greatly from fillers are the back of the hands and wrinkles on the knees and/or elbows. Since many patients are focused on the face, they forget that the hands can be a dead giveaway of age. Lifestyle choices, particularly sun exposure and the march of time take a serious toll on the delicate skin of the hands. The underlying veins and tendons become more prominent or “ropey” looking, as well as the overlying skin becoming wrinkled and crepey. Again, one of the primary causes of aging in the hands is volume loss. Adding some strategically placed filler can plump up the hands, camouflaging your blue veins and visible tendons.

Two other huge areas of concern for many women are the elbows and the knees. Women today work out hard at the gym and eat right in order to wear the latest fashions – many of which are sleeveless and/or hit above the knee. Volume loss in both of these joints can result in the kind of wrinkled skin that would look better on an elephant. Again, adding a little filler is a simple way to rejuvenate an oftentimes overlooked area that can have a huge impact. “These are all things that experience allows us to do comfortably and safely for our patients” explains Dr. Bucky.

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