It seems to be everywhere we look.

Pillow face.
Overfilled.
He used to be so handsome, now he just looks odd.
She used to be beautiful, now when she talks, she just looks WRONG.

There are examples of people who have gone too far with dermal fillers, aka hyaluronic acid fillers- Zac Efron comes to mind of late; Meg Ryan; Nicole Kidman and Madonna, among others.

The theory, as has been discussed before, is that somewhere along the way, “less is more” has morphed into “more is more” and if a little is good, a lot MUST be better.

Not so.

As I get tired of sometimes explaining, filler does not lift sagging tissue.

Many of the times, the sag and loose, crepey skin that we see, is due to loss of collagen and elastin in the skin. Many causes contribute to this- ageing, sun exposure, smoking, poor diet and other lifestyle choices among others.

When skin quality is poor, we are limited in what we can do to help improve it. We certainly cannot “just” lift it, with threads, with filler or anything else. The foundation of almost all healthy, glowing skin that is responsive to treatments, often begins with inducing collagen and maintaining it. 

Hyaluronic Acid Fillers

While hyaluronic acid (HA) fillers are great for adding volume to parts of the face that are clearly depleted, leading to some hollowing and potential sag in surrounding areas, they do little more than add volume and hydration beyond a point. Adding more and more fillers, will risk distorting the skin, stretching it and leading to very odd looking faces that resemble caricatures of their original selves aka PillowFace, Overfilled Face Syndrome and more.

Biostimulator Fillers Are a Potential Solution for Skin Volume Depletion

When someone who is volume depleted is replaced to maintenance, I begin to nudge them away from HA fillers to biostimulator fillers if they wish to consider an injectable form of collagen induction.

Why? These fillers (there are currently 3 on the market in Australia) work differently:
- 2 of them work by replacing some volume immediately

- one is especially good for gaunt, slim faces and restores collagen while adding volume. 

- all 3 of them work by stimulating your own collagen production over some months,  which may then last up to 2 years at a time.

Hyaluronic Acid Fillers vs. Biostimulator Filters

If Biostimulator Fillers  are so great, why are we not using them more, and on everyone?
- unlike HA fillers, most of these fillers cannot be dissolved if a mistake is made or a vessel accidentally injected into.
- so it makes sense that these fillers are better used by far more experienced injectors on their regular patients they have a relationship with. Can something still go wrong? Of course, but as with everything else, experience absolutely matters.
- they are also less commonly used and therefore more expensive even though they usually last longer and look more natural 
- unlike HA fillers, they cannot be used on all areas of the face. For example, they cannot be used in lips, or under the eyes for the most part, two of the commonest parts injected even in young people.

So why should anyone consider Biostimulator Fillers?
- unlike HA fillers, they do not usually lead to overfilling
- over time, these fillers work by stimulating your own collagen, which can last up to 2 years in the treated areas
- it is not an immediate result, but a far more gradual one, over 3-6 months, like most skin improvements, but your own collagen, once stimulated, will last a long time. This collagen is also your own, so does not move around the way filler might over time and repeated movements in highly mobile areas of the face such as the eyes and lips. 

- HA fillers, we are learning now, may be far more finicky than initially thought-

• they do not dissolve in the promised 6-18 months as we were told; they can migrate and cause duck lips and filler moustaches and unsightly bulges under eyes, among other things. Biostimulator fillers, for the most part, are more reliable in their mechanism of action, their ability to dissolve and stimulate your own collagen, which ultimately, is YOU.
• Biostimulator fillers are also great at stimulating collagen in other areas of the body such as lax skin around the abdomen after birth, cellulite ridden hips, flat buttocks and more.
• they are especially great at replacing collagen in gaunt people with significant hollowing and while collagen production slows down with age, and rapidly so after menopause, it is never too late to induce your own collagen if you want an injectable means to do it.  
  
  So the next time you want to consider ways to improve skin quality, add luminosity and do not want to look overfilled in the process or want a more gradual process that continues to build over time, make an appointment to talk to your doctor about biostimulator fillers and see if you might be a suitable candidate for a biostimulator filler over HA filler.