Sculpting Your Face With A Needle

What’s New in Injectables

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Injectables have revolutionized anti-aging. The procedure has minimal downtime and effectively rejuvenates the appearance of the face. When done artfully, dermal fillers restore and enhance facial contours without making them look unnatural. Originally, fillers were used to soften the nasolabial folds, or smile lines. Since then, doctors discovered new ways to safely augment/restore many more anatomical areas. Besides innovations in injection techniques, completely new types of injectables have recently been FDA approved and will be available soon. 

The most commonly used fillers are hyaluronic acid based: Juvederm, Restylane, Juvederm Voluma, and some newer ones such as Teosyal RHA, Versa, and Restylane’s Kysse. Hyaluronic acid (HA) is a popular choice because it is safe. It is a highly preserved sequence in our genome and exists naturally between our cells (interstitial fluid), eyeballs, joints, and skin. Because it is naturally all over our bodies, we are less likely to have an allergic reaction to it. Also, HA can be dissolved easily overnight with an enzyme called hyaluronidase. Reversability is a big plus for patients. 

Lip filler is perhaps one of the most youth-enhancing procedures, when done artfully. Excessive lip filler is unsightly and can deter thousands of people from ever trying it. The art is in the product chosen, the technique in placement of the injectable, and the volume that is used. When done properly, one should not be able to tell that the lips are filled—just that they look gorgeous! This principle applies to all dermal filler procedures.

Liquid rhinoplasty—or nose reshaping with filler—has evolved into a true art. Instead of surgery, nose contours can be corrected in minutes. In most cases, results last 9 months to a year. Patients are thrilled with their results, and ironically, their noses look smaller! This is a very advanced, off-label technique that should be performed by an experienced injector.

Chin and jawline augmentation—with HA fillers is something we have been using for years to help restructure the appearance of the lower face. For both men and women, restoration of jawline contour and improvement of chin projection, thus augmenting a weak chin, are popular procedures.

Undereye circles or hollows can be corrected with HA to improve contours and rejuvenate tired-looking eyes. This procedure is popular and very effective—some would say life changing! These circles are not always due to aging and can simply be an inherited familial trait. This is why people of all ages come to Bella Skin Institute for this correction.

Cheek augmentation with filler results in high cheekbones that contour and lift the face. Contrary to our patients’ common concern that it will make their face look “fatter,” this procedure actually results in a slimmer, more-defined look. Again, this procedure is popular at all ages. This procedure takes patients from “beauty” to “bombshell.”

Temples: think Cruella DeVille. Hollow temples are a distinct sign of aging. Recently, we have added volume there with HAs and collagen-stimulating injectables such as Sculptra. This is a youth-enhancing procedure that completes the look of a corrected aging face. 

Earlobes can lose volume and tone with time. And they start to sag and not hold earrings well.  Adding HA filler provides an instant plumpness and rejuvenation to the lobes. They look better and have better tone to hold earrings in place.

GUANCHELIFT ™ is a 15-minute filler facelift procedure that I invented to rejuvenate the appearance of the neck, jowls, and lateral brows. Filler is strategically placed off-face behind and above the ears (where facelift incisions are hidden) in order to lift and re-drape the skin.  Because injections are behind the hairline, there is no visible bruising, thus minimal to no downtime.  

Bella Microgold—this is a diffuse shallow application of HA over the entire face via microneedling. The HA is a humectant, thus leaving the skin looking plump, smooth, and hydrated. Along with the HA, neuromodulator (such as Botox) is introduced via tiny needles to the surface of the skin. This reduces tiny fine lines, pores, sweating, and oil production, leaving a perfectly smooth canvas for makeup. 

Additional areas for filler include the hands to camouflage veins and tendons (volume loss), rejuvenation of the chest and neck rings with collagen stimulators, buttock volumization or cellulite dimple filling, and more. 

We can literally sculpt the face (and body) with a needle. There are new injectables arriving soon, only to increase our armamentarium. Teosyal’s RHA and Restylane Kysse are already here. Qwo® for reducing cellulite and Renuva for stimulating your own body’s fat are coming in early 2021. We are on the forefront of innovation with noninvasive ways to contour all areas of the face and body. Stay tuned: The future is bright! 

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By Anna D Guanche MD FAAD
Board Certified Dermatologist

The statements in this article are for general informational purposes only and do not substitute for individual medical advice.