Prior to 10 years ago, dermal fillers were used to fill specific wrinkles and to augment to the lips. This approach might work for a younger woman who has generally good skin and good volume in her face but for most people, the results were lackluster.
I found this picture on the internet and it perfectly illustrates the deficiencies of targeting wrinkles. This woman has volume loss in her face resulting in bags under her eyes and sagginess around the nose, mouth and jawline. The folds around her nose and mouth were caused by the volume loss and loss of structural support in the cheeks and the bone structure of the face.
In the right hand picture, you can see that the nasolabial folds, marionette lines and glabellar lines (the dreaded 11’s in the forehead!) have been filled but she still looks sad and saggy.
She probably thinks that she will need a face lift and a lid lift (blepharoplasty) if she wants to look better. What she really needs is careful placement of filler in the cheeks and on the bone structure to restore the lift and softness to her face. New filler techniques would correct the bags under eyes, lift the folds and firm up the jawline.
Early dermal fillers
The products that we had available were different: hyaluronic acid fillers were not as long-lasting and were prone to some problems, such as nodule formation. Originally we had collagen fillers — derived from cow’s collagen! — that were seriously problematic, with a risk of a serious allergic reaction and a short lifespan.
People turned to permanent fillers because they didn’t like redoing their fillers every few months. Stop and think about this for a second: your appearance after using these filler techniques isn’t great because the techniques don’t address the underlying problems and now you’re going to make your lackluster results permanent? Can you think of a worse idea? And just to make it even worse, permanent fillers can cause serious problems with inflammation that flares up every time you have something done to your face. Bad idea.
In those days, we didn’t really understand how the face changed with aging. We treated what we were seeing, not what was really causing the wrinkles.
This is Part I in our series on the evolution of dermal fillers. Part II is here.