Hyaluronic acid fillers, or “HA fillers” for short, have boomed in popularity over the past decade and it is a procedure I personally perform often.   The evidence for this growing trend can be seen in the many advertisements for these products, as well as the many injectors found in medical offices and store-front med spas. It is very common to find nurses, physician assistants, dentists, primary care doctors, and even anesthesiologists performing injections. Too often, patients are told something and then wind up with an undesired look. So, can HA fillers really lift the cheeks and get rid of jowls?  Let’s explore that. 

There are many soft tissue fillers on the market and HA fillers are just one category. JUVÉDERM® and Restylane® both fall into this category. While they are not the only ones, they are the most well-known.   If you are considering fillers, there are some important things you should know: 

Understanding the limitations of fillers saves you from looking injected

All soft tissue fillers do just what the name implies… they “fill” the tissues and make things bigger. But do they lift?  The answer is not nearly as much as people think.

HA fillers come in a range of  “thicknesses”.  While a “thicker” one might be better at adding fullness to the cheeks, a thinner or more fluid one might be better suited for lip injections.   Fillers do as the name suggests. They expand the tissues.   So when injecting the cheeks, there may be a little lifting effect on the skin. But fillers do not achieve a directional pull, such as with a surgical procedure.   So should patients with sagging skin avoid HA fillers?   No, but patients should be aware of those aging changes that affected their appearance.    

Often times, as one ages, the face loses volume in the form of fat.  And the skin changes and becomes looser.  The result is sagging facial features.   HA fillers predominantly help restore some of the fullness that was lost.   And with more volume comes some skin tightening.  But the effect is limited.  

Many of the non-plastic-surgery injectors miss that point and continue to inject fillers until the skin is tighter.     They may have achieved the goal of tighter skin but at the expense of having over-filled features.  The result can be an odd or distorted appearance caused by too much filler.  It can happen in the cheeks, in the lips and even in the chin.   Dr. Tepper has extensive experience helping patients regain a more youthful and natural appearance.  

It’s important to work with a plastic surgeon who understands facial balance. 

Dr. Tepper has seen many patients who were initially injected elsewhere but were still unhappy with their appearance. Too often, the modern day “injectors” who aren’t board certified plastic surgeons overpromise results.   A plastic surgeon is ideally suited to help you understand how HA fillers can help your appearance while at the same time, properly guiding you when HA fillers may not be the right treatment option.  It is important to consider the entire face and to understand the natural relationship that exists between the different parts of the face and between the upper and lower lips.  Once you understand the aging process, you can better select appropriate treatments. And what might work well in a younger patient can have undesired effects on someone who is older.

Different providers may have their own sense of what’s attractive and appealing.  Some may not understand the limits of any particular treatment.  Dr. Tepper is highly skilled at both surgical and non-surgical facial rejuvenation and will often spend a considerable amount of time discussing one’s appearance, the changes that occurred, and how HA fillers may help.  His goal is always to help patients achieve a natural, more youthful version of themselves, without the of over-filled effect.

Don’t just go with any provider that is offering to perform your HA filler injections – make sure you put yourself first and find a plastic surgeon that will give you the personalized attention that you deserve. 

If you’re considering soft tissue fillers and want to learn more, you may schedule a consultation here.