Dermal Fillers

Dr. Saoly Benson:
Hi everyone. I wanted to take this moment to talk a little bit about aging. What causes it, what can we do to prevent it? So to have a better understanding of prevention, I wanted to first talk a little bit about what features we typically see on a youthful face, and what are some of the changes that happen with the soft tissues, as well as the underlying bony structure as we age.

There's something called the triangle of youth. I don't know if you guys can see well here, but with the triangle of youth, we typically see this inverted triangle, right? We see high cheekbones, full cheeks, a well-defined jaw line. As we age, this triangle becomes inverted into more of the pyramid of aging. You can see we have dragging skin in the cheek area, the cheeks become more flattened. Sometimes we see kind of this jowling at the jaw line, or sometimes even like a double chin, because of gravity, everything just kind of sinks downward.

Genetics also play an important role in aging. If you look at your mother and how your mother ages, this can kind of give you a glimpse of how you might age. There's also, of course, other factors, such as how much sun exposure you have, and your diet, lifestyle choices, like smoking, alcohol use, stress. All of those things can cause brown spots, rough skin and wrinkles. As well as the premature onset and progression of aging.

Genetics will affect all layers of your skin, and that contributes to the thinning, the dryness, and the loss of elasticity of the skin as we age. This is a mother and a daughter. The mother is 64 and the daughter is 26. I just kind of want to point out some of the differences in their faces here. You can see as aging happens, we see more discoloration and brown spots on the skin, more of a rough texture, loss of moisture and collagen. We also start to see lines and wrinkles, like the crow's feet, drooping skin in the cheek area, as well as kind of a flattening here, and then some sagging along the jaw line.

Part of the reason that that happens is because we actually have fat pads that are filling up the majority of the volume of the soft tissues of our face. As we age, the volume of all of those fat pads, it not only shrinks, but it also starts to droop from gravity. What can we do to fix that? This is where fillers come into play. I'm sure you guys have all heard of Botox, and maybe some of you have also heard of fillers. We've talked about Botox in the past, but just as a refresher, the difference is that Botox helps to relax muscles, which causes wrinkles, whereas fillers are more to restore the volume that is lost as we age.

There's a lot of different types of fillers out there on the market. You guys might've heard some of the names like, Restylane and Juvederm. These are all different types of fillers. They're also made of different components. In our office, we use hyaluronic acid fillers. Hyaluronic acid is something that we already have within our bodies, and it attracts moisture, so when we place the hyaluronic acid filler into the skin, the filler itself causes a plumping effect or restoring volume to the overlying skin. But then it also, in turn, attracts water and moisture, which also helps to increase the volume of the skin. We can really use the fillers to contour, restore and define certain areas of the face. This is great when you're starting to see some of these changes with aging. Fillers can be used to kind of bring you back to where you used to be, you know, reverse the sands of time.

Fillers can also be used to change the shape of your face. I think the most notable example that everyone knows of are the lips, right? A lot of women get fillers placed in their lips to add volume to their lips, even if they might never have had full lips to begin with. This is where a lot of people I think have a little bit of a negative association with fillers is because they think of, like, duck lips. But there's actually probably plenty of women walking around with soft tissue fillers in their face, and you don't even know. It doesn't have to be this crazy, dramatic look that maybe isn't for everyone. It can be pretty subtle.

Fillers are great, or hyaluronic acid fillers in particular are great, because they actually can be reversed. If you don't like it, there is something that we can put in to dissolve it, and then it just goes away. It's pretty safe to use, especially if you're kind of nervous about how it might change your face that you might not like it. It can be reversed. The other great thing about filler is that it is buildable. Say you want to add a little bit of volume to your lips, but you're scared it's going to get a little too big. You can start with just a little bit, and you can get used to it. And if you decide later on you want to go bigger, you can always go back in and add more fillers. So it's really nice that you can layer it on.

People often ask how long fillers last. They can last anywhere from about a year to two years. Everybody is different, and every product is different, so certain products will last longer than others. And then it's also affected by your metabolism and how expressive you are. Typically, people who have a really fast metabolism or who make lots of facial expressions, they typically burn through their product a little bit faster. The nice thing with fillers is that you can get it added on before it completely dissolves, so you're not going to just one day deflate. It slowly gets a little bit less volume, and then you can build it back on. You can just maintain the look that you're going for.

With fillers, we talked about how it can be great in the face, but there's actually another dental application, which I'm very excited to let you guys know about that not everyone is aware of. And that is to fill in what's called a black triangle in between your teeth. I'm going to show you a healthy dental model first. When we're young, we have gums that fill in the little embrasures, which is the space between the teeth here. The gums fill it up, it's kind of a pointy, pyramid shape that the gums fill in between the teeth. But sometimes as we age, the gums can recede, and it leaves what's called a black triangle.

I don't know if you guys can see in this model here. The black triangles in between the teeth here from the gums that used to fill that space, fillers can actually be placed in there to kind of plump that back up too. So that's really cool application of fillers that not a whole lot of people know about that I'm excited to be able to offer to my patients. Because in the past, sometimes we would get done with a patient's orthodontic treatment, their teeth are all perfectly straight, but then they have these black triangles in between their teeth, and they hate him.

I used to not really have much that I could do in order to fix it, and the patient kind of just had to live with it. Now we're able to use fillers to help fill in those black triangles, and give our patients a more aesthetic smile. That's it today. I hope you guys found this information helpful. If you have any questions or comments, please comment below.