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”As aesthetic doctors, our thinking nowadays is to preserve rather than to transform.”


What Are Soft Tissue Fillers?

Soft tissue fillers are injectable gels that help to lift tissue and improve the appearance of lines and wrinkles.

Fillers can be made from a variety of different substances but the vast majority that are used today are made from hyaluronic acid, a substance that occurs naturally in our bodies as a building block for our skin, drawing in water and providing hydration and support to your skin tissue. There are many different fillers in the market, and new ones are being introduced all the time. They differ in the amount of hyaluronic acid (HA) they contain, other additives, and how the molecules of HA are bonded together. These individual properties affect how thick or stiff a filler is as well as how long it lasts.

An Overview of Fillers

Soft tissue fillers have been around for decades but our understanding on how to use them effectively has sky-rocketed in the last few years. As aesthetic doctors, we often attend congresses where patients are injected on-stage with large amounts of fillers and we are left spell-bound by what can be done to transform a patient from looking old and tired to younger and fresher, with soft tissue fillers. Dr. Maricia Coertze and myself (Dr. Natasha Chapman) regularly attend congresses and workshops to ensure that we are up to date with all the latest thinking and techniques and we are continually learning and improving in what we offer to our patients.

We also use fillers (e.g. Juvederm® and Restylane®, amongst others) that have many years of research and development behind them, ensuring that we are offering our patients the best and safest fillers currently available in South Africa. When fillers were first introduced, we used them predominantly to lift lines and creases in the face. Today, our understanding of the aging process and how it affects our appearance has changed how we inject fillers, leading to less obvious and more natural-looking results.


The Aging Process

As we age, our bones and teeth resorb, leading to a decrease in skeletal and dental volume and a loss of support to the overlying soft tissue. Discreet and well-defined deep fat pads that are located all over the face are also resorbed, creating even less support to the overlying skin. Superficial fat pads move downwards, creating jowls and heaviness in the lower face.

The face is like a deflating beach ball, losing support and deflating, with the bottom becoming heavy and the top becoming more and more deflated with sagging of skin and tissue. At it’s extreme, we get what is known as a “hang dog” appearance.

Why Do Fillers Have a Bad Image?

Because soft tissue fillers help to re-inflate tissue and indirectly lift sagging skin, patients love the results. Fillers help to make a person look less tired, refreshed, and more youthful. Patients often ask for more filler to create more definition or lift jowls and eyebrows.

The aging process is a fact of life and we can’t change it. We can however, help someone counteract many of those changes (but not all) and help them look good for their age. As aesthetic practitioners, it’s our job to guide and advise and help patients from over-stepping the mark in their quest to look better. The goal should be to look good for one’s age rather than to look 10 years younger.

At Aesthetics on 5th, we are firm believers in helping our patients look good for their age rather than making them look overdone. Unfortunately, there are many examples of celebrities and people we know who have lost all sense of perspective and end up looking ridiculous.

Why It’s Important to Start Young

Contrary to what we used to think, we now understand that the aging process starts in one’s late 20’s. Loss of bone and fat pad resorption leads to mild sagging from a relatively early age. As aesthetic doctors, our thinking nowadays is to preserve rather than to transform. Our goal is to keep someone looking young and radiant and maintain their features as much as possible rather than to transform them radically when they reach their 50’s and many of the inevitable changes of the aging process have already occurred.

While we can’t keep our patients looking 28 forever, we can help them look good for their age, and ultimately, this is what most of our patients want. At Aesthetics on 5th, our consultations help determine what needs to be addressed immediately, what is likely to need attention in the near future, and where a patient needs to concentrate their anti-aging efforts over the long term to keep themselves looking good for their age.

Natasha Chapman

Dr. Natasha Chapman is an Aesthetic Medical Practitioner with over 16 years of experience in the aesthetics industry. She is passionate about what she does and regularly attends advanced training courses to keep up-to-date with the latest developments in the aesthetics world.