Choosing fillers is akin to an artist’s selection of brushes and paint—there are different ones for different effects. Fillers can be used to add to the chin, for example, or to fill out the jawline or cheekbones or creases around the nose. They can contour irregularities in the soft tissue of the face, fill out the lips and augment the deeper facial skeletal structures. And finally, they can be used to fill in superficial wrinkles. Want to know more? Here’s our OrangeTwist co-founder, W. Grant Stevens, MD, F.A.C.S., a world-renown plastic surgeon and a pioneer in facial rejuvenation.
Q: Tell us about the world of fillers. There’s so much to know. How do you choose them?
Dr. Stevens: At OrangeTwist, we offer many different kinds of fillers. Radiesse, for example, is in its own unique class because it uses hydroxylapatite, which is calcium-based. It augments deeper structures and the skeleton, versus other kinds of hyaluronic acids. There are very thin ones like Belotero that you might use around the lip or eye; you wouldn’t use it, say, in the nasolabial fold (more commonly known as “smile lines” that descend from the nose to the corners of the mouth) or where you had to fill in bigger areas. If you wanted to augment and highlight the lip, you’d use Juvederm for instance, and you wouldn’t use Belotero. Our therapist makes the decision on which filler to use based on what you’re trying to accomplish. So for someone who doesn’t want a chin implant but still wants to fill out that area, we’d use Radiesse or some of the higher hyaluronic acid substances.
Q: Can fillers be used for different purposes? For example, someone who was born with certain facial structures, or also if their face has changed over time?
Dr. Stevens: Yes, they could be used for congenital issues or issues they’ve acquired, such as scars, sun damage, trauma, surgery, a massive weight loss with descent of the skin or simply aging. The face actually loses volume over time and sags. So it’s not just about tightening skin or pulling skin like it used to be thought of, but rather, it’s about re-volumizing. As you age and you lose volume, you get more angular. When we re-volumize the face, it lifts the cheeks up. It fills the temple out. It takes care of the areas around the eyes, and people look much more youthful. We’ll use a variety of fillers and sometimes even the patient’s own fat.
Q: Sometimes you’ll see a photo go viral of a celebrity who hasn’t had good results. What happened?
Dr. Stevens: Overdoing the volume can make people look really extreme and almost unrecognizable. So if someone wants a really exaggerated lip, we won’t do that—but what we will do is offer a syringe of Juvaderm a couple times a year as maintenance. It’s very conservative; it just gives a little more youthful fill to the lip and to the lip line.
At OrangeTwist, we have certified instructors who are PAs, or physician’s assistants, who teach doctors all over the country how to do injections. That’s highly unusual. But they have way more experience than any doctor—it’s all they do, full time. They’ve done thousands and thousands of cases.
Q: Are the treatments permanent?
Dr. Stevens: Your makeup’s not permanent, your teeth cleaning isn’t permanent, cutting your hair isn’t permanent—very few things are. Results last from six to 18 months; we encourage people to come in about twice a year for fillers to maintain their look.
Q: Anything else people should know about fillers?
Dr. Stevens: Safety and results are what matter, so pick someone to treat you who has had the proper training and a lot of experience. We’re happy to talk to you at OrangeTwist about your options—schedule a consultation today.