The decision to get facial fillers becomes easier and easier every month, as more celebrities own up to having wrinkle reduction treatments with fillers, the cost comes down and the reliability of products goes up. There is one question that almost every prospective facial filler patient has, though, which is rarely answered comprehensively in the FAQ section. That is, “What does getting a facial filler treatment feel like?”. The most that people usually tell you is that the needle is barely felt, and that if you are uncomfortable with it you can get local anesthetise. Those who’ve had the procedure done know that there is a lot more to its ‘feel’ than a simple pinprick … we explore it from start to finish, for new facial filler patients!
How do dermal fillers work?
Dermal fillers work exactly as the name suggests. Most wrinkling as we age is due to a loss of volume under the skin – muscles shrink, and our skin tends to stay less hydrated. Facial fillers help fill out the tissue underneath the skin to correct wrinkles. The base product used for this is usually hyaluronic acid, a substance that ocsurs naturally in the body and is absorbed again by the body after several months.
What does the procedure feel like?
The procedure is nothing like a traditional cosmetic surgery procedure, such as breast surgery or liposuction. Depending on the amount of area that you want covered, you may have from one to six needle punctures. If you want, you can have a local anesthetic cream to cover the sites that will be injected. If you choose this route, you will feel almost nothing at the time of treatment, apart from a very mild pressure sensation. It is not painful at all.
If you choose to go au naturel, without local anesthetic, the only pain is that of a very fine needle being inserted. The wrinkle injection needles are thinner than those you are familiar with from vaccinations and blood tests.
How will my face feel directly afterwards?
The feeling directly afterwards is usually one of mild soreness. This is related more to the actual wrinkle injection that to the introduction of the facial filler into your skin. Patients describe sensations like:
- Mild pain
You’ll be able to notice the effect immediately after the wrinkle injections, however this is not necessarily what your face will continue to look like – you also have the effect of swelling to account for in what you see immediately after your treatment.
How will my face feel a couple of weeks afterwards?
All pain will have disappeared by this stage – and if it hasn’t, you should call your doctor immediately! The feeling of fullness will persist, though there won’t be any pain associated with it by this stage. You might notice a difference in feeling depending on which brand of facial filler was used for your treatment – some are said to be softer or more pliable than others, though they will have their own minor downsides. There is no numbness in the areas treated, you retain all of your normal nerve inputs. Sometimes cosmetic clinicians choose to put a little more filler in than is needed to get the desired result, in order to ensure you won’t have to come back in 2 months time – so what you see at this stage may settle down even further.
At this stage, you should be starting to find it difficult to tell that there is anything other than what your own body has created in your face – your facial filler should feel very natural!
When it comes to cosmetic surgery, there are few social hang-ups any more. Celebrities and politicians alike admit to having wrinkle reduction treatments – the main issue now is the best method to use for making you look younger! Botox has been around for quite some time, but relatively newer are the classes of facial fillers having such success in combating wrinkles either alone, or in tandem with Botox. Today we are looking at how women across the world are using facial fillers, some info on top brands and some pertinent statistics.
When you examine trends in how facial fillers are used, the most conspicuous statistic is the overall usage levels. Demand for products like these is literally skyrocketing. This is to be expected when you consider how facial fillers solve many of the issues with previous wrinkle reduction techniques:
- There is almost no downtime and very little bruising
- It is non-invasive
- They are not permanent – people can safely experiment with them, and go back to being their natural self if they choose
- They are becoming more cost-effective
- It is difficult to ‘overdo’ fillers, as is possible with collagen
- They are much longer lasting than collagen
- There is no loss of facial movement
Wrinkle correction with fillers
Wrinkle correction with fillers is done mainly with hyaluronic acid products. This substance occurs naturally in the body – a 70kg person has roughly 15 grams of hyaluronic acid in their body, and around 5 grams is degraded and re-synthesised every day. The product is naturally absorbed by the body over a period of time, and the effects have usually completely disappeared after 9-12 months. The procedure is usually charged per vial of facial filler that is used.
The facial filler market is now quite saturated – there is immense choice of very similar products. Some of the general, overall trends that cosmetic surgeons are noting in their wrinkle reduction patients that use facial fillers include:
- People who have never had cosmetic surgery before are increasingly enquiring about facial fillers
- They appreciate the choice of products in the market, but are also confused by it
- People are looking more towards the longer-lasting fillers
- Women look for clinics where they can have wrinkle reduction treatments right away, rather than having a several week wait
Juvederm and Restylane trends
When it comes to market share, Restylane is still leading over Juvederm. It has a longer lasting effect in many cases, though there can be a longer initial recovery period from the injections.
Juvederm is said by most patients to have a better, smoother feel and pliability than Restylane, although the wrinkle reduction effect doesn’t last as long. There has been a significant increase in men seeking Juvederm and Restylane treatments – around 9% of patients were male in 2007, and this was expected to grow to 15% by 2009.
For both Juvederm and Restylane, the naso-labial fold is the most popular area of facial filler application. They represent around 44% of total treatments. While Restylane is far more popular for correcting smile lines than Juvederm, the percentage of patients that use the main two facial filler products for forehead lines is fairly equal.
Dermal fillers (eg Juvederm) and Botox are like two identical twins that everybody assumes think and feel the same – but in reality they are completely different people! One loves to gossip, put on pink makeup and party at dance clubs, the other has a small circle of close friends, plays the bass guitar and wears nothing but black. The same can be said of injectable fillers versus Botox. While they are both administered to your face with a needle, and both are used to treat skin wrinkling, that is where the similarity ends. We delve into the inner lives of both Botox and dermal fillers as anti-wrinkle treatments, to help you decide which is best.
How does Botox work?
The name ‘Botox’ is a contraction of its scientific name, botulinum toxin. Its use as an anti-wrinkle treatment derives from the fact that it causes mild paralysis, so wrinkles that are caused by chronic muscle tension in the face can be corrected by Botox. It does this by blocking the release of acetylcholine, a neurotransmitter, from the affected muscle to its associated nerve. It can be used to treat blepharospasm (an eyelid twitch) and hyperhidrosis (excessive sweating) as well as for cosmetic purposes. There are occasional disturbing side effects with Botox including dropping of one eyelid, an uneven smile, and the loss of the ability to close the eyes.
How do injectable fillers work?
As we age, some of the fullness is lost from underneath our skin – this is a form of atrophy of the underlying tissue. As the tissue volume decreases and the skin volume remains the same, the skin will tend to wrinkle up. Dermal fillers aim to restore the plumpness to under the skin, and thereby correct the wrinkling.
Duration of effect
The duration of the effect varies according to the brand of dermal filler used and the individual response to the botulinum toxin. The duration of dermal fillers’ effectiveness also depends on the area treated – around the mouth where there is a lot of movement, top-ups might be needed in 5-7 months, whereas the forehead will stay reasonably wrinkle-free for 6-12 months. As a rule of thumb though, Botox lasts from 3-6 months, and injectable fillers last from 6-12 months.
Other advantages of injectable fillers
Injectable fillers have several advantages over and above Botox. While Botox has more general medical applications, injectable fillers can be used for a wider range of anti-wrinkle treatments and cosmetic procedures, without the paralysis effect of Botox. These include:
- Plumping the cheeks for a more youthful appearance
- Filling in deep acne scars
- Non-surgical nose jobs
- Making lips fuller, as well as correcting asymmetry or deformities.
- Filling in under-eye hollows.
As far as the medical profession knows, it is not possible to be allergic to injectable fillers. They are made from an ordinary naturally occurrung bodily substance, hyaluronic acid, that contains no DNA.
In contrast to the rare but sometimes serious side effects of Botox (not being able to close your eyes!), the side effects of dermal fillers include nothing more than bruising, temporary edema or swelling, and pain at the injection site.
Obviously, costs vary by practitioner, and are not the only thing to consider when thinking about the suitability of an anti-wrinkle treatment. Here are the average of a small section of costs for each procedure:
- Botox – frown lines – $400
- Botox – crow’s feet – $240 for 1 side
- Botox – Forehead – $320
- Dermal filler is charged $600 – 700 per syringe
You can also look for anti-wrinkle treatment providers that give discounts for repeated procedures or for doing multiple areas of the face at once.
One of the strongest forms of subconscious wisdom we have is the ability to read people’s facial expressions and body language to guess what they are thinking. If you enjoy the show ‘Lie to Me’, you’ll have a more detailed understanding of what I mean. However, nobody needs to have studied facial micro-expressions and their relationship to psychology to be able to ‘read someone’s vibes’, or guess what somebody is thinking or feeling. Due to a phenomenon known as mirroring, the ‘vibes’ we give out to people are often what we get back. This is where aging can play unexpected tricks on people – and colour their interactions with others as assumptions are made about their mood that simply aren’t true. We look at why and how these assumptions occur, and how dermal fillers (eg Juvederm) and other anti-wrinkle (eg Botox) treatments can help.
What is facial mirroring?
Facial mirroring is one of the methods that humans use to get along with each other. When somebody is speaking to us, people have often been observed to mirror their facial expressions and body language, in an attempt to show understanding of what a person is saying. Sometimes this will have unintended consequences – as we will see.
To explain this in practical terms, though, next time you are having a conversation with someone you can test the universality of mirroring. When you are both involved and concentrating on the conversation, shift your leg to a different position, and see if your friend copies you. A minute later, shift your arms to a different position, and see if they do the same. Take a sip of your drink … etc. It doesn’t always occur, but it will surprisingly often.
How we calculate facial expressions
Humans understand facial expressions through processes that we have learned since our first days of playing with our mothers and fathers. As adults, these recognition processes have become heuristics – rules of thumb, or familiar sets of actions – that the brain uses to assess somebody’s emotions from their face.
We understand these rules so well that software has been created that can mimic the decoding of emotions. Computer scientist Nicu Sebe at the University of Amsterdam developed facial recognition software that can pinpoint emotions with around 85% accuracy – similar to our own capacity.
The feedback loop of facial expressions
You can see that both the heuristics we use to understand what someone is feeling, and the mirroring phenomenon, can create a sport of feedback loop in which if you look a certain way, the other person will mimic and mirror that emotion, which you will then perceive and relay back to them. This is why it takes such discipline to remain calm in the face of anger, and why seeing somebody crying often triggers the same response in us. It is also why people say that smiles and happiness are contagious!
Facial expressions affected by aging
Some common facial expressions that are affected by aging, and often lead to misinterpretation of emotions, include:
- Dropping of the eyelid that makes people seem tired
- Lowering of the inner corners of the eyebrows towards the nose makes people seem angry or disgusted
- Increase in the distance between the eyebrows and eyelids can make people seem surprised or fearful
- Drooping of the outer part of the eyebrow makes people seem sad
How injectable fillers can help
Injectable fillers (eg Judeverm), other dermal fillers and indeed any anti-wrinkle treatment (eg Botox) can go a long way towards making people seem less tired, less sad, and less angry. Obviously there is less risk of creating unintended facial expressions with dermal fillers than with surgery, which might over-correct eyelid dropping and create a surprised or scared look for example. Another of the benefits of using injectable fillers to correct wrinkling and drooping (and the associated untruthful expressions) is that they are not permanent – your basic face is not irreversibly changed. They are worth trying, to see if the people around you react to you and treat you differently!