Age impacts filler treatments

September 1, 2006

Before age 50, patients might want to just soften the nasolabial fold, rather than completely reduce it, and they are looking to accentuate the lips, as opposed to making them fuller.

National report - When it comes to fillers, people in their 30s and 40s tend to have different needs than those in their 50s and older.

Seth Matarasso, M.D., clinical professor of dermatology at the University of California, San Francisco, School of Medicine, says younger patients tend to be extremely savvy about less invasive aesthetic options. They are up on the latest in fillers and know that there are quick fixes to be had.

Some examples, according to Dr. Matarasso:

Before age 50, patients might want to just soften the nasolabial fold, rather than completely reduce it, and they are looking to accentuate the lips, as opposed to making them fuller.

"To soften a wrinkle, you do not need as much of a product. That might translate into a less costly bill for the younger patient," he says.

Still, the younger person, he says, is more likely than the older patient to come in for touchups or a drop of something here and there, whereas the older patient might have a lot done and come in less often for touchups.

The pallet of filler products is similar for the younger and older age groups, but dermatologists might use fewer products or a different mix to achieve different goals.

"Just today, I saw a 28-year-old woman who is getting married. She came in for Botox (botulinum toxin type A, Allergan) just around the eyes. Her mother is having Botox in her forehead, in between her eyebrows and around the eyes," Dr. Matarasso says.

Varying technique

While filler technique for younger and older patients are comparable, Dr. Matarasso says that younger skin tends to be a little more resilient and thicker, so patients may not bruise as much.

"A woman in her 60s will usually have more sun damage, making her skin less forgiving with the injections, so there is more margin for error than there is with 30-something-year-old, supple skin," he says.

So he often adjusts his approach, depending on the patient's age.

"With a lip that has gotten a little more time on it, there is more anatomy to address. The younger patient just wants a little more volume. And she can get away with one product. Her mother, on the other hand, has thinner lips because of aging, but also the sides of the lips have come down. And she might have a deep nasolabial fold and smokers' lines. So we will need a few products and to do more work because there is more anatomy to address," he says.

The younger lip augmentation patient might only require a thinner filler product, such as collagen. The older patient would probably need a hyaluronic acid to address the nasolabial fold and, perhaps, collagen in the lip lines and botulinum toxin type A to soften the musculature around the lips, he says.

Dr. Matarasso is more likely to use collagen for lip augmentations in younger patients because products, such as Restylane (Medicis) give women in their 30s and 40s too dramatic a result.

"Oftentimes, the collagen products are more subtle. Dermatologists will use Restylane and hyaluronic products as volumizers, when with younger lips, we want to side on the more conservative," Dr. Matarasso says.

Around the eyes, Dr. Matarasso uses what he calls "triple-punch therapy."