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20
Jul

Fillers

As the world of aesthetics advances, newer techniques and products are developed keeping us looking younger more naturally. We have moved away from extreme procedures with long down times and favor those interventions that reflect subtle but substantial improvement. Rather than removing every wrinkle or fixing all folds, many specialists look to repair the underlying cause, the real reason that a jawline is sagging or the eyes are looking hollow. This is where fillers come into play and how I like best to apply them.

Fillers have been around since the 1970s and continue to become more sophisticated. Where we once only had Bovine Collagen (Zyderm and Zyplast), thin products lasting only three months, we now have products that last 1-5 years, are non-allergenic, and are dynamic (they move as the face makes expression, so that a patient doesn’t have a “stiff” plasticized look).

Our thought processes as, Dermatologic Surgeons, have evolved as well. Early-on, the general consensus was to obliterate or “fill” every wrinkle or fold in the skin. That thinking has changed, as a full face with no lines doesn’t necessarily equate with a younger, more attractive face. Contemporary thinking addresses the underlying cause of aging: the loss of volume that occurs from receding underlying bone structure, fat, and collagen. Now we understand that a heavier jawline and folds between the nose and the mouth are due to loss of underlying support structure for the overlying skin. If we can rebuild structure to a younger contour, we will restore a more youthful and not-overdone appearance.

Contouring faces is not a skill learned overnight; it takes years of evolution on the part of the provider. The most important component of your treatment is not whether Restylane, Juvederm, or Radiesse is used; rather, it is the technical ability and discerning eye of your Dermatologic Surgeon.

I have an art background and was a formally-trained clothing designer before medical school. Along the way, these interests have continued as hobbies: painting oils and watercolors, creating elaborate Halloween costumes for my children, and when unable to find the right outfit, well I just make it myself. All of this aesthetic training has culminated in precise technical skill and the ability to visualize a beautiful result: traits I have now honed for 20 years and am beginning to realize I am known for.

When a patient comes to me for enhancement, I look at the overall face for balance and symmetry. I evaluate for outstanding features and determine how to best accentuate them. Identifying the best feature and working from that leads to my avoiding a cloned look; I try to avoid generically pretty/handsome. Each individual is unique, and I enjoy the creative challenge of determining how to bring out that person’s individual beauty. Sometimes I find that the best approach is to do a small amount of product in a few different areas of the face. You would be amazed at how much a tenth of a syringe of filler can do if artfully and expertly placed. Other times, the best approach is restructuring one area, in particular. Often, this is an intuitive process for me.

Working on men requires a separate thought process, as men tend towards a more masculine structure, and I want to maintain that. It is important that your physician knows the difference between what makes a face masculine as opposed to feminine.

I have also been known, both at the University of Colorado and also here in the Springs, to correct or bring into balance work done by other providers and I am happy to consult with you in this regard.If you see someone overdone in my office waiting room, don’t judge; I may be fixing something done elsewhere.

My techniques have been taught to University of Colorado Dermatology residents and for the past four years, I have been their lead instructor in Aesthetic Dermatology. I teach my individual approach to these young Dermatologists, help them identify nuances of an attractive face, and hold their hands while they get comfortable with fillers.
I am more than at-home working in the enhancement arena, as at this point, it’s second nature. Come talk to me; tell me your concerns! Together we will come up with a solution you are sure to love.