[Updated] Getting Your Filler Results Right: It Takes Two

Dermal filler results created by Dr. David Mabrie in San Francisco, CA after a series of treatments.

Over the past decade, my team and I have helped thousands of patients rejuvenate and contour their appearance using non surgical dermal fillers and neurotoxins like BOTOX at our San Francisco practice. Experience has taught me that the softest, most natural, and healthiest-looking results require more than one appointment. When it comes to fillers, layering is key. Patients should plan for 2 to 3 appointments at Mabrie Facial Institute for the best outcomes. Read on to discover the benefits of layering treatments.

In this blog post, you will learn that the incredible results featured in our patient photo gallery are achieved by our It Takes Two approach, and why too much filler too quickly can make your treatment obvious and unnatural. We’ll delve deeper and explain why our patients benefit from scheduling a minimum of 2 treatments when rejuvenating or enhancing their features and how it sets our practice—and your results—apart from the rest.

The Essentials of Layering

Patients tempted to maximize filler and neuromodulator treatments in one appointment may be disappointed with the unnatural results produced by such an approach. Another provider may recommend trying to accomplish everything at once, but as expert Injectors, the MFI team knows that over-injecting a single treatment area can produce results that don’t meet ourstandards.

That’s because excess filler tends to spread out, rather than create a natural, lifted look. By injecting less filler, we can make sure it stays put, just where we want it. Too much filler will spread and can make a patient look puffy. No one wants to look puffy.

Layering filler at a second appointment allows us to “stack” onto the first layer and double the volume in the places where you need it. This second appointment is especially important for the under-eye area, where you want to completely eliminate shadows. In fact, all patients should think of the second appointment as an extension of the first appointment, which establishes the foundation.

Refining Results – Your Second Visit

This is where our patients go from happy to ecstatic. We schedule the second treatment somewhere between 1 to 3 months after the first appointment. There is a specific reason for waiting: swelling. We don’t want to add any additional filler until you’re completely healed.  No, you won’t look swollen for months, but it can take up to 4 weeks for the residual swelling to completely dissipate.

When we assess the results of your initial treatment, we want to be sure we’re looking at the actual outcome so that we can identify specific areas to refine. Besides waiting for all the swelling to resolve, waiting a month or so gives the fillers time to disperse. Think of it this way: It’s like applying 2 coats of paint or nail polish. When the first coat dries, it contracts and thins in certain areas, so a second coat is required to reach the desired result. Similarly, after the initial filler treatment, we must wait for the swelling to subside because the results will contract and different areas may need more filler.

Refinement treatments are the key to getting the amazing results that our patients want. There are no shortcuts. That’s why we say, It Takes Two.

A Special Note About the Under Eye

This is one of our most popular requests, and the reason we created our Midface Rejuvenation package. Treating the under eyes (tear troughs) is an anatomically challenging area that should only be performed by an expert Injector,  an area of our expertise where an It Takes Two process is required for results. During the initial appointment in creating the foundation for our next session, we treat adjacent areas (particularly the larger midface and cheek) to support the orbital rim and tear trough. Ignoring these “support” areas can create heaviness under the eyes or pooling of filler—the exact opposite of our goal.

To successfully treat the under eye, we must focus on creating a supportive foundation for the tear trough treatment to rest upon. At this stage, visible results may or may not be apparent after the first treatment. Understandably, this can cause patient distress and the reason that we always want to prepare our patients with as much information and education as possible.

The tear trough can be directly addressed in subsequent visit(s), during which patients will start to see a visible improvement. However, it is not uncommon for patients to require a third appointment to reach optimal results. Proceeding gradually is key to the best outcomes. Overfilling at any stage, particularly for the under eye, can produce unnatural or obvious results.

You can learn more about our staged approach to fillers and how long your results will last in this blog post.

Contact us using the online form to learn more about non surgical facial enhancement. Or call us at (415) 445-9513 to schedule an appointment.

Dr. David Mabrie

Dr. David Mabrie

Facial Plastic Surgeon & Founder of Mabrie Facial Institute Dr. David Mabrie is a recognized leader, innovator, and educator in the use of dermal fillers for facial sculpting and has dedicated his practice entirely to facial rejuvenation with injectables. Years of experience led Dr. Mabrie to pioneer the Illumination 360° approach, just one of the ways Dr. Mabrie brings life to his practice’s mantra: “your face, perfected.”

4 Responses to [Updated] Getting Your Filler Results Right: It Takes Two

    • Hi Marissa,
      I’m sorry to hear that you’ve had a negative experience with under eye filler. Puffiness is not a common result but can happen for various reasons. Some of these reasons include: your immune system is having an inflammatory reaction to the filler, the area was over filled, or the filler has migrated too closely to the surface of the skin. I recommend reaching out to your injector, as there are treatments to correct this. I hope this information was helpful.

  • Dolores says:

    Hi i did a second hyaluron treatment and it doesn’t look good. After two weeks it seems like is too much filler, you can see the line of the filler and I look worst than before, because is more shadow in undereye area. What can I do?

    • Hi Dolores, I’m sorry to hear about your experience with fillers! When layering fillers it’s important that the amount of filler injected at each appointment is appropriate for the patients anatomy. If you feel that your under eyes are overfilled, and the procedure was done using a hyaluronic acid filler, you can have the filler dissolved using Hylenex (aka hyaluronidase). However, before considering dissolving we recommend waiting 4 weeks post procedure since swelling, even minimal amounts, is still present. You can check out more about Hylenex on our website here. I hope this was helpful!

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