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I am a 61 year old woman and have been thinking about getting some kind of filler work done on my face.derm

Question posted by pinksuzanne from Ponteix

There are many options out there and have read about Juvederm and Teosyal filler and am wondering should different fillers be used in certain areas of the face.

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One thought on “I am a 61 year old woman and have been thinking about getting some kind of filler work done on my face.derm

  • Dear pinksuzanne,

    As one ages there is usually a predictable series of events that occur that I call “3D aging.”  3D aging involves three processes. The first is deflation or loss of facial fat volume.  Followed by Number two, descent which is the sagging and drooping of soft tissues.  And, finally, Number 3 deterioration or the accumulation aggregation of fine lines, wrinkles, sun damage, brown spots and broken capillaries.
    This 3D aging if all present requires 3D therapy.  Usually the first aging sign is loss of volume or deflation and the treatment of deflation is the use of some type of filler.  One can divide the filler options into natural such as fat grafting, fat harvested from areas of the body where you don’t want it, prepared, purified and injected into areas of the face where you have deflation.  Common areas of deflation in the 60s include the temples above the eyebrow, under the eyes, along the cheekbones, around the mouth and the jawline.  This natural restoration of volume can result in significant and natural appearing rejuvenation.  Of course, one needs to avoid using too much filler which is the expertise and judgment of the certified injection physician
    to avoid that “filler face look.”

    The disadvantage of using fat grafting it does require a small procedure to harvest the fat and this is injected immediately.  To create an even simpler process there’s been development of soft tissue fillers that can be used to restore lost volume caused by facial fat loss.  These soft tissue fillers can be divided into biostimulatories such as Sculptra, Radiesse or Articol, which have molecular structures that stimulate the production of collagen when injected in the face.  These generally not great volumizers as they are somewhat unpredictable can lead to nodule formation.  Over the past several years in Canada the emergence of long lasting hyaluronic acid sugar gel products such as the Juvederm family, Juvederm Volift, Juvederm Voluma and Juvederm Volbella have specific cross-linking technology called Vycross that allows the soft natural sugar gel to last for 12-24 months.  There are other brands that are also good such as Restylane, Perlane and Teosyal.  Within each family there are sub-products that are larger and smaller molecular sugar gels and in general in delicate areas such as under the lid, a small less hydrophilic or water loving product such as Restylane or Belotero or Volbella is used while in the areas where more volume and water absorption would be desirable such as the cheeks, temple and jawline.  Larger longing lasting products such as Voluma, Volift or even Perlane can be deployed.  Structural support in the lips or nose is often deployed using a product called Restylane.

    In general, soft tissue fillers in the face is very much an art and you want to seek out a cosmetic certified physician or plastic surgeon with a tremendous amount of facial shaping and sculpting experience using soft tissue fillers.  I have performed a procedure called the VolumaLift and have performed this on The Doctor Show and the Today show and this can be available for review on our VolumaLift page.

    It’s quite amazing what we can do now as certified plastic surgeons without the use of a scalpel and the judicious and strategic an aesthetically pleasing use of soft tissue fillers often in combination with Botox and fractional lasers can often reduce the appearance of the aging face by 8-10 years.

    I hope this information has been of some assistance and best of luck.

    For more information, please call to schedule a consultation at SpaMedica at (416) 922-2868 or alternatively visit our website at and fill out an e-mail consultation request.

    R. Stephen Mulholland, M.D.

    Certified Plastic Surgeon

    Yorkville, Toronto

Additional Information

Dermal Fillers (Soft Tissue Fillers)

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