Facial Fillers: Holistic Rejuvenation, Facial Balancing, and Natural Results

Dr Doris Day discusses why facial fillers continue to grow in popularity by shifting beyond simple volumization toward holistic facial balancing and longevity-focused rejuvenation. Learn how combining fillers with neuromodulators, energy-based devices, and other aesthetic treatments can deliver natural, undetectable results while improving patient satisfaction, trust, and long-term outcomes.

Transcript

I'm Dr Doris Day. I'm a board-certified dermatologist in New York City and clinical professor of dermatology at NYU Langone Health.

Despite talk of “filler fatigue,” what factors are actually driving continued growth in filler use within your practice?

Dr Day: In my practice, what I've noticed over time is that, especially after COVID, when we couldn't have as many patients sitting in the waiting room, so we had more time with each patient because we were seeing fewer patients in a day, I was able to do a more holistic, complete evaluation and tell my patients about all the options we had available, fillers, devices, neuromodulators, other injectables, and patients were way more willing to do more. I'm seeing fewer patients, but each patient is doing more per session and I'm spending more time with the patients. So the more I slowed things down, the more the volume of what I was doing increased and the happier the patients were and the more patients I got referred for doing that work. 

So I find that new patient acquisition isn't really so important. It's focusing on the patients you have in front of you, giving them your honest assessment about their whole face, what makes them beautiful, what their special features are, and how you can celebrate and enhance those in ways that they may not have thought of. So I don't wait for them to say, well, this line bothers me, fix this line. It's more of helping them understand why they have that line, how it got there, and all the different ways that we can combine our treatments to give them the most natural, authentic outcomes. And that's what makes the patients the happiest, and that's what keeps them coming back for more and sending in their friends.

How has your approach shifted from traditional volumizing to more holistic, structural, and longevity-focused treatment strategies?

Dr Day: My approach has never changed. It was never a volumizing practice. It was always a holistic approach. But what I found is that as I got more comfortable and as we had more products available and I could address things in ways that I couldn't before, I have softer fillers I could use around the mouth. So now I can address that area with fillers and combining it with devices. Whereas in the past, I wouldn't put fillers there because they added too much bulk or weight and the fillers were too visible. So it's a combination of having more options, understanding better how fillers behave over time, having a better opportunity to have time with my patients to help them understand what my strategy is for them and to develop a calendar for an approach that has really changed. But I've always had the same approach of never wanting to overfill or volumize. It was always about reflating and balancing.

What practical advice can you offer clinicians on combining fillers with other modalities to achieve natural, undetectable results while maintaining patient trust?

Dr Day: It's really important for patients to understand that there isn't one thing that will solve all their issues. So fillers can't fix everything that a patient may ask for. Neuromodulators can't fix anything. Devices can't fix everything. So each one has its place. It's up to us to help them understand why they have what they have in their face, why their brows may have dropped, why they have deflation in the perioral region, why they may look gaunt along the cheekbones, or have overgrown masseters. And then to help them understand that it's different tools for different issues.

And unless you can properly combine them and help them get to that authentic outcome which will not just be more beautiful it will help them age better, and people will just keep saying how come you look so good but I don't know what you've done. That's always the biggest compliment and that's what we love our patients to come in and tell us that their friends give them compliments but they can't tell why. So we want to work on skin texture, skin balance, and overall quality not just looking for one tool to solve all their problems.