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New Techniques with Dermal Fillers


When it comes to facial rejuvenation, sometimes it helps to be a little creative with dermal fillers. A recent article in the Cosmetic Surgery Times has highlighted the work of Dr. Steven Fagien, who argues that diluting hyaluronic acid fillers and preparing customized filler treatments presents new possibilities for facial rejuvenation.
“Once collagen went away, we stopped injecting the skin because all of the products currently available are subcutaneous or deep dermal fillers at best, and we kind of left the skin because we did not have an adequate skin filler,” he told the Times.
Dermal fillers like Juvederm, Restylane, Radiesse, and Sculptra have grown in popularity in recent years. They offer facial rejuvenation without the need for surgery, and can sometimes be combined with Botox or Dysport to provide the best results. By injecting them deep within the skin, cosmetic surgeons can add volume to the skin, erasing the appearance of wrinkles.
“If you really want to fortify and rejuvenate the skin, I do not believe that you can do it consistently with energy-based devices universally,” Fagien says. “I think we have ignored the fact that there are ways that you can manipulate existing products, particularly Juvederm, and make them skin fillers.”
Dr. Fagien’s approach is twofold. First, he makes sure to use the appropriate fillers in different parts of the face. Second, he alters the concentrations of existing fillers, and also mixes and matches different fillers for different target areas. With these diluted concentrations of carefully selected fillers, he can administer injections closer to the surface of the skin.
“Altering the concentrations of the existing compositions in order to optimize certain fillers has become a great passion of mine,” he told the Times. “Mixing different fillers with varying concentrations allows you to be somewhat more creative in applying these mixed fillers in the face by improving formulations that you get in a packaged syringe. You can more appropriately treat specific facial regions and create custom filler treatments individualized for each patient.”
Dr. Fagien’s results will appear in an upcoming article in the Journal of Plastic and Reconstructive Surgery.

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