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Plump Up the Volume? Is the over-filled face becoming a fashion trend?

By Dr. Sumeet Bhanot
In this age of social media, it has become commonplace to witness the successes and pitfalls associated with the use of volume in the form of injectable dermal fillers and fat. The current trend of rounded faces can be seen everywhere you look which leaves me to ponder: Will the cherubic faces of the twenty-tens be ubiquitous to the Jennifer Aniston shag haircuts that were so popular in the nineteen-nineties? Now that we are able to alter our appearances so dramatically, the effects on our facial contours may become as changeable as with trends such as hair and fashion.

Does this look natural? Is this the ideal? Is this truly what we are after? When I see patients in consultation the answer is almost always a resounding “NO”! Why is this trend so popular? Is this a situation where the solution dictates the problem as opposed to the problem dictating the solution? Are we injecting volume because it is easy and readily available?

Aging is a complex process that involves all facets of the face: skin, fat, fascia, muscle and bone. It is the culmination of the downward vector pull of gravity on the interconnected anatomic weave of the facial structures. We first notice the loss of the cheek bones. In reality, it is the fat pad covering the cheek bones that descends downwards in a pendulum fashion from the upper cheek to the mouth. The fat gathers above the laugh lines, deepening these lines while the fat from the lower cheek descends vertically, effacing the jawline and creating the jowl. This creates a relative excess of volume in the area around the mouth and a paucity of volume in upper cheek. This creates disharmony in the facial volume distribution.

How do we correct this problem? Well, as is always true in life – it depends on the severity. If someone is fairly young and these changes are minor, we can use volume to fill in the void of the upper cheeks and a small amount of fillers in the areas around the mouth to alleviate the hallmarks of early aging. If done judiciously, it creates a wonderful illusion of fullness and youth. We must remember that we are not lifting the volume that has fallen, we are just adding to the area to create this illusion.

In the case of more advanced aging the volume solution is not so simple; we are unable to compensate for the imbalance in the face. If we add a great deal of volume to the upper face to compensate for the descent of the fat pads, we inadvertently create an overly filled, round face. Our efforts, while sincere, are the genesis of the problem of the overly filled, plump face. In this case the solution is not “volume”. The solution is to raise these fallen fat pads to their original location using a very unique technique known as a “Deep Plane Facelift”, to restore a harmonious youthful, heart shaped face. This results in patients looking decades younger without anyone suspecting anything was done at all.

We are all born with a natural beauty, my priority is to restore it, not distort it! I use fillers in my practice to help postpone and augment a deep plane facelift – the key in surgery and in life is always to restore harmony!

Dr. Bhanot practices at 2038 Bee Ridge Rd., Sarasota.

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