Dermal Fillers in Surrey, BC

The cheek is often where volume loss shows first. The fat pads of the midface sit in layers, and as those layers thin and settle downward the cheekbone loses its definition, the fold beside the nose deepens, and the boundary between lower eyelid and cheek becomes a visible step.

This is not a facelift and should not be sold as one. Filler replaces volume where it has been lost, and because it sits deep against the bone it also takes up tension in the tissue above it, so the skin sits a little higher. The lift is modest. What it does well is restore the underlying architecture, which is why the cheek is often treated before the areas around it.

Cheek work needs a firmer, more cohesive gel than the lips do, placed deep, where it holds its shape against the movement of talking and smiling. Placed too close to the surface, a firm product can look and feel wrong. Deep placement in an area that moves relatively little also makes this one of the longer-lasting sites, though how long yours lasts depends on the product, the amount, and how quickly your body breaks it down.

Your appointment is booked for a full hour. The injecting takes a small part of that; the rest is assessment and planning, because Dr. Sarai would rather take her time than work to the clock.

A short ligament tethers the skin to the bone along the rim of the eye socket, and as the support around it changes that tether shows as a groove, the tear trough. The skin here is the thinnest on the face, so whatever sits beneath it shows through.

This is the area Dr. Sarai is most likely to advise against treating, or to treat somewhere else first. Filler works here when the hollow is well defined, the skin still has some thickness, and the fat pads beneath the eye are not already pushing forward. Where the lower lid is puffy instead of hollow, where the skin has lost its elasticity, or where fluid gathers there overnight, adding filler can make the area look heavier. In those cases the honest answer is that this is not the right treatment, and you should expect to hear it.

Often the better first move is the cheek: support at the upper cheek lifts the lid-cheek boundary and softens the shadow from below, and sometimes that is enough on its own. When the groove is treated directly, product goes deep and in very small amounts, because hyaluronic acid draws in water and over-filling here produces puffiness rather than smoothness. Results tend to last longer than elsewhere on the face. Bruising is common and can take a week or two to settle.

The requests here vary more than anywhere else. Volume in a lip that has always been thin, a border redefined where it has softened, an upper and lower lip brought into balance, two sides made to match. Those need different placement, and treating them as one request is how lips end up looking done. Proportion is judged against your face, not a template: a male lip is generally flatter and less projected than a female one, and treating it to female proportions changes the whole lower face.

The product differs too. Where the cheek wants a firm gel that holds structure against bone, the lip wants a softer one. A gel too firm for a lip can distribute unevenly and feel lumpy. Placing less and reviewing is the safer plan, and hyaluronic acid can be dissolved if you are unhappy with the result, which is one reason it is used here instead of a permanent material.

Expect swelling, and expect it to look excessive at first. Two weeks is usually the point at which the result can be judged, and asking for more before then is a common regret. Lip results are shorter-lived than filler placed deeper, because the area is in constant motion. If you have ever had a cold sore, say so at your consultation: injecting the lip can wake that virus, and a short course of antiviral medication beforehand substantially reduces the risk.