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To Fill or Not to Fill

Injectables / September 26, 2022
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written by:

Kerri Otto, PA-C MPAS

Aesthetic Injector, National Trainer

Vesper Aesthetics


Injectable facial fillers are one of the most popular services offered in medical aesthetics.   Products such as Juvederm and Restylane have been used in the skin for nearly 20 years.   Deciding if you are ready for a dermal filler treatment involves educating yourself regarding the how and the why behind this treatment.  I’ve been around since the beginning, so let’s hash out the details!


Traditionally, lip filler and nasolabial fold filler were the 2 places most commonly injected and the most commonly requested areas at Vesper in Chicago.  As we began to evolve as a medical specialty (yes, aesthetics is medicine), we started to really figure out the importance of treating & evaluating the face as a whole.  Addressing supporting areas in the mid face such as the cheeks, temples, under eye and outer aspect of the face actually helped improve the appearance nasolabial folds, thus creating more natural, aesthetically pleasing results. Lip filler is also something we have recognized needs proper skills.   It’s not just about injecting the lips anymore~the entire lower face supports the lip and treating any deficiency in these areas ensures a natural lip filler result.


Aging is a multifactorial process involving the skin, muscle, fat compartments and bone.  This creates a “down and inward” movement of our facial features instead of the“up and out” look that we have in our youth.    Patients will typically complain of excess nasolabial folds, jowling, and marionettes /downturned corners of their mouth and request options. During the initial filler consultation, photographs are taken and we review these together.   Addressing the goals of the patient while also explaining the aging process in depth is important; oftentimes the main complaint of what someone sees as an imperfection is actually a symptom of aging occurring in another place.    It is our responsibility as injectors to make sure we educate and explain the “why” behind our individualized filler treatment plan. 


So how do you know if you are a filler candidate?  The first step is finding an injector that you are comfortable with & trust as well as someone who has experience in injectable fillers.  It is also important for your injector to assess the skin integrity as well as review medical history.    Fillers support and add volume to the face; they do not tighten, lift or give surgical results.    We are always 100% honest with our patients and inform them if surgery would be a better option.   There are also a few medical conditions that can increase certain risks of filler injections, thus another reason to make sure your injector has experience with injectables.


The specialty of aesthetic medicine continues to grow and evolve.  The injectable fillers we have available now behave much differently in the skin than the original injectables we had years ago.    In my opinion, it’s important to have multiple fillers to choose from such as RHA Redensity, the complete Revance RHA portfolio, Sculptra Aesthetic,as well as the Restylane & Juvederm products.   My goal is to use the least amount of product to achieve natural, soft results and to enhance each patient’s individual beauty versus altering their appearance.   


What about safety? This is a major cosideration when one is thinking about filler.   The social media trends of fillers as well as the numerous novice injectors that are dipping into this specialty make it appear as an easy, quick procedure that can be done almost anywhere.  This is far from the actual truth.  Filler injections carry significant risks: infection, injection into a blood vessel, stroke & blindness.   An experienced injector will review these side effects before any injections are done as well as know how to recognize and treat these types of adverse events; when recognized and treated appropriately, complete resolution is usually possible.  In our opinion, filler injections should always be performed in a controlled medical environment to create the best possible scenario for infection prevention and optimal outcomes.  There are also several injection techniques, such as using a cannula, that can help decrease the risk of certain adverse events.


Injectable fillers are one of our favorite aesthetic treatments to offer to patients, but proper facial assessment, patient education, product selection, & safety are essential to this process.  Fillers are only going to continue to evolve and bring more opportunities for our patients.  We’re committed to continuing to learn and grow ourselves as injectors to enable us to offer our patients the absolute best at Vesper Aesthetics in Chicago!