Category Archives: fillers

Applying art to facial rejuvenation is key to making a face appear optimally youthful and at the same time completely natural. I have spent my lifetime studying faces to determine what are the qualities that make a face look younger or older. I particularly like to look at mother and daughters’ photos on social media […]

Glass of Water Emptying:  The Way I Explain the Aging of the Face When people ask me whether fat grafting is permanent, I say yes and no.  Yes, it is permanent because if done well by an expert injector (which I consider myself one) then once the graft gains formal blood supply over a period […]

Breaking down the Cheek into Aesthetic Subunits: Avoiding Chipmunk Cheeks There is nothing uglier than big, chipmunk cheeks other than perhaps a devil looking arched brow or a duck-like lip.  How do you avoid this problem?  Should one not fill the cheeks at all then?  The answer is no since the cheek is one of […]

Type 1 and Type 2 Eyelids One of my colleagues came up with the distinction between two types of youthful eyelids.  Type 1 is a very full upper eyelid that hangs almost over the eyeball itself (not quite).  Type 2 eyelid is an eyelid that is much hollower but at the same time still distinguishes […]

Breaking the Brow into Subunits: Designing a Brow for Cosmetic Improvement In a previous blog we discussed why low, full brows are sexy, youthful and attractive. In this blog, we will delve into the exact subcomponents of a brow that need to be filled to achieve that look.  I break the brow into multiple points depending […]

When Do I Do an Upper-Eyelid Blepharoplasty and How? But should we always just add fillers or fat to the upper frame of the eyelid and never remove any tissues?  The answer is no.  If the eyelid skin is above the eyelash margin, I rarely if ever remove skin.  Filling fat or fillers into the […]

When Do I Do a Lower-Eyelid Blepharoplasty and How? Like the upper eyelid, I find myself performing many more fat transfers to correct the aging process than traditional eyelid surgery.  Further, if I perform a traditional lower-eyelid procedure I will almost always use some fat transferred to improve the result.  In fact, I look at […]

Recently, I had a lady who at the age of 57 started modeling for the first time in her life thanks in large part to the syringes I have put into her face to make her look better.  Her new boyfriend remarked that she looked better than she had when he saw her 7 years […]

Recovery and Cost of Fillers vs. Fat Grafting I would like to focus on two specific pros and cons with fillers and fat transfer: cost and recovery. In the younger patient (under 35 years of age), fillers typically are the most affordable way to make a face look more youthful. The reason for this is […]

In my effort to find the best filler experience for an individual, I am constantly evolving my injection filler methods and the preferred products that I use to accomplish those goals.  In the past, I was a big advocate of Restylane injectable fillers but of late have found a real passion for Juvederm Ultra Procedures.  Is Juvederm great […]

Top 10 Things People Worry about After a Fat Transfer (During the Recovery Period) When I call one of my patients the night following a fat transfer procedure, I usually mention the top few things that can make them alarmed that will resolve over the period of the next couple of weeks.  Here is that […]

High or Low Brows?:  What is Sexier for Men and for Women? I am reading a book called Survival of the Prettiest by Nancy Etcoff in which she says studies have shown that a higher brow actually looks less attractive to subjects who viewed various individuals with different brow heights.  A low brow was considered […]

The Outer Face:  Converting Double Concavities into Convexities The one thing that I cannot stand is seeing a face that appears disjointed, i.e., part of the face has been over augmented relative to another.  Perhaps the two biggest problem areas that I see are the lips and the cheeks.  In fact, I have come up […]

Cannulas for Facial Fillers: The Evolution of My Technique Although I would estimate that only 1% of injectors currently use cannulas rather than standard needles to perform facial fillers, I truly believe that they have become the standard of care in my practice and I would hope the industry soon. I have been using cannulas […]

Cosmetic Facial Enhancement:  A Mechanic vs. an Artist I had a lady come to my office a few months ago who said that she went somewhere else for a facial fat transfer because it was a couple of thousand dollars less than what I charged.  She then came to me to touch up the work […]

Hollywood’s Pillow Face is a Problem As many of you know, I love facial volumization in which lost soft tissue of the face from aging is restored using fat grafting and/or injectable fillers.  The word that has dominated the media is a “pillow face” to describe this facial fullness.  I am very adverse to this […]

Downturned Corners of the Mouth:  How To Fix Them One of the banes of women’s existence is the downturned corners of the mouth. Whether they are mildly present or severe, almost every woman regardless of age is overly focused on them to their own detriment. I often think that the reason for this is that […]

Why I don’t use Sculptra First, let me say that I truly do not believe Sculptra is a bad product. In fact, I have many trusted colleagues who use it and use it well.  However, I have used it in the past but I do not anymore for several reasons.  The motivation behind this blog […]

Eyebags, Shorelines, and Rocks When we talk about eyebags, we are focused on the obvious, which is that there is a protuberant bag of tissue. However, is this really the case in the majority of situations? My answer is no. What I oftentimes see is that the lower orbital bony rim becomes exposed over time […]

How I use Permanent Facial Fillers: Fat Transfer, Silicone, Bellafill(Artefill) In my clinical practice I use both temporary and permanent facial fillers depending on a mixture of budget, desires, and safety. Although permanent fillers carry the risk that they are indeed permanent, I believe that it is important to delineate safety guidelines and also to […]

Notched Noses: How To Fix Them Without Rhinoplasty For me one of the biggest telltale signs a nose underwent previous rhinoplasty is the nostril is notched like an upside V-shape rather than a gentle upside U-shape. This notching that occurs after previous aggressive rhinoplasty may remain unaware to the individual that it is unnatural but not […]

Runner’s Face News Story Featured on 33 News Tonight I was featured on 33 News tonight at 9 pm on a segment entitled “Runner’s Face” for those hyper athletic individuals who prematurely age due to volume loss.  Melinda Arai goes through multiple syringes of fillers to help plump her face back naturally into a more […]

Leveraging the Hardness of Products in Cosmetic Injectable Fillers How hard an injectable product is can be a very good thing or a not so good thing. In any case, I try to use products based on its hardness factors for differing effects on the face. One of the softest materials that I use is […]

Use of Microcannulas: A Revolution in My Practice Using Fillers Many of my patients who have been with me for many years have witnessed the revolution in techniques that I have developed for injectable fillers.  Early on I started with rudimentary needle injections.  I then progressed to larger cannulas that I adapted from fat grafting […]

The Liquid Facelift Debunked A term that has become the bane of my existence is the “liquid facelift” due to a recent appearance on Dr. Oz that has caused quite a media stir.  Although I perform a huge volume of facial fillers and fat grafting in my practice, it is not the same meaning of […]

Injectable Rhinoplasty: When, Why and Why Not With the desire for non-invasive techniques today, many patients are turning to injectable rhinoplasty to make themselves feel better about their nose shape without undergoing surgical rhinoplasty. However, is this a good thing?  Who is a good candidate? First, let’s define what injectable rhinoplasty is.  It involves injecting […]

Managing Fine Lines Around the Mouth Fine lines around the mouth is perhaps the most important and at the same time least important topic for a written blog on facial plastic surgery.  Why is that the case?  Because almost every woman young and old is bothered to some degree about what they call “smoker’s lines” […]

Who is a Candidate for Lip Reduction Our society has been deluged with desires for lip augmentation or enlargement but who is a good candidate to have his or her lips reduced?  There are two principle groups of people desiring lip reduction.  The first group includes individuals who have had terrible lip augmentation procedures that were […]

Fat Grafting Using a Hair Transplant Model for Understanding Part 1:  Graft Growth Looking at my fat grafting results I was puzzled initially as to why I saw results continue to improve in patients somewhere between 6 months to 2 years after a procedure.  Being a very careful student of my own work by photographing […]