Facial Fillers: When They’re Indicated, How They Work, and the Difference Compared to Skin Laxity Treatments

Facial fillers are among the most sought-after aesthetic procedures for those who wish to restore facial volume and achieve a more youthful and harmonious appearance. From the age of 30 onward, it is natural for signs of facial structural loss to begin to appear—such as reductions in bone, muscle, and fat—creating the appearance of a “deflating face.”

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This loss is usually more noticeable in the malar and zygomatic regions, areas that over time begin to sink and create a sense of tiredness or aging. For this reason, fillers have become an essential technique in modern facial harmonization, especially when applied with subtlety and respect for facial anatomy.

According to recent industry data, the global facial fillers market has been growing at an annual rate of over 10%, driven largely by demand from patients aged 30 to 55 seeking non-surgical solutions for volume loss and facial contouring. Studies indicate that facial fillers are most commonly indicated for restoring lost volume in areas such as the cheeks, nasolabial folds, and lips, with hyaluronic acid fillers accounting for more than 70% of procedures due to their safety profile and reversibility. In contrast, treatments for skin laxity—such as radiofrequency and ultrasound-based technologies—are primarily recommended for patients experiencing sagging rather than volume loss, highlighting the importance of proper indication to achieve natural and effective aesthetic results.

In this article, you will learn when facial fillers are indicated, how they are applied, why they should not be used alone to correct skin laxity, and the role of CO₂ laser in improving skin firmness. Keep reading to discover how these treatments complement each other for natural, long-lasting results!

When Are Facial Fillers Indicated?

From the age of 30 onward, the face goes through a gradual process of volume loss. Facial bones undergo resorption, muscle mass decreases, and facial fat is reduced. Together, these factors lead to a sunken appearance, especially in the malar and zygomatic regions.

A simple test can help identify this need: if you place a finger below the cheekbone and gently lift upward and notice an improvement in facial contour and overall appearance, you are likely a good candidate for fillers.

First step: restoring the malar structure

Filler in this area replaces lost volume and restores support, promoting a natural lifting effect. This is the first step in facial harmonization, as this region acts as a structural “pillar” of facial support.

How Do Facial Fillers Work?

Fillers are applied strategically, using small support points on the lateral areas of the face and the malar region. The goal is not to change facial features, but to restore what has been lost over time.

The technique always prioritizes natural results—no exaggeration or artificial volume. The limit is determined by the patient’s own anatomy.

Complementing the lower third of the face

After the initial support, volume may be added to areas such as:

• Jawline angle
• Chin
• Nasolabial folds (smile lines)

Enhancing the jawline angle, especially in women, is one of the features most commonly associated with youth and balanced facial proportions.

Why Has the Concept of Facial Fillers Changed?

In the past, professionals applied fillers directly to the nasolabial folds or to areas where patients noticed specific concerns.

Today, the approach is different: it is first necessary to restore structure to the malar region (MD Codes), and only then complement other areas. This strategy ensures more harmonious, natural, and long-lasting results.

Fillers Do Not Treat Skin Laxity: Understanding the Difference

A common misconception is believing that fillers correct skin laxity. When there is excess skin, trying to “lift” everything using only hyaluronic acid can make the face look heavy, artificial, and disproportionate.

If a patient has significant skin laxity, applying excessive volume to the upper face creates an unnatural and visually uncomfortable effect.

Skin laxity is treated with LASER — not fillers

For skin laxity, the correct indication is:

• CO₂ laser, which improves skin firmness and quality
• Especially effective in the jawline region and lower eyelids

Laser treatment stimulates collagen production, reduces laxity, and leaves the skin firmer and more rejuvenated.

How to Combine Fillers, Laser, and Botulinum Toxin?

Combining treatments is the key to balanced and long-lasting results:

1. Laser for skin laxity
   Indicated when there is skin sagging and loss of firmness.
2. Fillers for structural support
   Volume restoration at strategic points, especially in the malar region.
3. Botulinum toxin for muscle control
   Helps prevent expression lines and complements overall facial harmony.

Conclusion

When applied properly and with a focus on facial structure, facial fillers are an excellent tool for restoring youth and balance. However, they do not replace the treatment of skin laxity, which should be addressed with technologies such as the CO₂ laser.

The correct combination of techniques is essential to achieve natural results while respecting each patient’s individual characteristics.

On our website, you can find more information about CO₂ laser, facial skin laxity, fillers, and many other treatment options. And, of course, if you still have questions, we are here to help you find the best approach for your case!

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A Clínica de Pele has specialized in dermatological treatments in Rio de Janeiro for over 60 years, since 1969. Dr. Szerman has more than 20 years of experience and teaches other physicians.