When Weight Loss Changes the Face FAQs
Q&A
Timing — When to Start Treatment
Q: Should I wait until I’m done losing weight?
A: We’d recommend considering a biostimulator during weight loss to help reduce volume loss as it happens. For contouring with an HA filler, it may be better to wait until you’re closer to your goal weight.
Q: Should face tightening be done first?
A: Not necessarily. Face tightening treatments generally target a more superficial layer than where fillers are injected. There’s also evidence that biostimulators can enhance the results of treatments like Sofwave or Vivace — they can be done the same day or within 1–3 months of biostimulator injection to boost results.
Product Differences & What Lasts Longest
Q: Can you go more into the difference between Radiesse and Sculptra?
A: Radiesse is CaHA, which provides support and stretch for the fibroblasts to increase collagen production. Sculptra is PLLA, which chemically activates the fibroblasts that produce collagen. Both have been shown to stimulate a similar degree of collagen production. HA fillers also stimulate collagen, but to a lesser degree.
Q: Which fillers last the longest?
A: Sculptra and Voluma have the longest FDA indications — both up to 2 years.
Q: How long do lip and cheek fillers last in general?
A: The FDA indication for lip fillers is generally up to 1 year. For cheek fillers, it’s generally 1–2 years for the products we work with.
Q: Which type of filler is safer or better to use?
A: All the fillers discussed are generally considered safe when injected in the right area with the right technique. “Better” really depends on what we’re treating. Some patients feel reassured by the reversibility of HA fillers specifically.
Q: Do fillers ever go away? What does that look like?
A: All fillers are gradually metabolized by the body. The FDA indication timeframe doesn’t mean every drop is gone at that point — product can remain beyond that window. With ongoing HA filler treatments, products can seem to last longer over time because old products weren’t entirely gone when new product was added. Biostimulators tend to be less of a concern in this regard, as the chemical is metabolized as the collagen-stimulating process occurs.
Treatment Areas
Q: What’s best for hollow or deflated cheeks?
A: A combination works well — HA filler for contouring and biostimulators for overall volume restoration.
Q: What about fat loss under the eyes from weight loss?
A: HA fillers can be injected into the under-eye area. Sculptra and Radiesse are generally not used there. However, volumizing the lateral face often improves the appearance of the under-eye area as well — sometimes enough that under-eye filler isn’t needed at all.
Q: Can the neck be treated with any of these injectables?
A: Yes. Biostimulators are injected more dilute in the neck area. Depending on the concern, it may also be worth considering Sofwave to boost results.
Q: Is it safe to use fillers around the eyes?
A: Some HA fillers have FDA indications for treatment around the eyes. It is an area more prone to side effects, so we generally work with HA fillers in that zone due to their reversibility or explore other treatment options depending on the concern.
Combining Treatments
Q: If I’m doing fillers and want to do Sofwave, is there an order or spacing I should follow?
A: Biostimulators can be done the same day as Sofwave, or the filler can be done 1–3 months prior to enhance the outcome. With HA fillers, it depends on the area being treated — talk to your injector for specific recommendations.
Q: What about red-light therapy — does it help with injectable treatments?
A: There’s potentially some benefit, particularly around collagen stimulation. Red light therapy may enhance the collagen-stimulating effect of the filler.
Results, Longevity & What to Expect
Q: Does your skin go back to the same sagginess after fillers wear off?
A: Generally, yes — as we continue to age. Maintenance treatments are recommended to preserve the effect over time.
Q: How long do fillers last for someone who works out regularly?
A: Filler duration varies from person to person. Extreme exercise may play a role in faster filler metabolism, but it’s impossible to predict a specific timeframe — it’s highly individual.
Q: How often do you see filler migrate?
A: True filler migration is not common. HA filler naturally becomes less sharp over time and spreads mostly within the area it was injected. Most of what people refer to as migration is a result of overfilling.
Q: Is there an age where Sculptra is no longer effective?
A: Results with Sculptra can vary significantly. Age and the overall condition of the skin’s collagen do play a role in the degree of response. It’s not that it stops being an option, but realistic expectations are important going into it.
Safety & Side Effects
Q: What are the potential side effects?
A: The most common are bruising and swelling. Less common include nodules, hypersensitivity reactions, infection, and vascular occlusion, among others.
Q: What about using a dry or steam sauna?
A: Generally, it’s not a problem for fillers, but avoid it for the first several days after treatment.
Special Considerations
Q: If you’re male and receiving fillers, where are they focused to maintain masculinity?
A: Overall volume with a biostimulator is generally well tolerated. For contouring, masculine faces have a mid-face and lower face width that are roughly equal — the jaw is wider at the chin, the mandible angle is more acute, and it projects roughly in line with the cheekbones. Contouring filler placement is done with these proportions in mind.
Q: How many treatments are required?
A: It depends on the individual and is best determined at an in-person consultation.
