This is one of the most asked questions. Just how much dermal filler do I need?
Obviously it is difficult to give a general answer to this. We are all individuals, we are at different ages, have lived different lives, and have different goals. But I will do my best to answer this, and give some more specific examples later on.
As we age we lose volume in the face. This process starts as early as from age 20, but speeds up around menopause for women. We lose collagen and thickness from the skin, but we also lose fat from the fat pads in the face. The fat pads are what gives the face the gentle full curves of youth, so they are vitally important. However we also lose bone volume from the face also. The underlying skull bones lose volume in key areas, leading to further hollowing and shape changes, as well as a loss of support for the overlying soft tissues.
The net result of this volume loss is that the face changes shape. It appears to droop or sag, when in reality it is mainly deflating. Temples hollow, brows become heavier, cheek fullness is lost and lower eyelids lose their support and become baggy and tired looking. The jawline is lost and lines and folds become deeper around the mouth. Generally the face often changes from being heart shaped or rounded to a square, oblong or diamond shape.
To keep things simple I usually tell my patients that there are three main things that make them look older. First is the skin – complexion and sundamage, also texture and tone. Depending on the issue we treat these issues with BBL, skin care, Tixel and collagen boosting injectables like “Honey Filler”. Second is expression lines – frown lines, crow’s feet, forehead lines – treated with anti-wrinkle injections. Third is volume loss – treated with dermal fillers. And volume loss is often the most important.
There is good news though. Dermal fillers are generally very safe and effective (significant side effects are very rare – maybe 1 in 20,000 treatments), whilst also being quite long lasting. Generally accepted to last 1-2 years in most instances, I have certainly seen them lasting over 3 years in many of my patients. And often not a lot of filler is needed to make a big difference.
Generally I find that patients over the age of 30 are looking for subtle, natural looking changes – they just want to look “good for their age” (or maybe a little bit better than their age!). We tend to be quite conservative with our treatments. Its easy to do a little bit, and maybe do a little more later on.
As a general guide, looking at specific areas of the face, the following volumes of filler can serve as an approximate guide.
Forehead – 1ml
Temples – 1-2 ml
Cheeks 1-2 ml
Cheek highlights in a younger patient – often only 1ml.
Jawline and marionette folds 1-2ml
Chin 1-2 ml
Nose reshaping 0.5-1ml
Under eye areas 1ml
Lips 1ml
In reality many of my patients looking for improvement of a specific area only need about 1-2ml on average. Most people are surprised at the difference just one syringe of filler can make to a problem area. Other patients who are looking for an all over holistic approach usually need about 3-4ml of filler, sometimes a little more.
Lips are a special area. Most patients want to keep the appearance very subtle and natural, whilst some younger patients want a more volumous look. We generally use half a ml for a very subtle change, 1ml for a average fullness that will never look overdone. Younger patients may want more than 1ml in total.
Article by Dr Christopher Leat – Medical Director Envisage Skin Clinic Gold Coast
Dr Christopher Leat – Medical Director Envisage Skin Clinic Founder and Director.
Dr Christopher Leat has 33 years’ experience in Medicine and is a member of The Royal College of Physicians of London.
Dr Leat has devoted the last 18 years to Cosmetic Medicine and is recognized throughout Australia as one of the most experienced doctors in the field of Cosmetic Medicine.
