Fillers have become one of the most frequently used options in aesthetic medicine. Their ability to restore volumes, especially in stages such as the onset of menopause, combined with their benefits in stimulating collagen and elastin in our skin, makes them one of the most popular procedures. That said, there can also come a moment when we look less flattering or have excessive filler, which is also known as “pillow face”.
In the case of fillers, one of their great advantages is that we can stop whenever we want, but at the price that the rejuvenation or freshness we had in our skin may no longer be present. At a moment when naturalness and the trend in aesthetics is to respect facial features, knowing whether we need to stop is also essential.
How Fillers Work in the Skin
First of all, we must understand how fillers work in the skin and what we can achieve with them. Dr. Cristina Corredera, medical director of IMR Torrent, in addition to being a specialist in medical-surgical dermatology, aesthetic medicine, and hair medicine, explains that “the two most important mechanisms are revoluminizing (providing volume) to structures that have been reabsorbed over time or that we did not have due to our anatomy (temples, cheekbone, lip, chin, jaw, etc.). The second function would be “stimulating the endogenous synthesis of collagen and elastin,” depending on the type of filler and thus improving the quality and appearance of the skin’.
All this is given, in the words of the professional, because “in an indirect way, when we lose bone or fat with natural aging, greater sagging and drooping of the skin appear, so the use of fillers can counteract them.” For his part, Dr. Carlos Gómez, general surgeon specializing in aesthetic medicine and anti-aging, considers that “hyaluronic acid, in addition to attracting water, also improves hydration,” elasticity and luminosity. In the case of other fillers, such as collagen stimulators, he mentions that “they act more in the medium term, since they stimulate collagen production.”
Areas of Application and Durability
Personalized guidance is very important when undergoing this type of procedure. If we speak of the areas where we can use them, Dr. Corredera considers “those areas where we want to increase or recover volume, provided there is no risk of causing complications due to the existence of vascular structures or other weighty reasons.” The professional divides the face into thirds and explains. The upper third, which would be the temples and forehead, in which “the area between the brows has a complex approach that should only be treated by expert injectors.” In the case of the middle third, this is the one that “is treated most frequently: under-eye area, cheekbones, cheek, nasolabial fold.” The professional emphasizes that “the nose is another vascular risk area and must be evaluated with great caution whether to treat or not.” Finally, there would be the lower third with “lip, chin and jaw.”
Once applied, durability is variable according to each case. Dr. Carlos Gómez mentions that “it depends on the type of product, the treated area, the patient’s metabolism and the technique used.” The professional elaborates on the types of filler and considers that “hyaluronic acid lasts between 6 and 18 months,” while “denser or structural fillers can last between 12 and 14 months and in areas with a lot of movement, such as the lips, it tends to last less (6 – 9 months).” Collagen stimulators can “remain for 18 to 24 months.” Gómez concludes that “it doesn’t depend so much on skin type as on metabolism, smoking, sun exposure, physical activity and muscle movement.”
Stopping Fillers
What happens if we decide to stop using fillers? How can it change our face? “There is a false belief that there can be a rebound effect when we stop using fillers,” says Corredera. She adds that “what happens is that the fillers we already have gradually degrade until they disappear completely or partially, and, therefore, we will age a little faster than we did when we were using fillers.” The expert believes that “if we had grown accustomed to an enhanced or more youthful version, we may not like seeing ourselves that way, but it’s not due to a rebound effect; it’s because we are no longer counteracting the aging that occurs when we don’t use them.”
Therefore, we may feel that our skin looks older, but, as Dr. Gómez notes, “the patient gets used to looking improved and, when that effect is lost, may perceive it as a worsening.” Another important point is that “during the years that fillers have been used, time has continued to pass and the skin has continued aging, even though the filler hid it.” That said, Gómez adds that “in some cases, after years of well-executed treatments, you may even see that the skin is better than before, especially if it has been combined with deep hydration or bio-stimulation.”
Returning to Fillers
We are always able to return to fillers; the key is to consult with our aesthetic physician. Dr. Corredera of IMR believes that “there is no problem resuming them, and “probably less product will be needed than when it first started to be treated if it has not yet fully reabsorbed.” Dr. Gómez recommends that “the ideal is to carry out a complete medical assessment, because the face may have changed and it is not always advisable to repeat exactly the same thing.” For that, he opts for “a progressive and natural plan, avoiding filler-for-fill, prioritizing facial harmony and structural support.”
Finally, Dr. Cristina Corredera believes that “they are a tool that in expert hands helps us slow aging and beautify our anatomy despite being young.” She recommends the “use of appropriate products and professionals” because “it will be a good decision, regardless of whether in the future we stop using them for any reason.” That said, she concludes that “in case of doubt, a good professional will also tell you that it is not advisable to use them if in your case it is better not to do so.”
