28
Jan

How Much Dermal Filler Do I Need? Plus How to Avoid Top Dermal Filler Mistakes!

So you have decided that you are interested in possibly getting treatment with dermal fillers, but outside figuring out what types of fillers are best for your aesthetic goals, when you are considering your budget you may also be wondering, “Well, how many syringes of this filler am I going to need to get the results that I am looking for?”

There are several things to take into account when determining the amount of dermal filler that you need. One would be the amount of enhancement you are looking for – are you wanting a slight, moderate or major change? The other would be age. Starting in our mid 30’s we begin to lose approximately 1cc of volume in the facial area per year. Because of this, most patients require 1 syringe of filler per decade of life. So, for a full correction at 40 years old, you would need about 4 syringes. 50 years old? You’ll need about 5 syringes of filler, and so forth. In combination with age, lifestyle choices, such as smoking and sun exposure, can also affect how much filler you might need.

If you are wanting your wrinkles to be relaxed, then Botox or another neuromodulator would need to be used instead of fillers, or to be combined with your filler treatment. You can learn more about neuromodulators which are used to relax wrinkles, typically in the upper face, HERE. An experienced injector can also use advanced injection techniques with neuromodulators in the lower face.

How Much Dermal Filler is In 1 Syringe?

The majority of dermal fillers are made from Hyaluronic Acid and contain 1cc per syringe. Keep in mind that this means that there is only 1/5 of a teaspoon of filler in that 1cc syringe! This means that it takes FIVE full syringes to make a up a single teaspoon of filler.

 

It is important to remember how much filler is actually in a syringe when thinking about how much you will need to treat the areas you are concerned with so that you are not disappointed with the outcome of your treatment. For most people, treatment with 1 syringe will be a subtle enhancement, which can be great for younger patients looking to maintain their appearance or those who do not want to see a lot of change.

There are some fillers, like Radiesse, that have 1.5cc of product per syringe. Radiesse is made from another naturally occurring substance in the body, Calcium Hydroxylapatite, and can be a great option for treating certain areas, but it is not an ideal option for every treatment area. You can learn more about which types of fillers would be best for you HERE.

So How Much Filler Will it Take?

Slight Enhancement

A slight enhancement would be something like filling in a few fine lines, smoothing or a slight plump in the lips, or having a small amount of hollowness filled in. Usually, a slight enhancement would be focusing on one area to improve upon, without a drastic result or significant change to your appearance, and these treatments only require a small to moderate amount of dermal filler. However, depending on things like the area being treated and your age, the amount of filler needed for this type of enhancement can still vary from approximately 0.5cc – 3cc. For example, a patient in their 30s wanting a slight enhancement in the cheeks to look more like the did in their 20s may only need 1cc to see those results, where someone in their 50s or 60s looking for similar results would need at least 3cc.

Moderate-Major Enhancement

Upper Face
The areas considered to be the “upper face” include the forehead and glabella. The glabella is the area between the bows that many people refer to as their scowl lines or “11s.” Once wrinkles have become etched deeper into the skin over time, becoming what we call “static wrinkles,” treatment with neuromodulators like Botox is not enough to completely eradicate them. First, the area would still need to be treated with neuromodulators, and once the toxin is in full effect small amounts of dermal filler are used to pop out the fine lines that remain. The total amount of filler usually needed to treat the upper face is 1-2cc.

Mid-Face
When we reach middle age, (gasp!!!), areas in our mid face begin to lose the volume they once had and become flattened. The areas included in the mid-face are the temples, the under eye area (tear trough), the cheeks and nose. Depending on your age and natural deficits, treating these can require a considerable amount of dermal filler. The tear trough typically requires 0.5-1cc per side, more if you have very large bags. Some people may just need 0.5cc per side in the temples, while others can need 2cc per side. The same goes for the cheeks, usually ranging from 1-3cc per side (yes this means you could need up to a total of 6cc just to lift your flattened cheeks). If you are looking for a total Mid Face Liquid Lift with full correction, you can expect to need a minimum of 4cc of filler.

Lower Face
The area referred to as the “lower face” includes the marionette lines from the sides of the mouth to the chin, the nasolabial folds from the sides of the nose to the corners of the mouth, the oral commissures at the corners of the mouth, the lip region (which includes lip lines, the lip border and any plumping of the lips), and lastly the jawline. The nasolabial folds are an area that tends to really bother patients as they continue to get deeper over time with the cheeks dropping and flattening from loss of volume. Replacing this volume in the cheeks helps to lessen the depth of the nasolabial folds, but these lines may still need to be filled in after with 0.5cc to 2cc of filler per side for a nice correction. Marionette lines typically require 0.5cc – 1cc per side. In order to reverse the turning down of the oral commissures in the corners of the mouth that begins to happen over time you could easily use 0.25cc – 0.5cc in just this area alone.

Many patients want lip injections for many different reasons, however, it is very common to misunderstand the actual amount of product required to reach their desired results. The lip lines around the mouth, which are often referred to as “smokers lines” can be an issue even if you never smoked due to loss of volume in the lips, and they may take as much as 1cc – 2cc to correct on their own. The deeper the lines, the more you will need to correct them. Enhancing the border of the lips can take 0.5cc to 1cc, and the actual lips themselves can need 1cc – 2cc. This means that for a for a moderate – major enhancement, the entire lip area could begin with needing 3cc of filler to correct fully. Now, that being said not everyone will require that much filler, but this is where things like being a chronic smoker, your age and genetics will come into play. The amount needed for the jawline could be anywhere from 1cc -3cc, depending on your desired outcome.

I Don’t Want to Look Weird – What About Overfilling?

After seeing the amount of filler that you might need for a full or partial liquid facelift, you are probably thinking that you would look very strange or “plastic” with that much product in your face. Unfortunately, there have been many celebrities in popular culture able to afford large amounts of dermal fillers who have gone beyond what is needed for a full correction. This is what we call overfilling, and it results in people looking unlike themselves with possibly bloated or unmovable features. While this “look” has become synonymous with fillers due to the attention that famous people can get for looking this way, it is not a cheap, easy or desirable look when it comes to aesthetic treatment. Dermal fillers were designed to lessen the signs of aging and enhance your appearance, not change it completely.

When it comes to dermal filler injections, more does not always mean better. It is important that your physician match the correct amount of filler to what you need for your desired results. It is always better to place less first and then add more later if needed. This ensures that any changes to your appearance are gradual and natural, and prevents any issues with overfilling.

You should find an injector who has a style that you are comfortable with. If you want to avoid looking overdone or strange, it is best to find one who emphasizes a more natural result, which usually includes the preservation of some lines and imperfections. Because fillers can be almost addictive for some people, it is also best to have a physician who cares more about your end result than lining their pockets, so that they can give you the best advice for when, where and how much to inject for a nice result. You may have also heard horror stories of situations where people have ended up looking strange or “misshapen,” even without a lot of filler being used. This is still possible, and is most often the result of dermal fillers being placed incorrectly, which is why it is also important to find a physician who is experienced with the science and artistry of dermal filler application.

 

The results from filler procedures tend to follow an inverted J curve. This means that you will look better when the right amount is put in, but then there will come a point where adding more will start to make you look worse. This usually happens when you go beyond simply improving on your appearance to changing it altogether. At times you may want to make changes to your natural appearance with fillers, for example someone who has always been self-conscious about having small lips wanting to increase their size, however, if you have smaller lips to begin with then there is still a limit to the amount of volume you can add without making them look unnatural or overfilled.

 

Common Issues From Overfilling

Puffy/Pillow Face

This look is a result of overfilling in both the cheeks and under-eye area. This is seen fairly often, as many Hollywood celebrities have succumbed to this syndrome. Having fuller cheeks is typically associated with youthfulness, however, when you overdo it in someone who is older it results in overly puffy cheeks which look unnatural, out of proportion and inappropriate for their age. This can also happen in younger people who are in pursuit of “apple cheeks.” When you overfill the cheeks and then tear trough area under the eyes, it obliterates the natural lid-cheek junction. The causes the entire mid-face to become one continuous bulge, like a pillow, making the eyes appear deeper and smaller.

This problem does not just affect women, and it actually can affect men even more. When you overfill the cheeks in men it results in their face becoming more feminine and can look strange, bloated and less masculine.

Maleficent Cheekbones

Having full cheeks can make us look more youthful, while strong cheekbones can go even further to contribute to the “perfect look.” Facial contouring with makeup has become all the rage to help emphasize this look, and when done correctly dermal fillers can go even further to shape our cheeks to make them more defined and youthful. If they are done incorrectly, either due to the amount used or placement, you may risk looking like Angelina Jolie’s character in the movie Maleficent with overly protruding cheekbones, creating a very “hard”, unnatural look. Your doctor should work with the natural shape of your face to determine where the best placement and amount of filler needed to avoid this result.

 

Duck Lips

Possibly one of the most common offenders on this list are the dreaded duck lips. This is one of the worst because it is seen so often that many people who could benefit from lip injections are terrified to get them in fear of having an unnatural-looking, protruding pout as a result. With what we now know about how much filler is needed for a slight – moderate enhancement of the lips, it is clear that the duck lip look would take several syringes to achieve, and be rather costly. You should not have to worry that you will have this type of result if you are only purchasing 1cc – 2cc of filler, and your injector should be willing to inject your filler in more than one appointment so that you can be sure you are getting the exact outcome you are looking for. Lips tend to swell a lot after being injected with dermal fillers, especially on the 2nd day after receiving them, so even if you do look like the pictures below for a day or so, do not worry because the swelling will continue to go down. The majority of first-time lip injection patients start out worried about getting too much put in, and then later end up wishing that some of the swelling would return after it goes down. This is why follow up appointments are so important, since more can always be added at that time if that is what you and your physician decide.

Sausage Lips

A step “up” from the dreaded Duck Lips is the even more extreme Sausage Lips. This happens when the lips have clearly been overfilled to the point of losing their lip-like shape all together, making them appear to look like two sausages placed on top of one another instead. Often times in these cases the filler will even go beyond the lip border, causing the area around the lips to swell out as well. Needless to say, this is not a look that most people would like to have, however being overfilled to this extent is almost always done by request of the patient due to the high cost of needing several syringes to achieve it, as well as the fact that many physicians would not even agree to the treatment amount.

What if I Feel I Have Received Too Much Filler?!?!

If you do end up unsatisfied with your results, the good news is that the majority of dermal fillers that are used today are made of hyaluronic acid or sugar molecules. Hyaluronic acid can be dissolved with injections of a substance called hyaluronidase. Also, if you do not want to dissolve your fillers, remember that they are not permanent will be reabsorbed by your body over time. Most fillers last anywhere from 6 months to 2 years.

One of the most important things you can do before selecting an injector for your dermal fillers is to familiarize yourself with his or her style. Consider scheduling a consultation prior to your treatment. While many people fear having too much injected, it can be just as disappointing to spend money on filler treatment and be undertreated. Be sure to communicate exactly what you would like to see from your results, so they can give you an accurate idea of how much filer you will need.

Many practices will offer specials and work with you on a treatment plan to help you achieve and maintain the results you are looking for, so be sure to ask what options are available to you when you schedule your consultation.

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