The Filler Effect – The New York Times

The Filler Effect - The New York Times

The cost of fillers is substantial.One syringe of Juvéderm Voluma, a product now commonly used on the cheeks, runs $700 to $1,200 in New York, with price variations depending on neighborhood and the doctor’s experience. A mild case of laugh lines can be corrected with one or two syringes. Severe volume loss could require four or more.

And there are limits to what fillers can do. Think of the neck as a litmus test. If it’s very loose or banded, fillers won’t help. Also prohibitive: inelastic skin. For fillers to work, they must have some structure to push against. Skin lacking collagen and elasticity, like severely sun-damaged skin, won’t lift.

“In my experience, using filler to correct drooping skin in somebody who already has prominent cheekbones is reasonable for about a year and a half or two years,” said Dr. Michelle Yagoda, a plastic surgeon in Manhattan. “After that, the pocket where the filler was placed stretches. Then to achieve the same look, doctors will inject more product. You start seeing cheeks that are very prominent compared to the lower face.”

Dr. Yagoda suggested deciding on an aging-intervention plan for 10 to 20 years out. “You might have to consult a facial plastic surgeon and a dermatologist to get the best mix of noninvasive and surgical options,” she said.

Doctors often credit Botox, the muscle-relaxing neurotoxin, as the facial aesthetics game-changer. “For the first time, doctors from different disciplines — plastic surgeons, dermatologists, ophthalmologists — were working together,” Dr. Graf said. “We learned from each other how the facial muscles work and how the face changes with aging.”

Dr. David E. Bank, a dermatologist in Mount Kisco, N.Y., uses thinner hyaluronic acid fillers, like Restylane Silk and Belotero, to improve skin texture and boost radiance.

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