Have Facial Fillers Fallen Out of Fashion?

Those ‘in the know’ have detected a subtle shift in the aesthetic industry away from one of its long-time staples – facial fillers. Whether helped or hindered by the emergence of the 'Mar-a-Lago look' (the term coined for the identikit features of the women in Donald Trump's inner circle), it seems that facial fillers may be… whisper it… falling out of fashion.

When I became interested in Cosmetic Dermatology years ago, the foundation courses were always 'Wrinkle Relaxing Injections & Facial Fillers'. It was taken for granted that any thriving practice would be offering fillers as they produce immediate results which in skilled hands, can be amazing!

There is no doubt that dermal fillers can be very useful in conditions such as lipo-atrophy and to treat loss of volume from any cause, including acne scarring. There are many different types of filler, with the majority composed of hyaluronic acid which is cross-linked to varying degrees depending on the level of flexibility versus volumisation required.

Others contain calcium hydroxylapatite or poly-L-lactic acid which stimulate collagen production over time as well as exerting their initial lifting effect. The judicious and skilled use of dermal fillers is an art and there are certainly some practitioners who have mastered it, with exceptional results. As with every skill, the more you do, the better you become so if you believe you would benefit from a filler, my advice would be to seek a practitioner who is a master in this craft.

However, there is a discernible change in consumers’ aesthetic preferences with many women choosing to distance themselves from the fake, overly-plumped 'done' look, preferring a fresher version of their natural face. There is also a growing awareness that fillers may not be as innocuous as they seem, with some reports claiming that fillers can not only remain in the body for years longer than their advertised duration, but can also migrate from the original injection site, resulting in unsightly lumps. In some cases, they also activate the immune system, triggering inflammation and rejection equivalent to a foreign body reaction.

On a personal level, I fell out of love with fillers year ago for two reasons.

The first was the safety aspect – I didn’t feel comfortable administering a cosmetic treatment where skin necrosis and blindness were potential side effects. I have seen patients for whom they have triggered severe immunological reactions which can take many months of strong treatment to settle. Yes, of course, these side effects are the exception, and all treatments carry some risk, but most practitioners acknowledge that filler complications are notoriously hard to treat.

I also found that often, the results just weren’t natural enough. Over time, I can spot people who have had fillers; most patients want to look 10 years younger and refreshed, not as though they have had obvious ‘work done’.

How long do hyaluronic acid facial fillers last?

The standard advice when administering dermal fillers is that a top-up may be needed after three to twelve months, with the exact timing varying from person to person, depending on the type of filler used and the metabolic rate of the patient.

However, recent studies have used MRI imaging to assess how long fillers really remain in the system. One study found that remnants of dermal fillers were still present up to fifteen years after the original treatment, and all patients scanned had filler visible more than two years after injection.

Whilst this might sound like good value for money, if you weren't happy with the results to begin with, or change your mind about the look you want, fifteen years is a long time to wait.

How can I achieve a more naturally rejuvenated effect?

While the public perception of beauty might be shifting away from the 'pillow face' aesthetic and towards the idea of growing old gracefully, many of us are still not quite ready to welcome ageing with open arms. Happily, there are some treatments available that will allow you to keep the wrinkles at bay whilst still appearing to have a more naturally rejuvenated look.

The facial rejuvenation treatments that are gaining in popularity are the ones that rely on your body's own healing response – so a more youthful look is created using your own collagen, rather than by adding an artificial filler. These include:

Platelet-Rich Plasma (PRP) injections

Not a new treatment, this is where a small amount of your blood is removed and spun in a centrifuge to extract the platelet-rich plasma, which is then injected back into your skin, stimulating collagen production and improving the skin's tone and texture.

Exosomes

Deemed regenerative aesthetics, these are the messengers that move between cells, stimulating growth and repair. For aesthetic use, exosomes derived from rose stem cells are injected to 'wake up' skin cells that have become sleepy with age, causing them to rejuvenate and regenerate like much younger skin cells.

Polynucleotides

Polynucleotides are purified DNA molecules extracted from fish, which are injected to stimulate the fibroblasts, which create collagen, resulting in naturally plumper, more youthful-looking skin.

Microneedling and fractional laser treatment

These treatments work by causing microscopic damage to the skin's surface, stimulating the body to produce the collagen needed to heal itself.

Which of these treatments is right for you will depend on many factors, not least personal preference. What they all have in common is a naturally rejuvenated result that relies heavily on the mechanics of your own body, rather than the injection of artificial filler.

Please contact us for more information or to book a consultation to discuss which treatment is best for you.