Check the doctor referral services of nearby university-based medical centers and national medical associations, such as the American Society for Aesthetic Plastic Surgery (www.surgery.org), the American Academy of Dermatology (www.aad.org), or the American Society of Dermatological Surgery (www.asds-net.org).
Confirm the doctor's board certification with the American Board of Medical Specialties (www.abms.org). Membership in a professional organization like ASAPS or the AAD is a plus.
Call each doctor's office on your list and get some basic info (see "Questions to Ask," p.175). Narrow your choices to one or two docs and schedule consultations. You're going to have an ongoing relationship with the physician you choose, so you want to feel comfortable.
All fillers work in the same general way:
They increase volume, either where no soft tissue existed or where it has diminished with age. Fillers can lift the depression of a crease, for example, or plump thin lips or flat cheeks. Fillers are often layered with one another and/or Botox, which relaxes the wrinkle-forming muscles.
"The art is in selecting the appropriate fillers to meet an individual's needs," explains Dr. Seth Matarasso, a professor of dermatology at the University of California, San Francisco. He offers an example of the fine-tuning that may be required for a natural-looking mouth: A dense filler can be injected to define the lip's borders, a less dense one to subtly plump them, and yet another to fill the fine superficial lines above the lip.
"What works where depends largely on a product's thickness," Matarasso says.
Here are the injectables you're most likely to be offered.
The extra padding on your hips might seem to be the ideal filler because it's your own tissue, but this method turns out to be unpredictable. In some people, the transplanted fat cells resorb quickly; in others, they last for years.
Fat is retrieved and transferred through a large needle, so bruising may occur. And because some of the fat will be reabsorbed within a few weeks, the doctor will slightly overfill to compensate for the expected loss. The resorption isn't always balanced.
"A lopsided lip, for example, can happen with any filler, but it's more likely with fat," says Dr. Theodore Kramer, medical director of the Riverview Cosmetic Surgery and Skincare Center in Norwalk, Conn.
More from Prevention:
Collagen, which gives skin its resiliency, is the granddaddy of all fillers. Injectable bovine (cow) collagen was FDA-approved in 1981 for lifting depressed acne scars and filling wrinkles. Major drawback: It's made from animal tissue and can cause an allergic reaction, so a skin test a month before treatment is essential. Plumping lasts for three to four months.
Cosmoderm and Cosmoplast are bioengineered collagen derived from human cells, so there is no allergy risk. Their lasting power is similar to that of bovine collagen.