Things you didn’t know you could do with a needle

Loss of volume is a significant cause of the appearance of facial aging, Jill Hessler, M.D., Palo Alto, Calif., said during her presentation at Vegas Cosmetic Surgery 2014. The resulting pseudoptosis can often be fixed using fillers to replace lost fat pad volume and restore natural contours to bony areas.

Key areas of focus for filler rejuvenation include the temples, submalar area and hollowing around the orbit, Dr. Hessler said. Choosing the right filler for each area is equally important.

• Lines are superficial. She uses a finer product such as Belotero (Merz);

• Wrinkles are deeper than lines. For these she uses Restylane (Medicis) or Juvéderm (Allergan);

• Folds are deeper than wrinkles and may be caused by volume loss. In this case, fillers such as Radiesse (Merz) or Sculptra (Valeant) are good solutions.

Dr. Hessler shared several tips for filler selection during her session.

"Use Restylane in the subbrow and tear trough for less swelling," she said, comparing these with Perlane (Medicis), which can offer more lift. Other tips included:

• Using HA fillers other than Juvéderm to avoid Tyndall effect in the tear trough;

• Use of HA fillers to revolumize and pick up the midface to “lighten” a heavy lower half. The result is a refocused emphasis on the eyes, where it should be;

• Use of fillers in athletic patients who prematurely lose volume in the temples. “By filling the temples, you restore balance, emphasize the eyes and soften the face,” Dr. Hessler said;

• Radiesse can be used to balance the cheek area and to lift and balance the face;

• Sculptra replaces deep fat fullness, fills submalar hollows, and is ideal for overall treatment of a thinning face.

Follow our VCS 2014 coverage