The F word.
I actually really dislike the word “filler”.
The word conjures up images in my head of puffy, round faces. The word filler takes me back ten years ago; when the goal of injectables was literally to fill a face with volume – from the lips to the cheeks to all of the natural folds that make our faces look human. There was a time when injectables, particularly dermal fillers, were still a new addition to the cosmetic toolbox for most aesthetic physicians. This resulted in a lot of over-injecting and over “filling”. This ultimately gave these procedures a bad reputation and instilled a lot of fear in people who were interested in improving their appearance but were reluctant to look “filled”.
Even now, years later, with significant improvements in injection techniques and better-quality products, patients still start each and every consultation with sentences like “don’t make me look crazy” or “I don’t want to look puffy” and “don’t make me look like a duck/frog/blowfish/chipmunk”.
To be honest, I cannot blame my first-time patients for having these concerns. We have all seen the over-filled Hollywood starlet or the unsuspecting patient who wasn’t properly advised by his/her physician when enough has been enough.
The good news is that there is no use for the word “filler” any longer.
When I discuss treatments with my patients I use words like “lift”, “contour”, “shape”, “construct” and “define”. We are no longer filling faces. We are contouring jawlines, we are defining facial shapes, we are adding structure to facial features. We are lifting and restoring balance to the face. In many cases we are providing surgical results with non-surgical techniques. To call these treatments “filler” treatments is almost insulting now.
The fact that all of this is possible is largely due to two reasons.
Firstly, the aesthetic industry as a whole has become more committed to delivering results that are more natural and realistic, but also significant and impactful. Allergan, the company that produces Botox, Juvederm and Belkyra, identified physicians worldwide that were committed to providing their patients with a superior service. They embarked on a 5-year program called MD Codes where all of these fortunate physicians were taught how to unlock the “codes” to beauty. We have flown all over the world to be taught by the pioneers in the industry how to adapt our techniques and immediately apply them in our practices. This has significantly impacted the way I assess and inject the face, and the results have been immensely satisfying and pride inducing.
Secondly, the accredited manufacturers of injectable products have been providing physicians with new products that have been game changing. When dermal fillers first hit the market, the options were very limited. Now we have so many options to choose from and the ability of these products to lift, contour and shape the face are mind blowing. Allergan recently introduced Juvederm VOLUX, specifically for the chin and jawline. This product has allowed me to shape chins and define jawlines that will last for as long as 2 years.
Prollenium, the Canadian manufacturers of Revanesse just recently introduced Revanesse SHAPE to the market. This product has already become a favourite in my practice for its ability to significantly add lift to the face, so that “filling” folds and lines isn’t even necessary.
The ability of newer products like Teosyal Ultra Deep to imitate bone has allowed me to perform non-surgical nose jobs that amaze even me on a daily basis. Patients arrive at the clinic with a lifelong insecurity and walk out happier and more confident with immediate results. This is not because they had “filler”. It is because a superior injectable product was used by a physician who is dedicated to delivering the best possible results by using techniques that are always updated and reviewed.
What I hope to see moving forward is less focus on how much filler is needed to achieve a result and more focus on the result itself. Patients especially seem to be fixated on “how much filler is needed”. We are moving towards a more results based aesthetic future. It is less important exactly how many millilitres it is going to take to achieve a desirable result and more important to decide what it is worth to the patient to receive that desired outcome. After all, do we ever ask an artist how many tubes of paint did it take to create a beautiful piece of art?