While I have never shied away from testing new facial lotions, chemical peels, or lasers (I've even used my own blood as a serum), having injections or undergoing cosmetic surgery has always made me feel nervous. (Of course, we support freedom of choice and wholeheartedly believe everyone has the right to do whatever they want to their face and body whenever they choose to—without judgment or shame.)
Thanks to sunscreen and a rigorous skincare routine I started at the age of 14 (growing up in a country without an ozone layer will do that to you), I am entering my 38th year with minimal signs of aging. However, the one place where I felt my age showed was under my eyes. It wasn't so much the lines that bothered me but the dark and sunken appearance that made me look (and feel) tired—even when I was well rested. So I started to entertain the idea of getting under-eye fillers.
Even though having fillers is so commonplace now, not to mention also a relatively simple practice to perform (it takes mere minutes), for some reason, I had a major resistance to getting them. When I really thought about why, I realized that much of my hesitation came from how I thought my parents would feel about it and the shame in telling my husband. I think this sentiment stems from the personal shame I felt around altering my body in the name of vanity. That I couldn't just accept or be happy with the body I was born with, or that I felt the need to change it to sit within society's expectations of me.
Ultimately I had to push those feelings aside and realize this wasn't about anyone else; it was about me. Getting a teeny bit of filler under my eyes was my choice, not theirs. Not to mention that this entire conversation was taking place inside my head, and in reality, who's to say they would even care? I pushed aside any shame (and perceived judgment) and booked an appointment with Jennifer Herrmann, MD, of the celeb-frequented practice Moy, Fincher, Chipps Dermatology in Beverly Hills.
Turns out, everything I thought I knew (and feared) about under-eye fillers was wrong. Keep reading to see my before and after photos, review of the process, along with the answers to some of the most commonly asked questions and myths regarding fillers below.
With Age Comes Bone Loss, Hence Fillers
As you can see in the above image, the tissue under my eyes was quite sunken in, especially on the right-hand side. According to Herrmann, this is a result of bone loss. (Yes, you heard right—bone loss.) As terrifying as this sounds, it is not uncommon at all. Apparently, everyone loses periorbital bone and around the mouth. As stated on Moy, Fincher, Chipps Dermatology's website, from the age of 35, "The number of bone regenerating cells in the face decreases. Gradually, the bone around our eyes widens, leading to eye hollows and flattened cheeks. Then, the bones of the central face and jaw degrade while rotating back and downwards. Together, these changes result in a diminished bone scaffold on which our fat and skin sit. Our tissues become too large for their underlying bones and wrinkles and folds become more evident."
Of course, there are natural ways we can prevent bone loss—like incorporating calcium, vitamin D, exercise, and excellent dental hygiene into our daily lives—but ultimately, bone loss is a natural part of the aging process. Fillers are a simple and effective option to plump these spaces back up (if that's what you're going for).
While there is no set age to start fillers, it depends on how a person ages and their personal preferences. Herrmann told me about a "prejuvenation" theory, which I was keen on. "It's much easier to keep a face looking natural by injecting very small amounts of filler slowly over time than wait until your 50s or 60s and require much larger volumes to restore what time has taken away," says Herrmann. Smaller injections definitely eased my concerns about fillers. I didn't want to drastically change my appearance, but I did like the idea of a slightly enhanced, less sunken-in version of my face.
What You Need to Know First
The first step before you undergo fillers is to find the right person to do it. This is very important. "Look for someone with not only training and experience but someone who has an excellent knowledge of anatomy," says Herrmann. "Understanding the exact relationship of facial bones to ligaments to muscles to facial fat pads is very important in understanding where fillers should be placed to give the most natural results. In addition, a mastery of anatomy is important to avoid severe side effects, such as injecting filler into a large blood vessel."
When you go in for a consultation, be sure to ask a lot of questions. You can even write down your questions and bring them with you so you don't forget. "Let your physician know what bothers you, and then have them walk you through a treatment plan," says Herrmann. "This may or may not include the use of fillers. If your physician understands what you see, it will help them select the most appropriate treatment plan for your goals. And make sure the products used are from reputable manufacturers."
How It Works (Hint: It Doesn't Hurt)
One of the biggest concerns I had about fillers was the pain. I don't have a fear of needles so that wasn't an issue, but I had read so many horror stories in the past about injections gone wrong that I couldn't help but anticipate the worst. I was also convinced that I would be left with black bruises and be relegated to my bedroom to work from home while I recover. Well, that could not have been further from the truth.
Before we did the injections, Herrmann marked my face with a pencil so I could clearly see the areas that needed to be filled (see image above). She also showed me the (very small) amount of Restylane she was going to use. This put my nerves at ease because I knew that the final look would be subtle and natural.
Herrmann then placed some numbing cream over the marked areas and let it sit for a few minutes. After the area felt considerably numb, she went in with the needle and started to fill it up, using her finger to mold the Restylane into place. This did not hurt at all. I was seriously shocked at how painless the whole thing was. It was also very quick—the process took less than five minutes. After the injections, Herrmann gave me an ice pack and sent me on my way.
The picture below shows my face immediately after. Notice that the two entry points where the needle went in are barely visible. The best part? I didn't have any bruising or any post-procedure pain.
Commonly Asked Questions About Fillers
Below, Herrmann answers some of the most commonly asked questions regarding fillers.
What is Restylane?
"Restylane is a synthetic hyaluronic acid gel used predominantly for facial rejuvenation. The Restylane product family contains multiple fillers that differ in their stiffness and pliability. Some are very soft and fine and excellent for filling finer lines and under-eye hollows, while stiffer, thicker products are better for lifting cheeks and filling deeper folds."
Is it safe?
"Yes. Hyaluronic acid is naturally found in the skin. It binds water molecules (up to 1000 times its weight in water), naturally giving the skin its plumpness and youthfulness. Because hyaluronic acid is naturally occurring, when the product is injected beneath the skin, it's biocompatible, meaning it integrates without causing an allergic reaction."
Why is it better than other fillers? How is it different?
"I don't think of one filler as being 'better' than another. There are many types, with distinct uses. Certain physical properties may make one filler more appropriate to use in a particular circumstance than another. Restylane Lyft is a stiffer product, for instance, and offers good tissue support. When placed deeply along the cheekbone, it can help lift cheek tissues. Restylane Refyne is a very soft, elastic product that appears quite natural in areas of high movement, including around and in the lips."
How long does it last?
"How long a filler lasts depends on how much is injected into the skin and its properties. Stiffer products may last close to two years while lighter products may last closer to six months. Your body naturally breaks down HA fillers just as it breaks down native HA, so it gradually disappears in a very natural way."
Courtesy of Moy, Fincher, Chipps Dermatology
The Most Common Filler Myths—Busted
It's likely that you've heard a lot of talk (both true and false) about fillers. Here, Herrmann busts some of the most common myths regarding the process.
Myth #1: You have to use a lot of product to get results.
"Subtle improvement is more natural, and results should be built slowly over time."
Myth #2: All HA fillers are the same.
"The individual properties of soft-tissue fillers make them useful for specific purposes. It's important to see a board-certified dermatologist who understands these differences so results appear most natural."
Myth #3: Fillers can smooth forehead, squinting, and angry lines.
"Some dynamic lines (like those you see when you're expressing emotions) are better softened with muscle relaxants like Botox and Dysport."
Myth #4: Fillers just "fill."
"Newer research has shown that in addition to 'filling,' HA products also stimulate collagen synthesis by pushing on fibroblasts and triggering them to produce native collagen."
As you can see by this makeup-free selfie I took three weeks later, my fillers have settled and look very natural. In fact, no one even noticed them. I just had a lot of people commenting on how good my skin looked, but I'm convinced that's because my eyes were a little plumper than usual and I don't look (as) tired anymore.
In conclusion, I would highly recommend fillers to anyone who wants to look a little freshened up and has similar concerns about bone loss. Plus, it's a super-simple, painless, and affordable option. I'm so happy I finally ditched the shame and did something that makes me look and feel good about myself. I can happily report that both my family members and my husband were incredibly supportive and loved the results too. In fact, they didn't even notice or really care. So, all of the fears and worries I had were in vain, and from now on, I will be confident in the choices I make that concern my body. It is mine after all.
This post was originally published on March 28, 2018, and has since been updated.