Photo Credits TK HereMAY 2020 SHAPE.COM 39
the mouth, ensuring that
you don’t get that stiff, fro-
zen look you might have
seen in the past. You can
talk and smile normally,”
says Ivona Percec, M.D.,
Ph.D., a plastic surgeon in
Philadelphia. Restylane also
works well under the eyes
because it doesn’t cause
much swelling, Dr. Rabach
says. But for lips she prefers
Juvéderm Volbella because
it resembles the texture
of delicate skin; for cheeks
she turns to Juvéderm
Voluma. “It’s a stiffer gel,
so it really helps to lift the
cheeks up,” Dr. Rabach
says. She also uses it in the
temples and even the nose
as a temporary, nonsurgical
alternative to rhinoplasty
(this method is often called
a liquid nose job).
All fillers eventually
absorb into your blood-
stream for up to two years,
but expect hyaluronic acid
fillers to last six to 12 months.
One major bonus? “They’re
dissolvable,” Dr. Rabach says.
If you need to get rid of them
for any reason, a doctor can
inject a solution called hyal-
uronidase that breaks the
bonds among the hyaluronic
acid molecules over 24 hours.
WHAT THEY COST: Most
hyaluronic acid fillers
cost $700 to $1,200 for one
syringe; the amount you
need varies depending on
the desired results. “For full,
natural-looking lips, you
usually need one syringe.
To fill hollow undereyes,
you would typically need
one to two syringes,”
Dr. Rabach says.Calcium
Hydroxyapatite
Fillers
WHAT THEY ARE: “These
fillers are made of a material
found in bone,” Dr. Rabach
explains.
WHAT THEY DO: Radiesse
is the most well known in
this category and is often
used to even out or define
areas where there isn’t
a strong bone structure or
there has been bone loss,
such as the jawline. “I often
turn to this filler to balance
the symmetry of the face,”
Dr. Rabach says. Though
radiesse lasts only one to two
years, calcium hydroxyap-
atite fillers are considered
semipermanent because
they leave trace amounts in
the body even after you can’t
see their effects any longer.
WHAT THEY COST: One
syringe costs $800 to
$1,200. “The amount you’ll
need depends on the result
you want to achieve and
the area you’re treating,”
Dr. MacGregor says. “It could
be just one syringe or many.”Poly-L-Lactic
Acid Fillers
WHAT THEY ARE: “The
particles in this synthetic
polymer spread under the
skin and stimulate your
body’s own fibroblasts to
produce more collagen,”
Dr. MacGregor says.
WHAT THEY DO: This filler
doesn’t have the immediate
gratification of the other
types (it takes from one to
two months to start showingresults), but it’s well worth
the wait. Sculptra, the most
well-known filler in this cat-
egory, was created to coun-
teract full facial volume loss,
so dermatologists tend to
inject it in multiple areas like
the temples, the cheeks, and
along the jaw. It can also be
used in areas on the body like
the neckline and butt. “ We
inject Sculptra a little deeper
than other fillers. Over the
months, your own collagen
builds up around it to create
the most natural-looking
fullness,” Dr. Rabach says.
It’s a favorite among many
dermatologists. “I use it as
a fertilizer in combination
with other fillers,” says der-
matologist and Shape BrainTrust member Elizabeth K.
Hale, M.D. “It stimulates
collagen production over
time while the other fillers
add the instant volume.”
WHAT THEY COST:
Sculptra costs $800 to
$1,400 per vial and requires
two to three injection ses-
sions spaced six to eight
weeks apart. “After that,
it lasts two to three years,”
Dr. MacGregor says.Inject Safely
The most important thing
you can do to set yourself
up for a positive result is to
choose an experienced injec-
tor. “No matter who you go to,
whether it’s a cosmetic der-
matologist, a plastic surgeon,
or a clinician at an injectable
bar or med spa, make sure
the person is well educated
in anatomy,” Dr. Percec says.
“Just because it’s minimally
invasive and requires only
a small needle doesn’t mean
it can’t cause problems. And
the injector needs to know
how to handle those situa-
tions.” Don’t hesitate to ask
about how often someone
injects patients and what
their experience level is with
the specific treatment you
want done.
The good news is that,
unlike more invasive proce-
dures, fillers don’t require
much downtime. “The lips
and undereyes tend to be the
most temperamental areas.
You can have swelling and
bruising that lasts a few days
or up to a week,” Dr. Rabach
says. After that, you’re look-
ing the way you choose to.WHAT ABOUT
BOTULINUM
TOXIN?
It’s an injectable
that softens the
appearance of
wrinkles too, right?
“Yes, but while fillers plump
up the skin to smooth
a wrinkle, Botox [and other
forms of botulinum toxin]
is a synthetic protein
that’s injected into the
muscle to stop it from
moving,” Dr. Rabach says.Does reducing
my facial movements
smooth my skin?
Repeated muscle
contractions eventually
carve wrinkles, like a frown
line between your brows or
horizontal creases across
your forehead. “Reducing
those movements can
help soften the etches you
already have, and small
doses of Botox can prevent
wrinkles before they form.
If you use it consistently,
it can even make the
muscles smaller, which
makes the skin smooth,”
Dr. MacGregor says.How long does it last?
“Botulinum toxin takes
up to a week to kick in and
then lasts two to four
months,” Dr. Rabach says.SHA0520WPLAB.indd 39 FINAL CONTENT 3/12/20 5:38 PM