Dermal fillers are very popular cosmetic treatments to enhance facial features aesthetically. They are injected into the soft tissue of the skin to shape and contour the facial features to perfection.

Filler injectables are also used to fill out the soft lines and wrinkles in the face to help correct etched lines. But most importantly, fillers help restore the lost volume and fullness of our facial features, creating a beautiful harmony between them. 

The world of cosmetic enhancements has to offer endless options for non-surgical beauty treatment: fillers, lasers, microdermabrasions, creams and prescription injectables. Dermal injectables are the most popular and fastest growing treatment amongst these.

Whether you’re curious to try a facial filler for the first time or have had the treatment before, we bring to you some fascinating insights into this non-surgical beauty treatment from Dr. Joel Kopelman’s Beauty Doc podcast. Dr. Kopelman is a recent conversation with Dr. Vince Bertucci discuss all about fillers their benefits and risks. Dr. Bertucci is a popular and globally respected board certified dermatologist and has also served as past President of the Canadian Dermatology Association.

What are Dermal Fillers?

There’s no question that many men and women would love to lessen the appearance of lines, deep wrinkles or the lost volume in their faces. With new pain-free cosmetic treatments around, this is not just possible but also quite easy.

Dermal fillers refresh and rejuvenate the facial skin and also reverse signs of aging like lines, wrinkles and spots. Beautifying the face by enhancing facial features through filler treatments is also very popular amongst beauty aficionados. Dermal fillers prove to be great alternatives to surgical cosmetic procedures.

These fillers are soft tissue injectables which help in:

Rejuvenation of the skin: They help correct or reverse age related issues like etched lines and wrinkles, shadows and other skin related problems 

Beautification of features: Fillers are one of the fastest growing treatments that help enhance and modify the facial features. For instance, someone may have small lips or a chin which is not very well projected or defined. Dermal fillers are an easy treatment to help recreate beautiful features with minimal side effects.

Types of Fillers

There are many different types of dermal fillers. Depending upon the downtime that you may have and the kind of results that you want, your cosmetic doctor will suggest particular cosmetic filler treatments.

Hyaluronic acid fillers are the most popular ones and also very easy to use. They have very few side effects and when injected for treatment give immediate results. By ‘immediate’ we mean that you can go to the clinic and get it done in an hour or so and the results will be visible. Yes, it’s True! 

This is one reason why these relatively risk-free fillers have become extremely popular go-to skin and facial treatments for many women. Some of the very common fillers are Juvederm and Restylane. 

But the best thing about hyaluronic fillers is that they are reversible. If something were to go wrong with your treatment, they can be dissolved. For example, dermatologists can immediately reverse the results of a bad filler treatment that you may have had before. A filler blockage in the veins can also be reversed which will not lead to big underlying health problems later.. 

Scultptra is another type of soft tissue filler used for global volume restoration. Global here implies the whole face. The amazing thing about Sculptra is that while enhancing and plumping the face, it also improves skin quality. It adds to the youthful springiness of your facial features. 

So surface wrinkles and lost volume in the skin can easily be treated with Sculptra. Unlike hyaluronic fillers though, Sculptra also called polylactic acid, is a series of treatments that takes some months for the best possible results to come out. Obviously the treatment has more longevity. But it’s not reversible. And so your dermatologist has to be very careful while using Sculptra.

What does the Dermal Filler Treatment Involve?

The most important part of filler treatments is perhaps the initial consultation. Coming up with an assessment and treatment plan for a patient is the most difficult part of the process. Dr. Bertucci however, says that there is nothing that a good consultation with your doctor cannot solve. 

Talking about his own treatment process, he says “I listen to my patients in an open ended way and then ask for their permission to do a full face assessment. This is because I feel that while they may want to get only their lips or cheeks done, as a cosmetic dermatologist I also have to recreate a beautiful harmony between their features making them look stunning, yet natural.”

He adds by saying, “For this, I do an analysis of the facial features of a patient from their hairline to the neck. I try to get a fair vision of the whole treatment by analysing different parts of the face separately and then as a whole. Understanding the ratios of the facial features, seeing the height of the forehead and length of the mouth also help a great deal. Are they roughly equal thirds and so on and so forth.”

The next thing that he does is to “divide the face from side to side and check for projections and shadows. The shape of the face becomes another indicator for seeing what procedure would be best for any patient.” 

Almost always, the mid face and eye area are very important features to consider before going for any procedure. A good, detailed conversation with the patient follows. This helps a great deal in planning for the best treatment options available for them.

Letting The patient Assess The Treatment

Many cosmetic dermatologists also inject Saline solutions for the patient to get a fair idea of a treatment. This solution stays put for 24 hours. It helps the patients see for themselves what results their doctor is trying to achieve. That’s one approach for the patients to assess the treatment plan for themselves. 

Dr. Bertucci says, “I show them a bunch of before and after photos. This helps them see for themselves the results that someone else, who resembles them, may have had with that same treatment.” It works very well too in giving the patients a good idea of the treatment in advance.

Dr. Joel Kopelman says that, “3D images of patients’ faces can also prove to be amazing sources to better understand cosmetic treatments.” Through them one can fly around and get in all the different views of the facial features. Usually people only see one dimensional view of themselves in the mirror. But others around them often view them in 3 dimensional ways in real life. To get that realistic picture which also includes the social view of the face is a must for cosmetic treatments. 

The Actual Non-Surgical Procedure 

Dr. Bertucci explains that “the human eye is generally directed to the middle of the face. We first see the cheeks and eyes of a person. Then come the lips. Our cheeks happen to be very important features, defining our entire look. They form the first impression that people have of us. Treating the cheeks becomes very important in dermal filler treatments because it provides support for the under-eye area.” 

Dermatologists have to take all of this into account. Reshaping the cheekbone zone of the face adds a fullness to the face. It enhances the facial features making them look younger and tight.

Talking about lip fillers, Dr. Bertucci suggests that “Patients often come to just get their lips done. But lips don’t exist in isolation. They have to be analysed in the larger context of the face. Say, for instance how wide is the mouth in relation to the width of the jawline. If it’s a wide face and a smaller mouth then injecting a filler for narrowing the lower face will help a lot to achieve the right look. This will make the lips look nice, plump and wide. I often work to get the ratios from base of the nostrils to middle of lips, and middle of lips to the chin to be 1:2. Sometimes I inject just the upper lip or the lower lip with a filler to create a beautiful balance between the features. I try to do things in consortium with others features.”

Safety Issues with Facial Fillers

But what about the needle itself? Many people want to go for non surgical fillers to get that volume back to their skin or have their features enhanced. But they also shy away because of the fear of the needle. Thanks to the unique benefits of blunt Cannulas, now even the needle has become a fear of the past.

Dr. Kopelman says that “safety issues are absolutely important.” 

He himself uses blunt cannulas primarily for injecting fillers. Cannulas are warm, blunt needles for injecting fillers into the dermis. The blunt shape of the cannulas prevents the filler gel from getting into any undesirable blood vessels. The needle on the other hand is sharp. This can result in the gel getting into blood vessels which can be dangerous for the patient in the long term.  

In some rare cases, blindness has also resulted from fillers injected into the wrong blood vessels of the nose. For dermatologists, the nose is a slightly more problematic zone. This is because the circulation of blood in the nose is relatively poor. If you inject a product in the nose in a haphazard manner, the injectable can go to the retina and result in blindness.

Dr. Bertucci says that doctors can avoid this problem by injecting the dermal fillers very slowly around this area. “It all depends on good technique and practice,” he says. Ultimately though if you choose an experienced cosmetic doctor you will achieve beautiful results.