About 10 years ago, we started using dermal fillers in a different way, to restore softness and lift to the face. Here are the before and after pictures of Kathy, who was in our 10 Years Younger in Burlington program:

Middle aged woman with damaged skin and signs of aging  Middle-aged woman with beautiful skin, cheeks and smile

You can see that Kathy’s filler has lifted her cheeks making her face look more tapered and youthful at the jawline. Her lips look feminine and pretty but not overdone.

In the 10 Years Younger program, we also used treatments to improve the overall condition of the skin — its smoothness, tightness, brightness and radiance — so we weren’t relying on the dermal fillers to correct everything.

Where people went wrong with dermal fillers was using them as the main or only tool to correct all of the problems of the face.


Lindsay Lohan: too much cheeks and too much lips This picture of Lindsay Lohan perfectly illustrates why dermal fillers get a bad rap.

Lindsay is naturally very fair-skinned and red-headed who should never tan. Her skin is horribly sun-damaged, making her look aged far beyond her years.

She is using dermal fillers here to try to create a more youthful appearance but has gone way overboard with too much lips and too much cheeks.

How much better she would look if she erased all of sun damage and restored her skin to the tightness and radiance it should have at her age.

The other mistake that was made with dermal fillers was focusing on the cheeks and lips, and ignoring other areas of volume loss in the face.

Courteney Cox too much lips, too much cheeks

On the left, we see Courteney Cox as she has looked in recent years; on the right, how she looked when she starred in Friends. She has had way too much filler put into her cheeks and lips, making her look really distorted. She looks very narrow at the jawline compared to how she used to look. Putting the filler in the lower cheeks to restore the softness and breadth to her face that she used to have would look much prettier and more natural.

For caucasian women, lips look prettiest and most natural when the upper lip is about 2/3 the thickness of the lower lip. Courteney’s lips used to have that ratio. However in her recent picture, the upper lip looks thicker than the lower.

I think it is a tragedy that Courteney let someone do this to her. I have heard recently that she had some of the filler melted (the beauty of hyaluronic acid fillers is that they can be melted using an injection of the enzyme that breaks down the filler). I hope that Courteney starts working with someone who will use better filler techniques to restore her to how she used to look.

In the evolution of dermal filler use, the switch from filling wrinkles to lifting cheeks was an improvement. We were starting to address the changes in the volumes of the face that occur with aging. However, the techniques and results were very much operator-dependent.

All too often, the filler would be taken to an extreme that made the recipient of the fillers look distorted.

This is Part II in the series on the evolution of dermal filler use. Part I is here.