Physician and Patient Soft Tissue Filler Resource.
There are no procedures that afford quicker results with shorter recoveries than injectable fillers. With that said there are no procedures that have collectively been misused and misunderstood.
As a plastic surgeon that is referred other’s filler complications I thought it prudent to provide a resource for both physicians and patients to learn my theories and choices.
This site provides my opinions and is based on my experience and is intended not as medical advice or as instruction on technique. For a consultation please schedule an appointment or seek out another qualified Plastic Surgeon.
 Some Theory: At the most superficial level in the skin is the most shallow wrinkle or line its depth of involvement is into the superficial dermis and will do well with a filler designed to be placed in the superficial tissues.
The next level involves a mid-depth wrinkle going into the middle third of the dermis and will also do well with a filler designed to be placed at the superficial level of the dermis. After this we have the deep wrinkle and/or skin fold . This structure involves the deepest level of the dermis and will need a bulking agent placed into the deep dermis or into the subcutaneous tissues to affect change from a distance.
See an example of how lines form: (from restylaneusa)
See an example of how fillers work: (from restylaneusa)
Superficial agents are the group of fillers that are placed into the deep dermis and mid to superficial dermis. They are designed to affect change where placed. They are best used for mid-depth to fine wrinkles, the border of the lip, acne scar depressions, tear trough and crows feet. Included in this group:
NOTE: SILICONE SHOULD NEVER BE USED
Bulking agents are the group of fillers that are placed to into the deep dermis and into the subcutaneous plane. They are designed to affect change at the surface from afar. They are best used for deep folds (Nasolabial and Marionette), hollowing, and atrophy. They include all of the fillers in the Superficial group (but not vice versa) as well as:
NOTE: SILICONE SHOULD NEVER BE USED |
