Question: I have had filler treatments over the years and some were good but some were not. I see many scary-looking people with overblown cheeks and lips. I’m interested in Bellafill. Because Bellafill lasts 5 years, I prefer that a plastic surgeon do the actual injections. Unfortunately, most plastic surgeons use nurses or assistants for injections. Why is it such a challenge to find a plastic surgeon willing to do their own filler treatments?

Answer: It has become a sad reality that most plastic surgeons do not perform their own injections but pass it down to a lower-level assistant. Most surgeons incorrectly believe that they should focus on surgery and not bother with “simple” filler treatments.

Because there is less “hands-on” filler experience by the surgeons themselves, most surgeons lack strong injector filler skills. At the same time, a lower-level injector does not have the same in-depth understanding of facial anatomy as the plastic surgeon does.

This trend comes from the increasing commercialization of plastic surgery where “time is money”. Injectable fillers tend to cost less than surgery so there is less incentive for surgeons to be directly involved with filler treatments. Also contributing to this situation is the resurgence of endless medical spas offering deals on fillers. Discounting encourages patients to shop around for filler deals. Patients also have the wrong impression that it’s okay to get a discount on your fillers compared to surgery.

In truth, the difficulty in finding a plastic surgeon who performs his or her own injections is due to faulty perceptions by both the patient and the surgeon.

In my practice of 26 years, I have always performed my own injectable filler treatments. My patients seek a natural result and do not compromise quality for the price. Many of my patients have had filler work elsewhere and learned, the hard way, to value expertise and skill over money.

Your face is a bit different from a Prada handbag. While Prada prides itself on quality construction, their bags are still mass-produced and go on sale when the new season rolls in. You only have one face. Each of us has to decide if getting a discount for your face is worth it in the long run.

This mindset is especially important when having long-term fillers such as Bellafill which lasts 5 years. Bellafill treatments should ideally be performed by BellaDiamond physician in the top 1% of Bellafill injectors in the world. It’s easy when the injection is not done correctly, with temporary one-year fillers like Juvederm and Restylane to tell the patient the result will go away soon. With Bellafill, it’s important to use a plastic surgeon who understands the detailed facial anatomy to also have a high level of injector skill in order to get it right the first time around.

The best way to minimize complications and unnatural-looking results is to seek a Board Certified Facial Plastic Surgeon who is not only skilled and experienced in the particular procedure(s) of your choice but also shares your aesthetic.