How much Filler Will I need?

Dermal fillers have gained immense popularity for their ability to restore lost volume in the face which occurs during the natural process of aging. Dermal fillers have become a popular way to create a fresh, contoured appearance, rebalance the face, and overall create a rejuvenated look.

A common question we get asked is, how much filler will you need to achieve your desired goals? During our consultation we will ask what your goals are, what concerns you would like to address, and your overall desired look that you hope filler will help you achieve. The consultation process will help us determine if filler is infact the treatment you need for your desired goals, as well as determine how much you will need.

While everyone we treat is provided with a custom and personalized treatment plan, we often times refer to "Decade Dosing", is a formula or guide to help determine how much filler you might need based on an age-appropriate solution to facial rejuvenation. In this blog post, we will explore what Decade Dosing entails, the areas where fillers are commonly used in the face, the amount of filler required for full facial rejuvenation, and other innovative applications of fillers using hyperdilute Radiesse techniques.

Understanding Aging Skin:

In order to understand if filler is a good option for you, and how much filler you might need, we must first understand the process of aging and the effects it has on our skin.

The process of aging skin involves several biological changes, which include the decline in collagen production, changes in elastin, and other factors:

1. Collagen Decline: Collagen is a key protein that provides skin its firmness and structure. As we age, our bodies produce less collagen. Starting in our mid-20s, collagen production decreases by about 1% per year. By the time we reach our 50s, we've lost about 30% of our collagen.

2. Changes in Elastin: Elastin gives the skin its elasticity, allowing it to stretch and return to its original shape. With age, elastin production decreases, and the existing elastin fibers become less elastic and more fragmented. This leads to the skin becoming less firm and more prone to sagging and wrinkles.

3. Decreased Skin Cell Turnover: Younger skin regenerates its cells quickly, but this process slows down significantly with age. This slower cell turnover can lead to a duller complexion and the accumulation of dead skin cells.

4. Decrease in Natural Oils: The skin's natural oils decrease with age, which can lead to drier skin and more pronounced wrinkles.

5. Thinning of the Epidermis and Dermis: The outer layer of the skin (epidermis) and the underlying layer (dermis) thin out over time, contributing to the appearance of aged skin.

6. Reduction in Hyaluronic Acid: This substance is vital for maintaining skin moisture. With aging, the body's hyaluronic acid levels diminish, leading to drier and less supple skin.

So, How does Dermal Filler and Radiesse Help improve collagen loss and other affects that aging has on the skin?

- Dermal Fillers: These are injectable treatments used to smooth wrinkles, restore volume, and enhance facial contours. They often contain substances like hyaluronic acid, which is naturally found in the skin. By injecting these fillers into the skin, they can help to plump up areas that have lost volume due to the natural aging process, thereby reducing the appearance of wrinkles and sagging skin.

- Radiesse: Radiesse is a type of dermal filler that contains calcium hydroxylapatite, a substance found naturally in human bones. It not only fills in wrinkles but also stimulates the body's natural collagen production. This helps to improve the skin's firmness and texture over time, beyond the immediate filling effect.

Both types of dermal filler treatments can significantly improve the appearance of aging skin by restoring lost volume, smoothing out wrinkles, improve hydration, provide a more supple and toned appearance of the skin, and enhance the overall facial contours (or area being treated).

Understanding Decade Dosing:

Decade Dosing is an approach that takes into account the natural aging process and the specific needs of patients based on their age group. Instead of treating everyone with the same dosage, Decade Dosing tailors the filler treatment to address the unique concerns of patients in different decades of their lives.

Aging Skin and why filler can improve appearance:

decade dosing and how the skin ages per decade infographic

Filler per decade:

decade dosing for filler in your 20s, 30s, 40s, 50s, 60s infographic

How Much Filler Will I Need, And Where?

so we come back to the question of: How Much Filler Will I Need, And Where?

Areas Where Fillers Are Most Likely Used in the Face:

Temples: As we age, the forehead and temples can lose volume, leading to a hollowed appearance. Fillers are commonly used in these areas to restore volume, reduce wrinkles, and create a more youthful contour.

filler before and after — Lambros V. (2011)

Cheeks: The loss of volume in the cheeks can result in a sunken or flattened appearance. By strategically placing fillers in the cheeks, a natural lift can be achieved, rejuvenating the entire face. As you can see below, the midface was treated with filler to provide more structure to the face, and improve the overall appearance and balance of the facial features. Aging affects how the facial appearance falls- toward the mouth due to loss of volume, decreased fat in the face, collagen support, and bone structure. Filler can act as a structure similar to bone in the midface (cheeks) to help pull the skin away from the mouth and rebalance the face to a more youthful appearance. Cheek filler can also improve the folds around the mouth and nose- creating a more contoured, yet soften appearance .

Under-Eye Hollows and Tear Troughs: Dark circles, bags, and hollows under the eyes can make us look tired and aged. Fillers can be used in the delicate under-eye area to smooth out hollows and improve the overall appearance.

Nasolabial Folds and Marionette Lines: These are the lines that run from the sides of the nose to the corners of the mouth (nasolabial folds) and from the corners of the mouth to the chin (marionette lines). Fillers can be injected into these areas to soften the appearance of these lines, restoring a more youthful look.

Lip Enhancement: Fillers are commonly used to add volume and definition to the lips, creating a fuller and more youthful appearance.

Jawline: The Jawline, one of the most commonly focused on area of concern for aging individuals. Dermal fillers can be used to enhance and improve the appearance of the jawline in several ways:

Adding Volume: Fillers can be strategically injected along the jawline to add volume and definition. By placing filler in areas where there may be a lack of bone or muscle, the skin becomes tauter, creating a more sculpted and defined jawline.

Balancing Facial Features: Fillers can help balance the overall proportions of the face by minimizing jowls and sculpting the mandible and chin. This can create a more harmonious facial appearance and enhance the contours of the jawline.

Augmenting Natural Angles: Jawline fillers can be injected in the angle of the jaw to elongate and enhance the jawline itself. This can give a more defined look, accentuating the natural angles of the jaw and creating a more sculpted appearance.

Improving Weak Jawline: Dermal fillers can be used to address a weak jawline by enhancing the bone structure and providing more definition. By injecting fillers into the jawline, it gradually improves the appearance of a recessed or less prominent jawline.

Lifting Soft Tissues: Injectable fillers can also lift and support soft tissues in the lower face, which can help reduce the prominence of jowls and provide a more youthful and lifted appearance to the jawline.

Chin: Another area that can truly change the overall appearance, and facial structure is the chin. Although a forgotten area by most, it is the second most important area to treat (in my opinion! The First is the Jawline!)

Getting filler in the chin can offer several aesthetic benefits and address specific concerns. Here are some reasons why individuals choose to get filler in the chin:

Chin Augmentation: Dermal fillers can be used to enhance the size and shape of the chin, providing a more balanced and proportionate facial profile. If someone has a weak or recessed chin, adding filler can create a stronger and more defined chin, improving overall facial harmony. Shape of chin can also drastically change the appearance of a person, as males have a more square and wide chin, a female typically has a more delicate and narrow chin. It is important that your injector understands the differences when treating the chin so that your results are consistent with the desired look you are hoping to achieve.

Chin Projection: By strategically injecting filler in the chin area, it can help project the chin forward, giving it a more prominent and sculpted appearance. This can create a desirable V-shaped or heart-shaped face, enhancing facial definition and contours.

Chin Symmetry: Fillers can be used to correct chin asymmetry, where one side of the chin may be less pronounced than the other. Injecting filler into the less prominent side can help achieve more symmetrical facial features.

Chin Rejuvenation: As we age, the chin area can lose volume and elasticity, leading to sagging skin and a less defined jawline. The chin slowly regresses, creating a lost chin look, emphasizing a double chin, and overall creates a lack of definition for the face. Dermal fillers can restore lost volume, smooth out wrinkles, and tighten the skin in the chin area, resulting in a more youthful and rejuvenated appearance.

Profile Enhancement: Fillers in the chin can also improve the side profile by creating a more balanced and harmonious look. It can help address issues such as a weak or receding chin, improving facial proportions and overall aesthetics.

Woman with filler before and after — Photo from Radiesse (Merz), results created by @Injectorjeff

How Much filler will I need for for Full Facial Rejuvenation?

How Much filler will I need for for Full Facial Rejuvenation?

The amount of filler required for full facial rejuvenation varies depending on individual needs and goals. However, as a general guideline, a full facial rejuvenation typically involves several syringes of filler. When using decade dosing, someone in their 40s should expect atleast 4 syringes, 50s should expect 5 syringes, 60s should expect about 6 syringes needed to create full facial rejuvenation and rebalancing. This dosage may be adjusted based on the patient's age, the severity of volume loss, and the desired outcome. It is crucial to consult with a qualified aesthetic professional to determine the appropriate dosage for your unique situation. Full facial rejuvenation, sometimes referred to as a liquid lift (LL) is truly magical, the results speak for themselves.

Other areas of treatment using fillers :

Apart from the traditional areas mentioned above, fillers can also be used in various other parts of the body using hyperdilute Radiesse techniques. These include:

Neck: Hyperdilute Radiesse can be used to rejuvenate the neck by improving skin texture, tightening loose skin, and reducing the appearance of wrinkles.
Hands: Filling techniques can help restore volume on the back of the hands, minimizing the visibility of veins and tendons, and providing a more youthful appearance.
Above the Knee: Hyperdilute Radiesse injections can be utilized to improve the appearance of sagging skin and cellulite above the knees, creating a smoother, more toned look.
Arms: Fillers can be used to address loose skin and crepey texture on the upper arms, resulting in firmer, younger-looking skin.
Stomach, Butt, and Hips: Hyperdilute Radiesse techniques can be employed in these areas to enhance contours, tighten loose skin, and reduce the appearance of cellulite, providing a more sculpted and youthful appearance.

Decade Dosing has revolutionized the field of facial rejuvenation by tailoring filler treatments to address specific age-related concerns. Whether it's restoring volume in the cheeks, erasing nasolabial folds, or enhancing other parts of the body using hyperdilute Radiesse techniques, fillers offer a non-surgical option for achieving a natural and youthful appearance. Always consult with a qualified professional to determine the best treatment plan for your individual needs.