They Don’t Have to Happen to You
April 2022 Issue
By E. Ronald Finger, MD
With the advent of Botox and Dysport and various fillers to restore facial volume such as the Juvederm and Restylane products, Sculptra, etc., men and women alike have jumped on the bandwagon to take advantage of these products to look more youthful.
The goal should be to look younger and better, but not look freakish or different. Most patients want to enhance their looks and look more youthful. What they don’t want is to have others look at them and wonder “Why do you look strange and even disfigured?”
One of the most common “bloopers” is overfilling the lips to the point they appear they have been stung by bees (although some patients actually do request overfilling). The injector putting too much filler in the lips, or putting it too deep or even in the cutaneous part (the skin between the red part of the lip and the nose) of the lips results in “duck-like” lips. For a natural appearance, the fillers should be added to the mucosa of the lips (the red part) and not into the muscle above the lips. This results in a “shelf” of filler above the lips that gives the person a “simian-like appearance” because the cutaneous upper lip now can extend beyond the red part of the lip.
Another frequent “blooper” can occur when untrained injectors of Botox or Dysport inject the frown lines between the brows (known as the “elevens”). If the injection extends above the inner brow closest to the nose, the result is drooping of the brow in this area. Then when raising the brow, the inner part cannot elevate, so the outer brow over-compensates and elevates too much, giving one a Mr. Spock appearance. This also makes the patient have a brow that looks “surprised” all the time, which is not a normal appearance.
Body Dysmorphia, such as over-sized rear-ends, overfilled lips, overfilled facial areas with fillers, and incorrectly injected Botox or Dysport, are linked to many celebrities and movie stars. As such, many younger patients see these results as the “norm” and often request the obviously overdone look.
This results in many patients shying away from using these products. They are fearful they will have that overdone look, when they really just want to look more rested, youthful and natural. The great news is, if done by a skilled injector, the actual results can make one look years younger with little, if any, downtime. If the injector understands the anatomy of the face and can re-volumize the areas that are causing the sagging and wrinkles, instead of just filling in the wrinkles, results are dramatic and look totally natural.
In most cases loss of facial volume contributes to the aged look as much or more than loss of elasticity. To turn back the clock naturally, the fillers must be placed skillfully and artfully into the areas of volume loss. However, the patient’s goals must always be kept in mind.
Dr. E. Ronald Finger was the first board certified plastic surgeon in Savannah. He continues to practice full time, specializing in both surgical and non-surgical cosmetic surgery. Call today: 912-354-4411.