Dear Friends,

I was out with a group of friends recently and the subject of fillers came up.  One of the women, whom I had only met that day, made a face.  She told a story of a friend of hers who had gotten a lot of fillers and "didn't look like herself" anymore.  She couldn't say exactly why, but the effect apparently was not good.

I nodded and agreed that sometimes fillers can be done badly or to excess, with the result being a face that looks slightly artificial or "done."  I immediately thought of the latest episode of "Real Housewives of Beverly Hills."  Those of you who know me and have read my newsletters know that "Real Housewives" is a guilty pleasure of mine.  Don't get me started; I mean, how "real" are these women, and can you really call them "housewives??" 

Anyway, my favorite is "Real Housewives of NYC," but I have occasionally watched the other versions too.  What I have noticed is that the dermatologists in NYC seem to do a better job at making their patients look natural.  Some of the women on the Orange County and Beverly Hills shows are downright scary with their trout lips and exaggerated cheekbones.  Maybe it's a west coast thing?  I don't know.

Using fillers is an art, and a good result should not call attention to itself.  A good result is you, looking 5 to 10 years younger, but still looking like yourself.  We all lose fat and subcutaneous tissue as we age, and fillers are a great noninvasive way to replace what has been lost, as well as to provide lift.  The art of filler injection has evolved quite a bit in the past five years.  We now focus on the entire face, not just a particular line or fold.  This is why I'll frequently suggest putting some volume in the cheeks in order to lift up on the nasolabial folds (smile lines.)  Patients usually are not even aware that their cheeks have sunken, but a little volume there makes a big improvement in appearance. 

Likewise, I'll usually suggest restoring lip volume in order to address those pesky vertical lip lines, many of which are due to lip deflation.  The important thing is that it's a restoration rather than an augmentation.  No one in my practice wants trout lips, and I certainly don't want to create them!  (Well, actually, I did once have a young woman who wanted large lips; I didn't make them big enough for her and she never came back.  Oh, well.)

I've recently been studying the Golden Ratio, which provides a mathematical framework for approaching the face.  It's fascinating, and I'm starting to incorporate some of these ratios into my work.  For more information on the Golden Ratio, click here.

I have many patients who are understandably hesitant about fillers, and it's probably because of shows like "Real Housewives" and stories like my friend's.  My patients do not want to look artificial.  I get that and I completely agree.  I am a working woman, like many of you.  I will treat your face as if it were my own.   In fact, I have treated my own face!   And so far, I don't resemble a Beverly Hills socialite.  :-)

Have a great week!

Kathy Farady and staff