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Micro Fillers

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This blog, I entitled micro fillers and it’s a bit confusing because I think a lot of people think micro fillers means really, really tiny amounts. Sort of that is true, but I will clarify them in a minute. Also, I do a lot of meso hyaluronic acid, which means injecting small amounts of hyaluronic acid into the dermis to improve the skin texture. That is something else that I guess could be deemed micro fillers, but I’m actually not talking about that. Also when I talk about micro fillers, I can be putting in four to six syringes, which doesn’t seem very micro at all. So let’s define what a micro filler is. So before we do that, let’s talk about how to conceptualize the aging of the face. If you understand that volume loss is a component, there’s gravity, there’s wrinkles and everything like that, but volume loss is definitely one component and then the natural idea is to sort of volumetrically expand the face. 


Yes, that can be done and it is done. And I do that. However, the problem with just volumizing the faces several fold. Number one is it can cost quite a bit of money because it takes so many syringes to augment a face through volume. And then the other component of it is that there are certain areas that someone can look overfilled. So from the best cost benefit ratio as well as limiting the chance of overfilling a face, I do this in a different fashion. So let me explain the style that I do this. Think of the faces in terms of watershed zone. So what watershed zones means there’s a transition of bone. So let’s say for example, under the eyes, the most classic area, there’s a transition from the bony rim to the hollow eyelid. 


And if you can just fill that transition, you can create a very good result where the eye looks blended into the face where you’re not actually augmenting the entire anterior cheek, but just a transition zone or what I call a watershed area. So the same thing. Let’s take a look at the outer cheek. When you can start to see the edge of the bone below the cheek, that’s a sign of aging. It’s a lot of women tell me they want to have cheekbones and that’s actually exactly the opposite. If you see a piece of bone sticking out the side of your face, you are actually showing aging. So what young women have is a cheek mound. Now the trick with the cheek mound is you don’t want it in an anterior place in the front. She, cause I just looks very pumpkin face and looks abnormal. 


So what I do is I fill under the arch of the bone, which is the zygomatic arch. And if I just put a little bit under there, that transition zone, your brain erases your ability to see the bone. So if you can hit these little bony transitions on the face looking for these shadow points, for example, the temple area, you can look at the what’s called conjoint 10 which is the transition from the temple over to the forehead. If you can just hit that little edge, your brain can erase part of the temple. Now there’s a lot more sophistication this than I’m talking about. I can tell you a million examples on the face where my brain is constantly looking for these transitions. But even if I’m using several syringes of fillers, I’m still putting these little drops in these little edges of the face because you know, one syringe is equal to one fifth of a teaspoon. 


I’ve had a lady that I’ve done work on for 15 years. She was on a layover, put one syringe on her face and made the whole face look fake. So one syringe can make someone look abnormal if it’s done wrong, but I can put in 12 syringes and still make it look natural. So micro fillers, what I’m defining here is not a small amount of fillers, although yes, I can use very small amount of fillers to make a big difference. I can use one syringe, oftentimes still make a nice change. I’m talking about understanding these transition zones between bone, the bone edges. And if you can just cover these little bone edges, you can make a really, really nice change in the face, make it look so much more youthful. And for a lot of my patients that are first timers, I’ll do a little area, show it to them, let them compare both sides and like, wow, you put in a 10th of a syringe, you made this difference. 


Yes. Now obviously the more I put in the greater longevity, and that’s another subject as I’ve really seen these fillers last many years. Once you start the building process. But I’m going to relegate that description to another blog. But just as suffice as say, when I talk about micro fillers, I’m not talking about small amount in total. I’m talking about small amounts and multiple small areas of the face to cover bone edges and what I call watershed areas. So hopefully that has you start to begin to understand some of my concepts of how I approach the face.