FILLER FASCINATION
In a world full of fillers, here’s how to look your best — while still looking like yourself
Heard of a Lunchtime Facelift? How about a Lunchtime Lip?
Long gone are the days when neuromodulators and soft-tissue fillers were treatments solely for the super-rich. These days, just about everyone has access to rejuvenation or pre-juvenation — nearly everywhere.
“Cosmetic treatments are increasing in popularity,” says Dr. Shannon Humphrey, dermatologist and medical director at Carruthers & Humphrey in Vancouver.
So, what’s behind the shift? According to Humphrey, there are two main reasons that more and more people are embracing cosmetic procedures. And at younger ages, too.
“One, is that generational shifts are driving this. When we look at millennials and younger, just as they do with smartphones, treatments like Botox are perceived in a totally different, totally mainstream sort of way,” she says. “When I hear millennials talk about coming in for their Botox, it’s like they get their teeth cleaned, their hair cut and they get their Botox.”
Humphrey says this “paradigm shift” is prominent among patients ages 25 to 37 and has largely been driven by social media. Meanwhile, the other factor driving the increase in these types of treatments, predominately for the older, “positive-aging” group, is simply word of mouth.
“When we look at gen-Xers, even older boomers, just by a more conservative mode of communication — through friends and through positive experiences — I think that group is growing as well,” she says. “But it’s really fast on the more youthful end of the spectrum. That’s one of the biggest shifts.”
While the idea of a 20-something booking in for a Botox treatment may seem shocking to some, to Humphrey it’s actually a positive, proactive move for those worried about how they’ll look as they grow older.
“It’s actually a great thing,” she says.
“They come in when they see the very earliest signs of aging — not to erase it, but really to just have a strategy and a plan to look their absolute best over time.”
The pre-emptive care cannot only potentially reduce signs of aging dramatically over time, it also allows for treatments to be administered with a concentrated outcome plan over a longer period, she explains.
“Very conservative treatments done over time are a) safer and b) have much more natural-looking outcomes,” she says. “They allow me to harness a preventive effect rather than just an immediateresult delivery.”
But she’s quick to stress that fillers and other types of injections aren’t for children, nor should they be done on patients who are under the age of 18.
“I would say a reasonable time to talk about goals and evidencebased skin care on a very conservative, preventive regime for skin health in the mid- to late-20s is perfectly reasonable,” she says, answering the how-soon-is-toosoon-question. “But, adults. These are treatments for adults.”
Whatever the final cause for the uptick in procedures, as treatments with neuromodulators such as Botox and fillers such as Juvéderm and Restylane Skinboosters have become more accessible — and accepted — so too have concerns surrounding proper use and practice.
“People who have overly arched eyebrows or who have a very frozen face,” she says of common potential concerns. “Nicole Kidman circa two years ago. This is just poorly done neuromodulator treatments.
“The part that really strikes me about it is, both the patient and the provider in those situations don’t seem to reflect on the fact that it looks terribly unnatural.”
Humphrey says while patients in Vancouver are less likely to ask for that over-filled, over-frozen look that celebrities such as Kidman, Kylie Jenner and even Sandra Bullock have been criticized for, “extreme modification” is not entirely unseen.
“Every patient who comes in, their first and foremost is, ‘I want to look natural’ and, ‘I don’t want to look dramatically different,’ ” she says. “It’s largely cultural. It bleeds into all aspects of how Vancouverites live. There’s such a focus on holistic wellness and taking care of all aspects of health, which includes skin health and appearance-related health.”
For patients who experience any “weird results” such as raised eyebrows or a funny expression from neuro-modulators, Humphrey says an expert can usually correct or modify the results — to a certain extent. “Unfortunately, the over-frozen look, you have to wait for that to wear off,” she says. “Typically, that’s within four months.”
For botched soft-tissue fillers, over-inflating or a lopsided application, for example, Humphrey says the solution is relatively simple.
“We’re quite lucky these days in that most of the fillers we use are hyaluronic acid fillers, which is a naturally occurring sugar and it is reversible,” she says.
Humphrey points to an enzyme called Hyaluronidase as the oftused remedy for injection errors.
But, quickly — and correctly — remedying concerns or failed outcomes is a key reason that Humphrey stresses to potential patients how important it is to find a provider who knows what they’re doing.
“That is not a skill that all filler providers have. And that is not an enzyme that all filler providers even stock in their office,” she says of the Hyaluronidase fix. “Cosmetic or not, this is real medicine.”
It’s for this reason that Humphrey recommends those who are interested in having a treatment such as neuro-modulators or softtissue fillers do their research on who the provider is — and what they’ve done before.
“What I say to them is you want someone who can do a good job, but what you want even more is someone who can, if something goes wrong ... can deal with it. Not just reversing an unnatural result, but addressing an adverse event or even emergency that arises from the treatment. This is why you want someone who is highly skilled.”
She says the American Society for Dermatologic Surgery (ASDS) is a good place to start, when searching for a qualified professional.
“You want a specially trained physician, dermatologist or plastic surgeon who has fellowship training specifically in cosmetic procedures,” she says. “You want someone who has a great reputation for natural-looking outcomes, for listening, for treatment planning and that’s going to be the most important thing.”
After choosing a practitioner, Humphrey says it’s then time to consider what your goals are.
“Spend some time before you go thinking about what you want. Not in specific terms,” she says. “I don’t actually think patients should know what treatments they want, I think they should know what their goals are for their appearance.”
“Not to be cheeky, but I went to university for 14 years to do this,” she says. “So, that’s where the expertise piece comes in. But I don’t know what’s in my patient’s head — so, their job is to tell me what they’re trying to achieve in more general, value-based terms.”
To ensure a successful outcome post-procedure, Humphrey encourages patients to think of their “overarching strategy” for their appearance, acknowledging the “values around beauty and attitudes around aging ” they possess before committing to a treatment.
One source of assistance for this, she says, can be photos.
“With more positive-aging patients — so patients who are older and want to feel their best over time and maybe slow things down a little bit — if they have a photo from a time in their life when they felt most confident about their appearance, it can be helpful just to comment and discuss what changes have happened,” she explains. “It doesn’t mean that we’re going to be trying to make them look like that photo — if it’s, for example, significant volume loss or sun damage — we can have that objective perspective to work toward addressing some of those changes that have happened.”
What Humphrey says should be a no-go, though, for when it comes to reference photos, is sticking to a celebrity image.
While Humphrey says she’s “fully open” to seeing a photo of a celebrity, she says it’s important that the patient be ready to acknowledge that one’s unique face shape and features should be taken into consideration. Meaning, while you may want to look like Kylie Jenner — you might not be able to.
“Everyone, myself included, could not have Kylie Jenner’s lips. It would look ridiculous and completely unnatural,” she says.
And that’s where Humphrey emphasizes the importance of finding the right provider — driving home the fact that you want someone who is not afraid to tell you ‘no.’
You want to go with someone who will ensure that, when you leave their office, you’ll look like the best version of yourself — but still yourself.