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By Marc Meisfelt (2010)
Fillers are substances that are injected into the skin to support the underlying structure, in the hope to straighten wrinkles in certain areas.
My own experience with fillers is that they provide little benefit, compared to what can be achieved with other procedures, and compared, too, with what they cost.
They are primarily applied in the lower facial area, on the chin and around the angles of the mouth, not because they would work so well in these areas, but because for these areas, nothing better is available.
To get rid of forehead wrinkles, no fillers are needed. For forehead wrinkles, either a forehead lift does the job, or one smoothes them quite nicely with Botox.
Around the eyes, Botox also works very well. And tear bags can be cut off easily as tissue around the eyes heals with very thin scars.
On the forehead and around the eyes, wrinkles, by and large, are the traces of repeated muscle contractions, and those can be obstructed very well with Botox.
But wrinkles in the corners of the mouth are skin folds, rather than muscle folds. And the same is the case for the horizontal half-moon wrinkle between the lower lip of the mouth and the chin.
I like to do whatever is possible to look as young as possible (to look older later, I won't have to do much). Sure, the wrinkles in the corner of my mouth are no soooo bad. But they also don't agree with a claim of being in one's early 30s.
Therefore, if I could get rid of them, I would go for it. I have tried hyaluronic acid (at Yanhee Hospital in Bangkok), but the improvement was minimal. The price was 14,000 baht for 0.75 ml.
There are other fillers, some of which have been around for decades, such as bovine collagen, but none of them have ever been as convincing as Botox.
Many fillers also have a side effect profile that is not as gentle as that of Botox. Fillers sometimes lump, and in areas of thin skin, this can easily result in an appearance that is worse than the small wrinkles that are supposed to be treated away.
Another possible side effect is a kind of granulation, which is not just a cosmetic, but a medical condition.
Because of the lumping and granulation risk, even modern fillers such as Artecoll and Artefill are, in most countries, approved only for wrinkles of deep tissue where lumping will be better absorbed, such as the vertical folds between the cheeks and the nose... but then, these folds are easily diminished by an old-fashioned facelift.
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Copyright Marc Meisfelt