Fill Power

Bangkok Bright Smile

Advances in facial fillers mean less pain from injections and longer-lasting results.

by Meg Farris

Three years ago Theresa Rhodes, 42, had weight loss surgery. Today she is down to 120 pounds. But along with her newly slim body came something she did not like.

"I noticed my face … was a little droopy and not firm," Rhodes says.

Editor's note: Dr. Patricia Farris is no relation to Medical Reporter Meg Farris.

  • Editor’s note: Dr. Patricia Farris is no relation to Medical Reporter Meg Farris

While it’s youthful looking for your body to be thin, it’s not when it comes to your face. "(Scientists) found that … for twins over 54 years of age, the twin who was heavier actually looked younger," says Dr. Patricia Farris, a Metairie dermatologist who is chairwoman of media relations for the American Society for Dermatologic Surgery. "So we know the roundness some people carry in their face … does make them look younger."

Rhodes turned to dermatologist Dr. Mary Lupo for help regaining a full, youthful visage. Lupo provided Rhodes with injections of Sculptra, a filler to plump up the face. The FDA initially approved it in 2004 to correct facial fat loss in HIV patients. Since then, it has been approved for cosmetic use.

"(Sculptra) stimulates collagen production and thickens skin that has been damaged and collagen (that has) thinned from sun damage," Lupo says. "It’s the filler to use if you don’t want anyone to know you’re doing anything, because the improvement is very gradual."

Injected a few times over several months, Sculptra’s final results are visible in about six months and last up to two years. While Sculptra is good for filling a gaunt face, hyaluronic acid fillers are better suited for the smile lines and lips. New technology has also addressed the issue of pain management: Hyaluronic acid fillers now come with a built-in painkiller or numbing solution.


Look for Meg Farris' Medical Watch reports, including "Weight Loss Wednesday" and "Wrinkle Free Friday" stories, weeknights on WWL-TV Channel 4 and anytime on

  • Look for Meg Farris’ Medical Watch reports, including "Weight Loss Wednesday" and "Wrinkle Free Friday" stories, weeknights on WWL-TV Channel 4 and anytime

"The first time I had (Juvederm injections, a hyaluronic acid treatment), I could feel some of the injection sites," says Melissa Ciolino, a patient of Lupo. "This time I felt nothing, none of the injection sites."

"I have a lot of patients who are needle-phobic," says Dr. Elizabeth McBurney, an LSU Health Sciences Center (LSUHSC) and Tulane dermatologist who practices in Slidell. "They really don’t like the needle stick, so I still use some topical anesthetic in these patients. But … it’s made a tremendous difference (especially) around the lips because that’s so very painful. "

"I think when they realize we do have fillers with lidocaine (an anesthetic) in them, we will get patients who were previously afraid," Farris says.

"All of them are stating that it is much less painful, and also it makes the treatment a little bit faster," says LSUHSC and Metairie plastic surgeon Dr. Kamran Khoobehi.

The good news about these hyaluronic acid products goes beyond the reduction of pain. They too stimulate your body to fill in wrinkles naturally.

"As you keep injecting any of these products, whether it’s Sculptra, Juvederm or Restylane, all of them cause your body to build up collagen," says dermatologic surgeon Dr. William Coleman, editor-in-chief of the journal Dermatologic Surgery. "If you keep coming back for treatment, you’ll need treatment less and less over the years because your own collagen is gradually replacing these materials."

Doctors say it’s best to get injectables from someone who uses a variety of them, since most doctors layer different products to get the best results. Lupo says patients should make sure they get enough product injected for a full correction. That way, less will be needed to maintain the look as it wears away over the year.

In the meantime, both Rhodes and Ciolino say the subtle difference is working.

"I get a lot of people telling me, ‘You know, you look younger. You look more refreshed,’" Ciolino says.

Tags: CUE, Dr. Patricia Farris, American Society for Dermatologic Surgery, Dr. Mary Lupo