If the women gracing our reality TV screens are any indication, the fillers trend isn’t slowing down anytime soon. The statistics confirm this: in the United States, the use of fillers has increased tremendously from 1.8 million procedures in 2010 to 2.68 million in 2018, according to data from the American Society of Plastic Surgeons. With so many people going under the needle, I *Carrie Bradshaw voice* couldn’t help but wonder: are fillers even safe? To find out, I spoke with Dr. Oren Tepper, a board-certified plastic surgeon, and the Director of Aesthetic Surgery at Montefiore Health System.
What Exactly Are Fillers?
Like the name suggests, fillers are used to fill in wrinkles and other creases or depressions on the face by injecting a substance into the facial tissue. There are a variety of substances that can be used depending on what the patient is trying to achieve and the doctor’s preferences. Some examples are hyaluronic acid, collagen, fat and even stem cells.
Who Are Good Candidates For Fillers?
Because fillers can be used to address so many different facial issues, most people are good candidates for fillers. As far as the age range, Dr. Tepper says he has seen patients as young as in their twenties to those in their elderly years taking advantage of the procedure.
Who Should NOT Get Fillers?
Of course, those that have had bad reactions in the past are more likely to have issues again. You should also avoid fillers if you have a bleeding disorder, inflamed skin, are taking blood thinners, are pregnant or breastfeeding, or have a history of an allergic reaction to fillers.
What Are The Side Effects?
Swelling is to be expected and can range from being minor to requiring a few days to a week to subside. More seriously, a bluish discoloration can occur if the fillers are injected too close to the skin and, in rare cases, if the filler finds its way into the bloodstream, it can occlude the arteries and result in tissue loss. Dr. Tepper says that these more serious complications are relatively rare, however, occurring in fewer than 1% of cases. The FDA also cites scarring, blurred vision, and blindness as other rare but serious risks that can occur if the filler is injected into a blood vessel.
How Much Is Too Much?
According to Dr. Tepper, the general rule of thumb is that if somebody notices you have fillers, you’ve gone too far. I guess most Bravolebrities have yet to get this memo. The goal is to subtly enhance your natural facial features—key word being subtly. Another important factor is ratios. Dr. Tepper says that while “volume alone may not be the threshold for what makes somebody look unnatural or natural, the ratio of your upper lip to your lower lip is a real giveaway.” Generally, when the upper lip is equal to or bigger in size than the lower lip, the result looks overdone and unnatural. What’s worse, an oversized upper lip can actually make someone appear older. Too much filler on the upper lip pulls it down and accelerates its natural drooping, which, according to Dr. Tepper, is about 1 millimeter every decade. Great, now I have another thing to be worried about. Another option, if you’re thinking of getting lip fillers in particular, is to take a more comprehensive approach and consider how you want your mouth to look as a whole. Dr. Tepper recently teamed with aesthetic dentist Dr. Jonathan Levine to introduce LipSync, a dual-specialty approach that changes both lip length and tooth position, so your entire smile looks better and you avoid the dreaded balloon lips effect.
But if you do go too far, there are some ways you can fix a f*ck up. According to the American Board of Cosmetic Surgery, mild irregularities like lumpiness or slight asymmetry may be fixed be massaging the area, which your provider can do or help you do at home. Certain types of fillers can be dissolved by injecting an enzyme (more on that in a sec), but otherwise, the best option is just to wait for the fillers to get absorbed by your body.
How Long Does It Last?
This depends on which type of filler is injected into the face. Dr. Tepper estimates that hyaluronic acid fillers will last anywhere from six months to a year and a half. One of the benefits of using hyaluronic acid is that if you are unhappy with the results, there’s an enzyme that can be injected afterwards to dissolve the filler. For those seeking something longer lasting, approximately half of any fat injected as filler stays in the face, according to Dr. Tepper. While there are permanent fillers such as silicone, Dr. Tepper does not recommend using them. Not only are the results irreversible, they can lead to disfigurement, infection and other serious problems. Yikes.
What’s This Going To Cost Me?
This varies tremendously depending on the filler used, the practitioner you go to and the area(s) to be treated, but Dr. Tepper estimated that the procedure usually costs about $1,000 per area on average.
Are There More Natural Alternatives?
While sadly there is no magic face cream that will annihilate your wrinkles and pay off your student loans, certain fillers are more natural than others. Using fat or stem cells may be a good choice for those who don’t like the idea of injecting unnatural substances into their body. Dr. Tepper will often inject saline into the desired area to give the patient a sense of the results, but this only lasts several hours rather than several months. A lip lift is another procedure that can add volume without injecting filler. If you’re looking for something sans needle, topical retinoids are a good preventative measure that can help fight wrinkles and hold off the need for the needle.
What Should I Know Before Committing?
It’s important that patients considering fillers understand exactly what they are getting into. In Dr. Tepper’s experience, many people mistake overdone filler for botched plastic surgery: “The overdone lips, the overinflated cheeks. Those are not surgical issues, those are overfilling.” In order to avoid this, it’s okay to start small and get a few injections in stages over a period of time in order to carefully assess the results instead of doing everything at once. This is especially true for those who haven’t had the procedure before. Dr. Tepper uses MirrorMe3D, an innovative, new visual technology with the ability to scan and print out a 3D version of your face. This allows patients to see what they could and should look like following a procedure, as well as what has been done throughout the years in case they visit more than one doctor.
At the end of the day, fillers are generally safe and effective, so long as you stick to the non-permanent versions and visit a doctor with proper training and credentials. While it might seem tempting to click on that 50% off Groupon, refrain, lest you end up looking like a case study on Botched. Or, we could all just collectively agree that wrinkles are perfectly natural and forego the whole thing entirely. Crazy, I know.
Images: Sara Bakhshi / Unsplash; Giphy (3)
It’s 2019, so we’re not going to pretend anymore that getting plastic surgery is some kind of weird taboo that women do in dark rooms on their 40th birthday. Embracing the chance to change something on your body that you feel insecure or uncomfortable with is f*cking awesome, and stigmas are not. And if you’re going to do something, it’s better to have all the information than to go in blind because you were too embarrassed to do research and end up with a botched procedure, right? Right. That’s why we chatted with Dr. Gary Linkov, a Facial Plastic Surgeon from New York to answer all your questions about preventative, non-surgical, and surgical facial procedures.
Which Facial Procedures Are Most Popular?
Nonsurgical: Botox, Filler, Chemical Peel
Surgical: Rhinoplasty (nose job), facelift, blepharoplasty (eyelid surgery), and lip lifts are growing in popularity
When Should You Start Non-Surgical Preventative Treatments?
Although rumours and Instagram ads may suggest otherwise, Dr. Linkov believes that the only truly preventative strategy is botox. He’s had clients who start as young as their early 20s, ranging to about late 20s to early 30s. So if you’re still a child and scared of needles like me, there’s no need to panic. You can still prevent those wrinkles in due time.
How Do You Know If You’re Overdoing It?
It’s not hard to spot an overkill face (we’re looking at you, Tori Spelling), but when you’re in the heat of it, how do you know if you’ve gone overboard? Dr. Linkov says that with Botox, you’re too far once you’ve lost the ability to show emotions through facial expressions and have difficulty animating your face. This low-key sounds like a really good thing that I’d 100% be down for, but it doesn’t look so cute.
In terms of filler, you want to avoid anything that looks disproportionate to the rest of your face. Like, you can legitimately pick anyone from the cast of Real Housewives of Beverly Hills and go as far in the opposite direction as possible. The facial procedures are meant to enhance what is already there, not build cheeks from silicone. For lips specifically, you want to avoid an anterior projection that is unnatural, aka you don’t want to look like you’re making the duck face all the time (unless that’s your strategy, then go for it).
How Do You Fix Botched Work?
In his line of work, Dr. Linkov has seen plenty of botched faces. He says the most common type of corrections he performs for non-surgical procedures has to do with too much filler being injected or filler being injected in the wrong place. In that case, he needs to dissolve all the filler and start from scratch.
For surgical facial procedures, rhinoplasty is often one that needs correction. Sometimes too much cartilage is removed during the initial surgery, causing the nose to lose shape or sink in. Or Maybe Becca from Long Island got her nose job the summer before college and did way too much coke so now the bridge of her nose is collapsing. But like who really knows, we all started with a deviated septum anyway, right?
How Do Patients Decide The Best Course Of Treatment?
A lot of what Dr. Linkov spends his time doing is actually talking to patients and truly understanding their concerns. He likes to get a background on what procedures they’ve done prior to coming to see him, as well as their tolerance for various intensities of treatments. It’s also vital that Dr. Linkov has time to properly analyze a client’s face to choose the right method of approach. The bottom line is your surgeon should work with you, not for you, to help determine the best way to achieve what you’re looking for.
When Is The Best Time To Get A Facelift?
Dr. Linkov suggests getting a facelift once the jowls start to show *shivers* and there is some heaviness forming in the neck. Usually, this happens in the mid to late 40s for most women, but it can be later for some lucky betches. The trick, he says, is to do the facelift while the underlying muscle still has good integrity and strength. If you try to get a lift too late, the muscle will have already thinned out and will not support a transformative lift.
Do Facial Gyms Help Wrinkle Prevention?
So apparently taking a spa day to have someone smack your face doesn’t count as going to the gym. Shame. Dr. Linkov says there is very little data to show that facial gyms and wrinkle-prevention exercises actually do anything. In fact, strengthening muscles may even promote wrinkles, since wrinkles are from the activity of the skin’s underlying musculature. It’s fine, you tried.
Who Would Preventative Treatments NOT Be Beneficial For?
If you have limited wrinkles (even when you smile or do a double chin or whatever weird sh*t Snapchat prompts you to do) you don’t actually need preventative botox. Lucky. Fillers, on the other hand, are never really 100% preventative, according to Dr. Linkov, so no one should be trying that out before they want to commit to it.
How Do You Choose A Location And Person?
While these procedures can be pricey, there’s no benefit in trying to cut costs. Dr. Linkov says a lot of people often hunt for the best price per unit of Botox or syringe of filler, but those are also the faces that get botched and have to end up paying more for corrections in the future. Dr. Linkov instead strongly recommends picking a doctor by their experience to treat the face and maintain safety as their top priority. Some treatments can have side effects that range from mild to more severe, so having someone who knows what they’re doing and can do it well is very important. He also suggests that you make sure your injector has the appropriate antidotes, such as hyaluronidase for fillers, and to ask what type of filler is being injected.
What Are Typical Price Points For These Procedures?
Botox: Anywhere from $10-25 per unit or $200-500 per area
Filler: $500-1000 per syringe
Chemical Peel: $200-300 per treatment
Is There Any Downtime?
Botox: Rarely any downtime
Filler: Can have bruising or swelling for up to two weeks, but usually one to two days of downtime
Chemical Peel: Depends on the intensity of the peel, but about one week
Rhinoplasty, Facelift, Liplift: One to two weeks of downtime
What Are The Side Effects?
Botox: Paralysis of neighboring muscles, bruising (rarer)
Filler: Bruising, swelling, vascular occlusion (including skin changes, or in rare cases, blindness)
Chemical Peel: Scarring, skin pigmentation changes
Rhinoplasty: Swelling, bruising, breathing issues, cosmetic deformities
Facelift: Scarring, bleeding, facial nerve damage
If you want to learn more about Dr. Linkov and the procedures he specializes in, feel free to check out his website. To keep up with his daily surgical antics you can follow him on Instagram.
Images: Giphy (2)