One of the most powerful ways that our faces change with age is that we lose facial volume. When we are young, our faces are round and full. We have fullness in our foreheads, temples, cheeks and mouth. This is because these areas have structures called fat pads that are fully inflated in our youth. Over time, the effect of gravity causes the structural supports for these fat pads to weaken and fall. When you combine this with the tendency of our fat pads to deflate over time, you get a subtle but very real downward slide! The upper part of our face begins to look hollow, while the lower part begins to look full and heavy – this is the classic appearance of an aged face.
One of the tools that we have available to fight these natural changes are dermal fillers. These are products like Juvederm (Ultra XC, Voluma, and Volbella), which contain a gel of a sugar-like molecule known as hyaluronic acid (HA). These HA gels are very natural and safe, because our bodies naturally contain HA in our skin and joints. So there is no need for allergy testing and they contain no animal-derived products like past fillers, such as collagen.
Each of the gel products has its own, unique properties that make it a great choice for the area it is designed to revolumize. Almost any facial structure can benefit from filler: hollow temples, mid and outer cheeks, creases beneath the eyes (tear troughs), around the lips and the lips themselves, the corners of the mouth, the heavy folds around the mouth (nasolabial folds), the chin and the indention on the sides of the chin (pre-jowl sulcus) are just a few of the places that filler can be used to replace full, youthful volume.
The overall effect of using these products is to literally “lift” the face by restoring lost volume to key facial structures. This is why their use (especially when combined with neuromodulators like Botox and Dysport) has become known as a “liquid face lift”. While it is not surgery, you can often achieve a look with volume replacement that you simply cannot with a surgical facelift. In the hands of a skilled injector, you can achieve a very soft, full and natural looking result.
Since our bodies are equipped with natural enzymes to break down HA, the gels themselves do eventually dissolve, but many times, the duration of their effect when used for deeper structural correction can be as long as 2 years if placed in the correct place and in the right amount. In places like the lips, you are more likely to need retreatment in about six months.
Injections of these products can be painful. Usually, most of the products come premixed with Lidocaine, which helps produce a local numbing effect in the area that’s being injected. Topical numbing cream and ice can also help with the initial discomfort of the needle stick as well.