On: April 22, 2021 In: Blog Comments: 0

Interest in plastic surgery is at an all-time high, but stigma and misinformation still surround the industry and patients. Welcome to May Pharm, that aims to explain cosmetic procedures and provide all the information you’ll need to make the decision that is right for your body — no judgment, just the facts. Here, we’re covering everything you need to know about fillers. 


We hear it from experts every day: Cosmetic injections are not akin to haircuts and shouldn’t be approached with the same it’ll-grow-back attitude, since having prescription drugs and medical devices — as neurotoxins and fillers, respectively, are classified by the Food and Drug Administration — shot into one’s face can carry consequences far more serious than a botched bangs trim. But doctors’ crusades against being too cavalier about fillers is constantly receiving pushback. In Los Angeles, for instance, the hair analogy is being spun as a win by an injectables outpost dubbed the “Drybar of  Botulinum Toxin,” which offers hyaluronic acid (HA) fillers (like Metoo, Rejeunesse, Revolax, V-Line SOL), neurotoxins (botulax,  neuronox, innotox, re n tox), and fat-melting Kybella, with a breezy-as-a-blowout, nothing-to-fear vibe.

Injectables are big business: Over two million people received botulinum toxin or filler injections in 2017, according to the American Society for Aesthetic Plastic Surgery. The popularity of temporary HA fillers, specifically, has soared 85 percent since 2012. And practitioners of all kinds — with varying degrees of training and experience — are capitalizing on the demand.


Consequently, doctors are seeing a dramatic rise in both complications (from fillers, in particular) and plain, old bad work. Beyond fixing her daily share of filler-related lumps and asymmetries incurred by other injectors, New York City dermatologist Shereene Idriss has more and more “patients coming in looking like caricatures of themselves — with disproportionately large lips and flattened nasolabial folds — due to misplaced filler injected by untrained practitioners,” she says.


And while some fillers can be dissolved with a quick shot, not all mistakes are so easily undone. “With every kind of filler, there’s the risk of unintentional injection into a blood vessel, which can result in skin death, scabbing, scarring, even blindness,” Idriss adds.


That said, fillers are generally very safe when injected by board-certified dermatologists and plastic surgeons armed with an intimate knowledge of human anatomy and “filler crash carts” stocked for potential complications. (Shoutout to New York City plastic surgeon Lara Devgan for sharing that gem of a term.) But this is merely rule number one of getting filler. Read on for everything experts want you to know before submitting to the syringe.

Despite their chemical similarities, the HA gang is actually a very diverse group. These 14 gels vary in density, viscosity (or flow), elasticity, lift-ability (or stiffness, what docs call “G prime”), and longevity — traits that shape their personalities and determine their role among fillers. 

Depending on how a formula’s molecules are strung together, some HAs will break down faster or swell up more than others (and while that added oomph may benefit areas like the cheeks, nobody wants puffy under-eyes post-injection). Doctors take all of this into consideration when selecting the right product for you and your features. Which brings us to our next need-to-know….

Fillers can do more than enhance lips and downplay wrinkles.

They can elevate sunken scars; reinflate hands; brighten cavernous under-eyes; and sharpen jawlines that have gone soft.  For the transparent under-eye area, injecting a fine layer of a more fluid HA — one that doesn’t swell or cast a bluish glow (something known as the Tyndall effect) —can lift the skin up and away from underlying vessels, obscuring discoloration and hollows.


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