• Anita Mandal M.D.

    Board Certified Facial Plastic Surgeon

A Surgeon's Skill, An Artist's Soul, A Woman's Compassion

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Layering Fillers For More Effective Results

Question: I am 63 and have droopy mouth corners and marionette lines. I had Radiesse injections to lift my mouth corners and I’m happy with those results. However, I saw no improvement in the fine marionette lines at my mouth corners. My doctor told me that the filler I had was injected deep and can’t be used for the finer lines. Is there a way to treat both my mouth corners and marionettes lines or do I just have to live with my marionette lines?

Answer: Your doctor is correct in that Radiesse is typically injected into deeper skin planes and is not ideal for treatment of finer lines. My approach typically consists of using a deeper filler to lift sagging mouth corners in combination with a fine line filler such as Restylane Silk or Bellatero, if needed, for treatment of finer lines at the mouth corners.

A broad range of injectable fillers exist on the market. Since not all wrinkles are the same, similarly, not all fillers are the same. A skilled injector can match the appropriate filler to the appropriate concern.

This multilayer, dual filler approach is not only used for droopy mouth corners with marionette lines but can also be effective in other facial areas. The following areas can be treated with a layering technique, depending the degree of aging you experience.

  • Nasolabial depressions with overlying lines
  • Chin wrinkles consisting of deep and superficial wrinkles
  • Deep lip wrinkles mixed between finer lip lines
  • Hollow cheeks with overlying fine cheek lines

Injectable fillers commonly used for hollowing, depressions, sagging and deeper grooves or folds include Voluma, Bellafill – The 5-Year Filler, Radiesse, Sculptra, Restylane Refyne and Restylane Defyne. Choice of filler depends on area treated, extent of aging and longevity of filler but ultimately lies with the judgement of your surgeon.

Injectable fillers commonly used in superficial tissue planes include Restylane-L, Restylane Silk, Bellatero and certain forms of Juvederm. Sculptra has also been used to treat finer lines in certain circumstances as well.

A thorough consultation with a Board Certified Facial Plastic Surgeon is the first step in assessing your facial rejuvenation needs and determining the most suitable combination of fillers that can give you optimal results.

Look 9 Years Younger in 90 Minutes or Less

  • Stem Cell Fillers: Using your own stem cells, long-term, minimal downtime
  • Laser WhisperLift™, 90 Minutes: 1 cm micro-incision surgery, tighten sagging neck & jowls, local anesthesia, minimal downtime.
  • Bellafill, 60 Minutes: The 5 Year Filler – Dr. Mandal is a BellaDiamond physician in the top 1% of expert Bellafill injectors in the world
  • Infini RF, 40 Minutes: Non-Surgical Facelift for sagging jowls and neck, no downtime
  • SculpSure, 25 Minutes: Permanent, non-invasive body fat reduction
  • Kybella, 10 Minutes: Permanent, minimal invasive neck fat removal

Dr. Anita Mandal

Dr. Anita Mandal is a double Board Certified Facial Plastic Surgeon practicing since 1998. She exclusively specializes in facial rejuvenation and non-invasive body contouring. In addition to being on the medical staff at Jupiter Medical Center, her offices house both surgical and laser suites. Dr. Mandal is committed to giving her patients the most natural looking results.

Mandal Plastic Surgery Center

Address: 2401 PGA Blvd., Suite 146, Palm Beach Gardens, FL 33410

Phone: (561) 238-0040

Website: MandalPlasticSurgery.com

E-mail: drmandal@comcast.net