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How much filler do I need and what if I’m not ready for that?


Ask Dr Imaan : Fillers are expensive! So I can budget, can you tell me how much I will need for my cheeks/ jawline/under eye bags?

Great question, thanks for asking!

I was caught out last week on this very question!

I saw a young woman, who is also a friend, for fillers. I was fairly confident of the amount she would need in her cheeks. Unfortunately, as soon as I began injecting, it became clear that I had grossly underestimated the amount her cheeks would need to help improve her main complaint, which wasn’t the cheeks but sagging tear troughs, with flattening of her cheeks.

The end result – a slight improvement for her, me feeling flustered, and second guessing myself, and likely disapointment for her, not to mention the cost!

Yet the day prior, I had correctly estimated this lady’s need for only 0.5ml filler to each cheek to add to the 2 mls she had elsewhere 8 months ago:

Post 0.5/0.5ml thick filler








And 2 days after my friend, another young woman, also 0.5ml to each cheek, with more to come gradually in a month or so:

29yo with 0.5/0.5ml thick filler








The take home message- every face is different. Every person’s anatomy is different. Even in the most experienced hands, we can get it wrong by underestimating, as I did with my friend.

Tear trough deformity img_0476

The cheeks and jawline are notorious for the ability to be “black holes” that swallow huge amounts of filler, seemingly without desired effect. In many cases, what the patient sees as being the issue (droopy eye bags, sad smile lines and jowling) are symptoms of the actual problem, which may be loss of volume in the cheeks. To fix the underlying issues employs time, energy and effort and filler- often a fair bit of it.

Yet, even in those cases, I encourage patients to look at the time, filler and money as an investment:

  1. the 1-2 mls of filler isn’t wasted- it is laying the foundation for more work that needs to be done in 6-12 months.
  2. the longer one leaves the early signs of ageing (flattening of the mid face, early formation of jowls, hollowing of the cheeks, eye bags), the more filler is usually required to first fill up this defect and then to rejuvenate the area.

Q: Apart from regular treatments with wrinkle treatments and fillers, what else can I do at home?

For solid evidence, we come back to the staples- plenty of sleep; a diet rich in green leafy vegetables and fruits and low in sugars and fast food; sunscreen everyday, rain or shine, and not smoking.

Additionally, there are so many quick fix solutions and lotions and potions on the market today, for everything from pigmentation to wrinkles, to more. Unlike many of these, Vit A cream works (via a prescription from your family doctor) as can Vit C; in addition to that, anti wrinkle injections work by relaxing muscles so they slow down or halt the appearance of further wrinkles while smoothing out older wrinkles leading to smoother skin that makeup doesn’t cake over.

Fillers work by hydrating the skin from within, and plump wrinkles by smoothing out the overlying skin.

Purely hydrating products such as the SkinBoosters, work NOT to lift, but purely to hydrate skin from within for upto 5 months at a time – 2 treatments a year should, in theory, help with dry skin, photo damage from the sun and so on.

Lastly, having regular injectables to the face works in small part by stimulating collagen production and increased skin turnover, producing fresher skin compared to no treatment (this is partly why procedures such as microdermabrasion and micorneedling also work to help keep wrinkles at bay).

So if, like me, you are a busy person, a working mum, or a working single mum, budgeting for some of these may be the best way to “wash and wear” the skin your’re in!

Questions? Email me!

Hope to see you in a clinic soon!

And announcements for April:

Winter special

  • Dr Imaan Joshi has been working as a doctor since graduation from the University of Sydney in 2001. She spent years between 2004-2011 as a surgical trainee before switching to a different speciality program for work-life balance. She is passionate about her work in Medicine and especially about procedural Medicine, and loves her work as a Cosmetic Physician. When she isn't working, she is busy focusing on an active life with her family, which includes 4 active children! Dr S Imaan Joshi BSc, MBBS, FRACGP


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