Fillers

We talked about the different types of wrinkles. Some wrinkles aren’t actually wrinkles at all. Fillers are used to treat some of these non-wrinkle wrinkles.  The best example is the fold that runs from the nose around the mouth to the chin. It’s called the smile line, laugh line, parenthesis and nasolabial fold.  This fold becomes more obvious with aging.  After the eyes this is the single most aging feature of the face. There are two ways to improve this fold.  A face lift (midface lift, for those who read the face lift chapter) improves but does eliminate this fold.  To see what you can expect from a facelift, I will teach you a little trick. Get a hand mirror and sit on the edge of the bed.  Take a good look at your facial features, especially the laugh lines.  Keep looking in the mirror as you lie back on the bed.  That’s you without the gravitational effects of aging.  It’s impressive, isn’t it? That’s how you would look after an old school facelift. The other trick is fillers.  Fillers are also used to augment the lips.

If you look closely at your upper lip you will see a margin that separates face skin from lip skin.  This margin is called the white roll. It should run from one corner of the mouth to the other.  In the center of the upper lip line there is a little peak on either side with a depression between them.  The peaks and the depression are called cupids bow. Regardless of how thick or thin the lips actually are they appear thin if this white roll and cupids bow are not well developed and well defined.  This is what makes lips sexy, the architecture of this line. This line is why professional makeup artists recommend lip liner. Lip liner not only slows the bleed of lipstick when done correctly liner makes the lips look fuller with a perfect pout.  In some people the line doesn’t go all the way to the corner of the mouth, I call this short lip.  In either case I inject the filler directly into the roll.  In the center of the upper lip in the cupids bow area I am very careful to create a nice peak on either side. When this is done there is usually some filler left.  The left over can be used to create a little pout or to add volume to the upper or lower lip. Filler can also be used to fill pits and craters or depressed scars.  Take a good look at yourself before your filler appointment.  It’s best to tell the doctor in advance what you would like to do with any leftovers. The nice thing about fillers is they work immediately.  I usually do one side then let the patient look in the mirror to compare the treated side to the untreated side.   First time patients always say “ohh wow”.