When it comes to dermal filler, how do you determine when enough is enough?
In today’s hyper-connected world, we’re constantly bombarded by the pressure to conform to whatever beauty standard is popular. In the world of aesthetics, we’ve idealized what the “perfect” face looks like. We’re inundated with this apparent perfection dozens of times a day: every time we open a social media app, turn on the TV, or even head out with friends.
It seems like we’ve been taught that in the world of aesthetic medicine, filler is the answer to the slew of skin and complexion issues that seem to abound us the older we get. Plus, nowadays, when there’s an injector on every corner offering Groupons galore, it’s easy to assume that if filler is so popular, it’s got to be the holy grail answer to anti-aging.
While hyaluronic acid dermal filler has its place in the anti-aging treatment lineup, I’m here to say it: HA filler is not the be-all-end-all to facial rejuvenation! Unfortunately, inexperienced or untrained injectors may have been led to believe otherwise, and this can result in patients who are overfilled, particularly in the midface area, an issue dubbed “pillow face” in the injectable community.
“Pillow face” denotes a swollen appearance where a patient’s cheek filler appears puffy and unnatural. The face often looks disproportionately wide, the overall shape may seem artificial, and the person can appear older. An overfilled face can even appear uncanny looking, which points to a phenomenon where humans can detect something amiss or not quite “naturally human” within the complexion.
The most common cause of pillow face is too much hyaluronic acid (HA) filler. Hyaluronic acid fillers are currently the most popular fillers on the market (think Juvederm, Restylane, RHA). Hyaluronic acid is naturally found in the skin as a component of collagen. It’s hydrophilic, meaning it attracts water and therefore is an excellent option for providing isolated volume and firmness.
We all know by now that as we age, our body produces less collagen naturally and, thus, less HA, which leads to less plump, hydrated, and youthful skin. Knowing this, it totally makes sense to inject HA, right?
Not so fast. When we inject HA, the primary function of the treatment will inevitably be an increase in volume, which is excellent…when you need a boost of volume in a particular area. But when we’re looking holistically at the aging process of the entire face, including skin texture and laxity, we have to aim for a more dynamic treatment approach that addresses not only volume loss but also skin regeneration ability and overall skin health. This holistic approach is how we avoid “pillow face” syndrome.
One of the main focuses regarding overall facial rejuvenation should be collagen building. While it’s a great ingredient, HA is not a collagen builder or stimulator. A better choice for overall facial rejuvenation is a collagen-building treatment + filler and tox as needed + medical-grade skincare.
What is Collagen?
Collagen is a protein within the deep dermis of your skin. It gives your skin structure and supports the functions of elastin and hyaluronic acid (HA), which help maintain skin’s shape, smoothness, and hydration.
Overall, collagen helps keep your complexion looking youthful, plump, and radiant. After the age of 20, we begin to lose about 1% of collagen per year! If we want to maintain beautiful skin, choosing treatments that help restore collagen can be a great way.
Collagen-Stimulating Treatments
Let’s dive into some of the best collagen-stimulating treatments to help you achieve the plump, firm, youthful skin you’re dreaming of and avoid that unnatural, overfilled, chipmunk-cheek look.
Microneedling with Platelet Rich Fibrin (PRF)
During a microneedling treatment, we use a device that creates controlled micro-injuries to the skin with tiny needles. This triggers your skin’s natural healing response, and your body begins repairing the injury by producing more collagen. The result? Radiant, more youthful-looking skin!
When we pair PRF with microneedling, the magic happens! PRF is a substance extracted from your blood. It’s a natural healing elixir with 7 growth factors which boost your cells’ collagen-producing abilities for tighter, smoother, and healthier skin.
Microneedling with PRF…
- increases collagen by stimulating new cell turnover
- fights acne by exfoliating old skin cells
- diminishes eye wrinkles and fine lines
- eliminates dark spots and acne scars with collagen production
- boosts your products’ effectiveness
Best results are achieved using a series of treatments (typically 3).
For your PRF Microneedling treatment, visit Stephanie (@thestephanieglow) at CULT Aesthetics Dallas or Mandy (@theinjector.mandy) at CULT Aesthetics Atlanta!
Sculptra
Sculptra differs from other hyaluronic acid (HA) fillers because it’s made of poly-L-lactic acid (PLLA), a collagen stimulator. Rather than providing immediate volume and drawing water towards the treated area, Sculptra works with your body at the injection site to restore lost collagen and elastin.
Sculptra is an excellent option for patients who want to achieve natural-looking rejuvenation because it activates the skin’s innate regenerative process! 🌟
The PLLA Sculptra is made of a synthetic biocompatible, biodegradable material consisting of microparticles that your body absorbs deep in the dermis of your skin.
As your body absorbs the Sculptra PLLA microparticles, the particles help stimulate collagen production. The restored collagen strands begin to gradually increase facial volume and fullness, improving the appearance of wrinkles and folds. 😍
☝️When it comes to Sculptra, the best results are obtained over a series of treatments administered by a trained injector. The number of necessary appointments and injections per appointment will vary from patient to patient. On average, a series of 3 appointments is needed over a few months.
Radiesse
Radiesse is a dermal filler made of calcium hydroxylapatite (CaHA) that works with your body to stimulate collagen for long-term improvement.
After injection, the CaHA particles begin to integrate into your skin over time and create a scaffold that stimulates collagen and elastin production. Eventually, the gel carrier breaks down, and a firm network of collagen fibers forms in its place, smoothing fine lines and improving skin structure. The collagen in the treated area will continue to increase, and you’ll experience skin rejuvenation over the next 12+ months. 🙌
Lasers
Laser treatments use light energy to penetrate deep into the skin to induce regeneration. They can treat everything from uneven skin tone and texture to fine lines and wrinkles, hyperpigmentation, skin laxity, and more!
For your laser treatment, visit Katherine (@lawoflasers) at CULT Aesthetics Dallas and Liz (@laseredbyliz) at CULT Aesthetics Atlanta.
High-Quality Medical Grade Skincare
Using medical-grade skincare formulated for your skin type + concerns is imperative. If you’re new to skincare, this means cleansing and moisturizing your face 2x a day and exfoliating 2-3x per week while adding in serums and other actives as needed. Most importantly is using SPF daily!
You can invest in all the injectables in the world, but without a foundation of good skin care, your efforts won’t produce the results you truly want.
I recommend skinbetter for a fantastic medical-grade skincare brand. ✨
KEY 🗝 Takeaway:
Your injector should always assess your entire face to determine the best treatment plan for you, which should involve more than one treatment modality. Ideally, your treatment plan will include a form of collagen-building therapy.
I am all for having open communication with your injector. Aesthetic medicine treatments are still medical procedures, and you must have a relationship with a skilled injector you trust. Your injector should always be focused on recreating/accentuating/highlighting the shape and contour of your natural, youthful face instead of just pumping you up with volume, volume, volume.
As a patient, do your due diligence before having a medical aesthetic treatment, just like you would any other medical procedure. Your injector should pay attention to you, your goals, and your unique facial shape and provide you with a dynamic treatment plan that is feasible for the long term. Look at your injector’s work and ensure they’re not just filling lips and cheeks or only focusing on specific areas of the face rather than the entire face.
⭐️ Remember: The whole is greater than the sum of its parts. HA filler paired with collagen therapy and other anti-aging treatments is the best bet to keep your entire complexion rejuvenated and glowing for life.
Have more questions about anti-aging treatments? Visit us online at CULT Aesthetics 💉or on Instagram @cultclinics. Book a consultation with us HERE, or call CULT Aesthetics offices in Uptown, Dallas, TX at 469-720-1086 or Atlanta, Georgia at 678-812-2212.
Resources:
“HOW TO AVOID PILLOW FACE // Botched Face Fillers.” YouTube, 15 June 2021, https://www.youtube.com/watch?v=WU76smlg7cQ.
John, Hannah E, and Richard D Price . “Perspectives in the Selection of Hyaluronic Acid Fillers for Facial Wrinkles and Aging Skin.” Patient Preference and Adherence, 21 July 2009, pp. 225–230., https://www.dovepress.com/getfile.php?fileID=5077.
“Pillow Face from Too Much Face Filler – What Is It and How to Avoid It.” YouTube, 30 Mar. 2021, https://www.youtube.com/watch?v=rOq2Gj1h2N8.
“Why the Overfilled Don’t See It…” YouTube, 21 July 2022, https://www.youtube.com/watch?v=Rab1Q8h7rqk.
