Facial filler has been the literal topic on everyone's lips ever since a certain reality star-inspired challenge. Whether or not you're into the idea of fillers, you have to admit—those before and afters are pretty intriguing, right? To clear up any misconceptions, we spoke to cosmetic surgeon Victoria Karlisnky, M.D. at New York City's New Look New Life surgical arts center, who gave us a crash-course on the subject. "I think an important message to carry through is that people shouldn't be scared of fillers if [they] feel that the treatment is right for [them]," she tells InStyle. "Be realistic with your expectations, and don't go overboard. When you have that idea in your mind, then you won't go wrong." Keep reading to get all the info you've ever wanted to learn about filler, whether you're considering it (no judgment!) or are just the slightest bit curious over what the fuss is about.
What Is Filler?
Filler is a compound, usually comprised of hyaluronic acid, which does exactly what the name suggests—it is used to fill in deep wrinkles and restore volume to areas where it is lost. "As we get older, most of us will start to lose bone volume, fat, muscle tone, and skin elasticity goes away. As a result, your face sort of ends up shrinking," Karlinsky explains. "Filler has become a great answer to replete volume where it's needed."
Is It Similar to Botox?
To be frank, the only similarities between filler and Botox are that they are both delivered in a syringe. Each compound does completely different things. "Botox helps to eliminate wrinkles that come from muscular contractions by keeping those muscles from moving. Filler can help to smooth over wrinkles that have already formed," says Karlinsky. While some wrinkles may be too deep to be treated with Botox, rest assured that filler can address the issue. Additionally, Botox takes a few days to kick in, whereas the results with hyaluronic acid filler are immediate.
Where Is It Used?
Some of the most-popular areas to inject filler include the nasolabial folds around the mouth—known as "laugh lines" to some—in the lips, in the cheeks, and in the temples. "We sometimes have to fill the temples when a client has lost a lot of weight, and their head takes on a weird shape," adds Karlinsky. "There are multiple areas they can be used to improve the look of the face, because a fuller appearance always looks more youthful and rejuvenated."
Who Should Use It?
If you have a stubborn area that can be addressed with filler, then you're probably a good candidate, but Dr. Karlinsky urges her patients to be realistic with their expectations, and not to go overboard. "I start out very, very slowly, especially if someone hasn't done this before. I limit their treatment to one syringe at a time, unless they're asking for something specific," she tells us. "I typically have them do a little, let it settle, and if they want to come back and do something else, we'll discuss that. It's never a problem to add more, but you never want to be in a position where you need to start diluting what you've already put in." Overall, the goal is to look like yourself—albeit a slightly refreshed, softer version.
Is There Any Downtime Involved?
Generally speaking, no. Karlinsky notes that some post-injection swelling is to be expected, and depending on the individual, there may be some slight bruising, but not to the point you'll have to shut yourself away for a few days. Follow your doctor's orders for after-care, and avoid putting too much pressure on the treated areas immediately after. "Just like any medical procedure, there are risks, but they're extremely rare, and that's why a person should go to someone who is trained and knows the anatomy of the face to reduce those risks," says Karlinsky.
What's with the Different Formulas?
You've probably heard of Juvederm, Restylane, Radiesse, and Sculptra—although each filler has a different name, they all accomplish the same thing. "Sometimes it all boils down to the physician's preference and what they determine would be best to treat the issue at hand, but also, the preference of the patient in the case that they tend to favor one over the rest," explains Karlinsky. "The hyaluronic acid groups like Juvederm and Restylane are the most common." Juvederm has three different formulas: Voluma, the thickest, which lasts for two years, Juvederm Ultra Plus, the middle-range one that lasts roughly a year on deep wrinkles, and Juvederm Ultra, the thinnest compound, which works best best on the lip area. Its competitor, Restalyne, also has three different formulas that range from thick to thin, with roughly the same timeframe attached.
How Long Does It Last?
Depending on the area you inject and your formula of choice, you can expect your filler to last 6 months at minimum, and 2 years at most. "It typically goes away faster in the lips because there is so much motion from eating, talking, and laughing," Karlinsky says. "When we inject people in more static areas, like the lower eyelids to counteract the hollowness, the filler can stay for 2 or 3 years because it sits directly on the bone and doesn't go away so quickly." Additionally, the thicker formulas, like the aforementioned Voluma and Restylane Lyft variations, will have more staying power than their thinner counterparts.
How Should I Go About Finding a Practitioner?
Karlinsky advises doing your research on doctors in your area, and once you find a few potential options, read as much as you can to get an idea of what your experience could be like. "You definitely want to make sure they're in the cosmetic surgery or cosmetic dermatology world—someone in the correct field," she tells us. "If you read multiple accounts, you'll be able to determine who is reputable and who isn't." Seek out someone who is board-certified, and it also goes without saying, but we wouldn't recommend seeking out any Groupon-esque treatments in this field. If something seems too good to be true, then it probably is.