I just returned from a national conference of the Foundation for Facial Aesthetic Surgery, a symposium attended by physicians in the three core specialties trained in this field. They are Oculofacial Plastic, ENT/Facial and General Plastic surgeons. This is a forum where generally the more enlightened surgeons, those who believe that instead of being competitors and guarding our “turf” (so last century) we and our patients benefit more by our getting together and sharing ideas from our various perspectives. Because this kind of mindset requires confidence, there were many nationally and internationally known surgeons in attendance, and the meeting was absolutely fascinating.
I had been asked to speak on integrating fillers and “neuromodulators” (BoTox, Dysport, etc.) for restoration of the face, but I asked to speak instead on permanent fillers, knowing that it would be a much more controversial and compelling topic. Besides, the issue of permanent fillers is one I feel more passionate about, both pro and con. Here are a few of the pros:
• I’m happy to stand corrected on this, but I have conferred with a few surgeons regarding the statistic, and they agree that after the age of 30 we lose about 1cc of volume from the face each year. That’s 5cc per year (this would include both bone and soft tissue). Each syringe of filler that we use to correct volume loss contains between 0.8 and 1.5cc of product. Depending on the filler, these syringes run between about $450 and $1,000 a syringe for our patients. It doesn’t take much arithmetic to realize that this becomes prohibitively expensive for our patients unless they have unlimited resources, are content to chase their tails forever, or eventually just give up and/or age out of the process with little to show for it if nonpermanent fillers have been used.
• People generally don’t like having needles in their faces.
• Sadly, I do a considerable amount of “repair work” on poorly done surgery and fillers. Having suffered the results of that work usually involves some psychological trauma for the patient. Where fillers are concerned, the advantage of permanency is that once the repair work is done the patient can put the event behind them and move on rather than having to revisit the memory over and over as the “repair” wears away.
• We’re going to age anyway, and replacing lost volume in smaller increments rather than having to start essentially from square one each time, especially as the aging process becomes more profound, results in a better outcome.
• Most people want the attractive facial curves of youth, but they don’t necessarily want the world to know that they’re having something done to get them. With permanency, again we can do little bits at a time so that the upkeep attendant to the aging process is virtually undetectable.