Each volumizing agent has its own set of characteristics that make it the right choice depending on what you are looking to tackle, how long you want the results to last and what you are willing to endure (in terms of downtime and recovery). “It’s all about using the right ones in the right areas of the face on the right patients,” says New York plastic surgeon Alan Matarasso, MD.
If you have never had fillers or injectables before, stick with hyaluronic acid fillers since they can be reversed if you don’t like the way you look, and they fade over time.
If you have a wasting away of the cheeks or are a hard-core exerciser and have gauntness in the cheeks and chin area, fillers such as Sculptra Aesthetic or Radiesse may be better since they provide more of a filling effect.
The Quick Fix: Fillers and Injectables
Depending on the degree of deflation in your face and how much sagging skin you have, your dermatologist or plastic surgeon can inject hyaluronic acid fillers or collagen-stimulating injectables to reinstate deficient areas. “Picking which filler to put where has a lot to do with the way the product flows through the syringe and into the area. For smaller spaces, you want something more viscous, but larger areas like the jaw and cheek require filler to be placed deeper, which is why Radiesse, Sculptra Aesthetic and Juvéderm Voluma XC work well,” says Dr. Matarasso. Fillers are best for those who have minimal to moderate fat loss and need subtle improvement. If extra skin is a problem, they can cause a doughy or pillowy look.
How Long They Last: About six to nine months or longer. When fillers are done right there should be a natural-looking reflation.
Best For: Those undergoing other surgical procedures: Fat Transfer
Some patients prefer surgery over having a foreign substance put into their face—and that’s where fat comes in. To obtain the fat, your surgeon will perform a microliposuction procedure (you may be a little swollen for a few days after) and spin down the fat cells before injecting them. Unlike fillers, fat transfer requires some downtime, ranging from a few days to two weeks if large amounts are placed in multiple areas. “Fat is more cost-effective when you find yourself spending a lot on fillers annually,” says La Jolla, CA, plastic surgeon Robert Singer, MD., adding that it gives a smoothness and vibrancy to the skin. Some doctors, like Northbrook, IL, Plastic Surgeon Iliana Sweis, MD., feel that liposuction patients should use the removed fat to augment the face (as long as it is needed). “It’s your own tissue and instead of discarding it, make use of it.”
How Long it Lasts: Fat lasts long-term, but it may not be a permanent solution for everyone.
The Permanent Solution: Facial Implants
Made of solid silicone (or other materials), cheek implants (your plastic surgeon should size them before inserting them) give constant definition. “Implants are a good option for someone who needs a lot of correction that would require extreme amounts of filler or fat to make a difference,” says Dr. Sweis. They are also advantageous for those who are very active and have very little body fat. “If you work out a lot and have fat grafting done, there’s the chance that you can burn off some of the transferred fat. But with implants, you don’t have to worry about that,” says Westlake Village, CA, facial plastic surgeon Kristina Tansavatdi, MD, who often adds fat on top of the implant to smooth out any contours, so that they become virtually undetectable.
How Long They Last: Indefinitely
Insider Tip: According to Dr. Singer, most dermatologists and plastic surgeons avoid using permanent fillers in the face, other than fat, because of the potential for long-term problems and complications.
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