Amy F. Taub MD
An anniversary is a time to celebrate longevity and embrace perspective on what are truly integral discoveries as well as appreciate their maturation process. The JDD's 10th Anniversary is an appropriate time to pay fitting tribute to filler science, which may have started humbly as a small procedure for nasolabial folds and upper lip rhytides but has evolved to an entire field where all core aesthetic specialties have embraced reshaping the face with volume as a primary key component of anti-aging strategies. The stars aligned for me as well with my 20th wedding anniversary occurring and my only child going off to college. I can remember back to the first ODAC meeting and chuckle at its inauspicious start, yet be amazed at the myriad of excellent speakers and the hugely successful annual event it has become. Similarly, I can remember doing skin tests for collagen yet now routinely injecting 3 cc to 8 cc of fillers with cannulas! Let's see, playing peek-a-boo and...helping to shape a scholar going to Penn!
This is one issue you will want to keep for a long time, as it has so many valuable articles that could be considered reference material. The complete review of the basic science of fillers by Gilbert, Hui, and Waldorf (The Basic Science of Dermal Fillers: Past and Present Part I: Background and Mechanisms of Action) could have easily anchored a textbook. Two phenomenal articles on the safety of dermal fillers by Gilbert (The Basic Science of Dermal Fillers: Past and Present Part II: Adverse Effects) as well as one by Macrene Alexiades-Armenakas (Safety of Dermal Fillers) are truly the last word on safety and will give you some great tips on how to avoid complications and/or treat them effectively.
In the United States we have a paltry number of filler brands compared with the rest of the world. Do we need more brands here? Our 5 million-mile globetrotting international representative, Michael Gold, will give us the perspective we need from his deep connections with Asian and European physicians and companies (An International Perspective on Fillers in Dermatology—From an American Perspective). Belotero, one of those many brands, looks like it may gain entry here. We get a fascinating close-up view of the real-life experience of a German clinic's experience with 317 patients over a 5-year period (Five-Year Retrospective Review of Safety, Injected Volumes, and Longevity of the Hyaluronic Acid Belotero Basic in 317 Patients).
I have solicited articles for two areas of filling that I consider to be technically difficult: Sculptra and lip augmentation (with hyaluronic acid). These are both areas that require much experience to achieve beautiful results consistently. In order to help us favorably shift the learning curve, presented here are insightful how-tos from masters of these two areas, Melanie Palm (The "Skinny" on Sculptra®: A Practical Primer to Volumization with Poly-L-Lactic Acid) and Robert Gotkin and Deborah Sarnoff (Six Steps to the "Perfect" Lip).
I have been so impressed by how a 5-minute procedure (other than botulinum toxin)—cheek augmentation—can cause such a sensational and immediate result that I performed a small project just to demonstrate how much patients respond positively to simple cheek augmentation (Cheek Augmentation Improves Feelings of Facial Attractiveness). Tung, et al, looks more rigorously at volumizing the upper face by combining smaller particle with large particle hyaluronic acid filler (Brighter Eyes: Combined Upper Cheek and Tear Trough Augmentation—A Systematic Approach Utilizing Two Complementary Hyaluronic Acid Fillers). Although not an overlooked area, the upper face/cheek area should have more primacy in the consultation on fillers. The rejuvenation of this area resets the shape of the aging face to one that is more ovoid and less rectangular, a primary goal of anti-aging and one that yields results that are terrific patient-pleasers.
Finally, we all need to know more about cannulas. Reducing downtime and discomfort from fillers will lead to the increased utilization and popularity of fillers and mesh well with our patients' increasingly busy lives (Filler Injections With the Blunt-tip Microcannula).
I want to truly thank the editorial staff at JDD for this special honor, and especially Perry Robins for continuing to make a huge difference in our dermatology world.
Amy F. Taub MD