Injectable Fillers and Needle Fatigue

Injectable fillers and toxins have been little mini miracles for all those hoping to stave off aging a little longer and, especially, avoid having a facelift.

Although many experts will tell you that injectable fillers like Restylane are only delaying the inevitable facelift, for many women (yes, and men), a little smoothing out of the forehead or plumping up those naso-labial folds are all they really want to ease them into eventually looking older.

But injectables have an upside and a downside — and it's the same one — they don't last long.

The upside: If you don't like the result, injectable fillers wear off after about 4 to 6 months, depending on what filler or toxin we're talking about. Not all doctors have the same technique or level of expertise so results can vary. And frankly, after an informal survey of several doctors, results can vary even with the same doctor. So the fact that injectable fillers wear off can be a good thing.

This phenomenon does allow stars to lie more easily, though, as in 'I don't do that stuff '— the "right now' is silent. Or they let it wear off for a role, but it's happily in place come red carpet season, as aesthetics consultant Wendy Lewis so adroitly points out in her book Plastic Makes Perfect.

The downside: If you do like the result, they still wear off. So there's concern that you'll get the same result the next time around. Plus, that means another $300 - $800 (again depending on what you're getting, where, and how much), adding up to $1000 - $2500 per year for injectables alone. Cost aside, there's also 'needle fatigue' — for some users, injections year after year can be tiring, to say the least

I asked Wendy about her take on needle fatigue.

I definitely have clients who calculate the economics of having fillers every 6 - 9 months over years and are looking for an alternative. Plus, there is a subset of women who balk at the idea of needles and can't stand having fillers done, even if they love the results they get."

Ever since plastic surgeons determined that it's volume that makes for a more youthful look (note Madonna's face, or more recently Marie Osmond's), as opposed to stretching and tightening, fillers such as Radiesse, Restylane, Juvederm, Perlane or Sculptra (slightly different, comes in vials, but still administered via syringe), and of course Botox and its imitators, Dysport and Xeomin, have taken center stage.

The fine point:

It's all about maintenance, Wendy Lewis points out. "At 30, you can get away with 1 syringe or maybe 2. At 40, 2 becomes 3 plus. At 50, you may need a little Radiesse, some Sculptra, and a few syringes of Juvederm, plus Botox of course. The older you get, the more syringes you need. If you add it all up, that's a lot of needle sticks. Most women would like to go in for an annual tune up, like we are programmed to do for a mammogram. That's why they call it 'filler fatigue'.

What to do about injectable filler fatigue
A lot of women today are anxious to stretch their beauty budgets, Wendy explains. And rightly so, especially in this economy.

Having injections done every 4-6 months can get expensive when you calculate your investment over years of treatments. Past a certain age, one syringe of anything won't get you too far. Most women in their 40s, 50s and up need multiple syringes of one or several different fillers to get a sufficient improvement.

Couple the monetary spend with the investment in time seeing a doctor and occasionally downtime from bruising and swelling — it can be a deterrent unless you are very motivated.

Collagen stimulators, such as Radiesse and Sculptra Aesthetic, can last longer which accounts for why there has been an uptick on these products. Longer-lasting products help to reduce 'filler fatigue'.

Artefill fills a niche for people who have been treated for years with temporary fillers, and want something more permanent for deep naso-labial folds (the creases that form from the nose to the corners of the mouth). Longer-lasting fillers are also a good choice for someone who has stayed away from injectables because she doesn't want to have to keep going back to maintain the results."

This is why experts say a facelift is inevitable — because eventually, for some, the filler fatigue wins and women opt for a much more long-lasting choice. Plus, new techniques make today's facelifts a far cry from the stretched, taut faces of the past. As Wendy points out, "Even with Artefill, there is no such thing as a permanent filler because as your face ages, you will still need to keep up with the aging process."

There are more and more options being explored. Just as the dawn of injectable fillers promised new horizons for facial rejuvenation, newer therapies like Ultherapy and eMatrix and Pelleve, that tighten and lift skin with radio frequencies, heat, or ultrasound, join the mix and mitigate the need for so many syringes.

Just letting you know what's out there. You can always just opt for your jar of Olay and leave it at that.

Other questions about plastic surgery explored:
Would You Consider Plastic Surgery on Your Hands?
Plastic Surgery: Does It Hurt?