To Fill or Not to Fill ~ Part 1

As social media hits our society intensely in the recent years, the rise of ‘selfies’ has made us extra conscious of our facial features. There is also an increase in the cosmetics & fashion industry because what is a social media post without #ootd or #makeup hashtags right?

When it comes to make-up, the techniques have also changed whereby the play of different shades to create better contouring for beautiful feature-enhancing ‘selfies’ are more desired these days.

As for the cosmetic medicine side of the world, the ‘contouring’ part can be obtained with dermal fillers. But firstly, I would like to share a little bit about the process of aging, because only then we would understand how dermal fillers can be used optimally.

A youthful face has 3 unique features:
1.High cheekbones
2.Full cheek volume
3.Well-defined jawline


Having these three attributes are often referred to as the “triangle of youth” with the base of the triangle being at the cheeks and the point at the chin. As we age, this triangle becomes inverted. The cheeks flatten, jowls start to appear and the face generally looks more oblong-shaped.
There are four key layers of our facial anatomy:
1. The bone
2. The fat pads
3. The muscles
4. The skin
All four layers play a role in aging and by understanding the aging process of these four layers, one can achieve the most ideal face rejuvenation treatment.
The facial bones give us a strong structure for the muscle and skin to ‘drap-on-to’. As we age, bone atrophy (reduction in bone density) reduces tissue support and this can cause structural changes in the face.


Good news – as we age we do lose fat, bad news – we all wish it would be those belly or thigh fats, but no! It is at our facial fat pads and this fat loss together with gravity’s effect on it descending down inverts the ‘triangle of youth’. As the fat pads travel down, the skin overlying it will automatically be pulled down south as well!


Our daily facial expression causes repetitive muscle contraction which can then make the overlying skin above it forms wrinkles. For instance, habitual frowning can lead to the glabella ‘11’ lines formed between the eyebrows.

The skin loses elasticity due to collagen breakdown as we age and gives that sagging skin appearance.


So the question of whether ‘to fill or not to fill‘ depends on how the anatomical changes affect our general appearance. If there is a volume loss due to the reduction of fat pads and noticeable bone resorption, having dermal filler injection procedure would be beneficial to the person.
In part two, I will zoom in on various types of fillers available in the market and considerations to take when choosing the right one to achieve optimal results!