Should You Get Fillers? Here’s How to Tell, According to a Plastic Surgeon

We asked a plastic surgeon for all the gritty details.

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The word “filler” usually doesn't have the most positive of connotations: Filler conversations are boring; filler relationships suck; and filler anything is usually just something to pass the time until a better option comes along. Fillers in regards to your face, however, are a different story. They can enhance and improve, taking years off your appearance. To find out exactly how fillers work and what the appropriate age is to consider them, we spoke with Dr. John Diaz, and asked him all our pressing questions. Keep scrolling to learn everything you need to know about fillers!

Meet the Expert

John Diaz, MD, is a Beverly Hills-based board-certified plastic surgeon with advanced specialty training in cosmetic surgery of the face, breasts, and body.

The Facts

In case you have no idea what fillers actually are, Diaz explains that it’s a term used to refer to a variety of medical products “designed to rejuvenate the face by filling in areas of volume loss.” Some of the most common brands? Juvederm, Restylane, Sculptra, Boletro, and Artefil. Diaz says all fillers have two things in common: “One is that they target lines, wrinkles, and volume loss by filling in the areas, unlike Botox, which works by relaxing muscles. Secondly, all fillers, regardless of how they are packaged, must be prepared in syringes and injected using small needles. No surgery or incisions are required.” Noted.

So, you’re plumping up your skin with a substance under the skin—how long is the result supposed to last? And um, how painful is the process really? Diaz says hyaluronic acid-based fillers, like Juvederm, can last anywhere from six months to a whole year. “Consistent treatments will give you optimal results and you may need less filler over time,” he says. Diaz says that Voluma is a type of filler that has a slightly different composition and can actually last up to two full years. As for pain, Juvederm contains an anesthetic called lidocaine that helps numb the injected area, which Diaz promises will relieve any discomfort, as will icing and applying a topical numbing agent.

Fillers vs. Botox

We talked about Botox, too, recently as a way to get rid of lines and wrinkles. So, what’s the difference? “Botox works very differently from fillers,” Diaz says. “Botox cannot fill in any lines or wrinkles, or areas of volume loss. Botox works by relaxing the muscles that pull on skin and cause lines and wrinkle to form.” Diaz also mentions that, in general, the areas that respond the best to Botox are located in the upper one third of the face—this includes the lines around the eyes, the lines between the eyebrows, and the lines on the forehead. Whereas, he says, fillers work best for areas in the middle and lower third of the face.

Telltale Signs

So... how are you supposed to know if you’re a good candidate for fillers? Diaz says that one of the biggest telltale signs is a noticeable deepening of the nasolabial folds (these are the deep lines that form next to your mouth, aka marionette lines). Another sign? If you notice your once-prominent cheekbones deflating, especially when you look at your face at an angle, fillers can help. “It’s aesthetically pleasing to have a defined curvature over this area,” Diaz says. “Once the curvature begins to flatten, fillers can be used to restore the shape in this area.”

A Surprising Use

If you’re young/lucky/both and don’t have deepening lines or deflating cheekbones, Diaz says that some younger people still get fillers for a surprising reason: to improve their bone structure. Um, what? “For example, there are many young patients who may have very weak bone structure around the cheek or the jaw,” he says. “In most of these cases, the lack of fullness is not due to aging, but rather genetics.” So in case you really, really want Karlie Kloss’ cheekbones, at least you know of this nontraditional means to an end. Diaz does warn that fillers should be used by adults, only; he says they can hinder the bone structure if it isn’t fully developed. 

And finally, one last word of advice? Diaz says to always, always seek treatment and advice from a doctor who is board certified in either plastic surgery or dermatology. “Unfortunately, there are many doctors out there who are not plastic surgeons or dermatologists who are claiming to be board certified in cosmetic surgery or cosmetic treatments,” he says. “These are not actual specialties and represent titles which can be claimed by anyone with a medical degree, even if they are in another specialty entirely.” Good to know—we’ve seen too many scary botched jobs to ignore this advice. 

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