Friends, gone are the days of having to endure obvious lines and wrinkles. So if you’re contemplating hiding the evidence of the lazy beach days or hangovers of your 20s, and find yourself curious about fillers, then you’re in the right place. 

First things first: it matters who does your filler. There’s an art to facial injections, and every practitioner has varying levels of experience, as well as her own philosophies about technique. You want a doctor who knows facial anatomy. Case in point: Afraid of the dreaded duck lips or trout pout? Well, filler will look natural when expertly injected, and the changes should be so subtle that it’s likely no one will notice. It should look like you got airbrushed in Photoshop. 

If you're fearful about the discomfort, don't worry: if the needles are tiny enough and the technique is right, you shouldn’t feel more than a slight to strong pinch. There’s also the option of topical numbing or a nerve block for the lips.

But enough from me—it's time for an expert to fill you in. After an informal survey of local notables, I frequently heard the name Dr. Elizabeth Callahan of SkinSmart Dermatology. You may have even read this In the Glow interview with Kim Mancini where she dropped the name, too. Not only is Dr. Callahan an invited expert to industry summits, she’s also an injector trainer, with an encyclopedic knowledge of facial anatomy. Here, she shares insight on everything first timers (and the convert) need to know and beyond...

What are the differences between fillers and neurotoxins?

Fillers are generally used in the lower face, in areas where there are wrinkles and volume loss.  Neurotoxins (like Botox and Dysport) are primarily used in the upper face to soften the lines between the eyes and lift the brows.

What injectables do you favor and why?

All injectable fillers serve a different use and I use them all equally. I think of facial fillers as paint brushes; each patient has a unique set of needs.

Regarding a consultation appointment, how should a patient prepare?

Before you come for a consult, think about one area that you want to improve, and have an understanding that fillers are not the same as having surgery. 

What are your goals as a physician?

My goal is to make you look like a more refreshed, subtly rejuvenated version of yourself.  Everyone will notice your freshness and beautiful skin, but no one will know what you did. My ultimate goal  is that you walk out of your house every day feeling confident, happy, and bold. 

Some of us are not fond of needles. What’s the discomfort level?

The level of discomfort is minimal with the use of topical numbing cream.  People always comment that it was “much easier” than they thought it would be.

And is bruising expected?

Every patient is given my custom pre-filler instruction sheet that discusses many ways to avoid swelling and bruising. We also recommend a topical treatment before and after filler treatments that reduces bruising by about 50 percent.  You are allowed to wear make up the next day, but we recommend no big events for 2-3 days.

How often does the average patient need a re-fill?

Once we get to the point of desired correction, I generally do maintenance about every six to nine months.  Botox and Dysport are done every four months.

Anything else a patient should know when considering fillers?

Always ask yourself, “Who is your injector?  What are their credentials? Are you comfortable seeing a nurse, or would you prefer to see a doctor who is trained expert in facial anatomy?" You should never just consider cost.  Your face is your most valuable asset.  My favorite quote is “an educated patient is a happy patient.”