Creases, wrinkles, and folds may be just the tip of the iceberg. As we age, our face deflates. The layers of skin, fat, muscle, and even bone lose volume. Would you rub moisturizer onto a wrinkled helium balloon or fill it back up with helium?

Fillers can be injected into soft-tissue using a needle or smooth-tipped cannula using a variety of different techniques. Frequent areas of treatment include the temples, outer cheeks, inner cheeks, nasolabial folds (aka NLF or “smile lines”), lips, and lines around the lips, marionette lines, chin area, jawline, the back of hands, and other off-label areas.

A conscientious provider will continually expand his or her fund of knowledge. Your injector must have a thorough understanding of 3-Dimensional facial anatomy, high-risk treatment zones, potential filler-related complications, and know how to minimize risks and treat complications. Make an educated decision about who you choose to perform your procedure(s). You should prioritize provider experience, knowledge, and one who has a track record of good outcomes.

Products vary in price and can range from $410 to $833/syringe.

The aging process is continual and due to many different causes. Years of volume loss contribute to this by the time most individuals seek treatment. There is rarely a one-and-done procedure. Full correction may take multiple syringes or a combination of treatments over time. This is why it is best to consult with your provider face-to-face, so that a proper evaluation can be done. You and your provider will explore treatment options depending on your needs, expectations, and budget.

Legitimate practices know the cost of FDA-approved products. When offices offer HA fillers near wholesale cost, this raises a red flag. Providers are often approached by unauthorized suppliers of HA fillers that have not been approved by the FDA for use and sale in the United States. It is illegal for individuals to import drugs or devices into the U.S. from other countries in most circumstances. Legal issues aside, are these products vetted to be safe? Are they counterfeit products?

Once you find a credible provider, pay for the honest expert injector, not just for the product. A good injector will always be focused in providing you the best outcomes, with a huge emphasis on safety!

The 4 Rs of facial rejuvenation use a comprehensive approach to address different aspects of aging:

• Relax – Botulinum Toxin A (5 different FDA-approved types) is used to relax muscles of expression and to soften the creasing of skin. Over time, untreated creases get deeper.

• Refill – HA fillers, biostimulators, fat (autologous or exogenously sourced). Over time, we are deflating. Biostimulators include Sculptra, Radiesse, and Bellafill.

• Resurface – procedures that restore youthful skin surface qualities (superficial volume, even color, texture, tone, tightness). This category may include chemical peels, laser and light modalities, microneedling with or without radio frequency (RF), other energy modalities, platelet-rich plasma (PRP) in combination with some of the above, prescriptive and/or cosmeceutical products, PDO threads.

• Redrape – this category surgically addresses loose skin (e.g., eyelid lift, face lift, neck lift).