I was out shopping and noticed a young female with a splint on her nose. I also noticed taping of the tip that told me that she had certainly had a rhinoplasty. There was also some noticeable bruising under her eyes. It made me think…do people mind if others know that they underwent a cosmetic procedure? Years ago, it was believed that the signs of recent cosmetic surgery served as a status symbol. There were even surgeons who had a signature ‘stamp’ on their nasal splint so that others would know that the rhinoplasty was done by them!

 Gone are the days where cosmetic surgery is only performed on the wealthy and elite. But does the public still perceive it this way? The media is still fixated on whether Kim Kardashian had butt implants or if Jennifer Aniston has ever had Botox. My opinion is that cosmetic surgery is seen as more acceptable than ever; I attribute the widespread use of Botox and fillers to this trend. Patients who are injected with a dermal filler probably have a more open view toward cosmetic surgeries like a rhinoplasty or facelift.

 I would like to think that the young woman who I saw in public today with a nasal splint wasn’t out in public to ‘show off’ her recent surgery. Rather, I would like to think that she was feeling good after surgery, and wasn’t worried about what others thought of it. After all, cosmetic surgery should ultimately be done so that someone feels better about themselves in some way, not necessarily how they are perceived by others.

Every day, at least one of my patients tells me that they are afraid to try fillers because they don’t want to look ‘fake.’ So can fillers make patients look fake? Well, it depends. If you put enough fillers into a patient’s face, they will certainly lose their natural look. The reality is that this would likely take much more filler than is usually injected. If fillers are correctly used to fill in lines and wrinkles around the face, this usually produces a refreshed, natural look.

As with everything in life, there are exceptions to this general rule. The lips are one area of the face that is easily over-filled. This is why is takes an experienced eye, good judgment, and a proper technique in order to produce a natural result. I take pride in the natural, plump lips that I can achieve with my technique. My choice of filler for most patients is Juvederm Ultra, as I like the ‘soft’ look that it produces. Restylane is also a good choice as well. Personally, I think technique is far more important than product choice.

Another area that can look unnatural when overfilled is the cheek. The ‘cat lady’ socialite in New York is the epitome of what overfilling the cheeks will do (although there are most likely implants in there as well). But again, with good judgment, a natural look with a youthful, plump cheek can be achieved every time. I like to use Radiesse to fill in the cheek, but at times, I will also ‘layer’ fillers by using Perlane on top of Radiesse.

The final area to be careful in is the tear trough, between the eye and cheek. I rarely see patients who have been over-filled in this area (at other practices), but when I do, it looks very bad and unnatural. This is a difficult area to inject, and for this reason, many physicians won’t even inject here. Personally, I love injecting this area, since the patients are usually some of my most satisfied filler patients, and it can really  go a long way in rejuvenating the lower eyelids.