The Secrets of Natural Looking Filler

As the use of fillers becomes more prevalent and the uses of fillers more widespread, the goal of creating a natural look with fillers has become increasingly attainable. We now know that the best use of fillers is the replacement or creation of volume, rather than the simple filling of lines and grooves. Most people want to look better and younger, rather than look like someone else. Therefore, it is a good idea to have an idea of what is the goal that you're aiming for.

A photograph, or series of photographs, is a good place to start. In our office we have a book of photos of attractive young patients, to give other patients an idea of what an attractive young face looks like. We encourage our patients to bring in photographs of themselves when they were younger. This is often a good place to start. Sometimes people realize that what they think they want is really not the way they looked when they were young. Often this leads them to reconsider their goals.
This is not meant to imply that the goal should always be to recreate the appearance of their youth. If they had small lips, a receding chin, or a lumpy nose, and they never liked these features, then improvement of these is a reasonable goal. Where mistakes are often made is in trying to alter the anatomy to meet an arbitrary goal. There are many people walking around with hollow looking eyes, because there was at one time the idea that there should be no overlapping of upper eyelid skin. This was the "ideal" for women, but it is uncommon in young women and should never be the goal in men. If you look at recent photos of Kenny Rogers, and focus on his upper eyelids, you'll see a good example of how things should not be done.
Finally, it's important that surfaces be smooth without depressions or lumps. Having a physician with a good eye for this helps a lot. None of us fills completely 100% of the time. However, by using a forgiving filler and making small corrections as necessary, we can come close to perfection a significant percentage of the time.

Gerald N. Bock MD
California Skin & Laser Center
Stockton & Lodi, CA