How much cosmetic filler should I use?

How much cosmetic filler should I use?

today is it possible to turn back the
clock with just five mils hi guys my name is dr. Sarah Tonks I’m a cosmetic
physician in London ah something I get asked an awful lot is do I really need
all that filler well I guess it kind of depends on do you really need to see a
result when you have your treatment done if you’ve seen any of my previous videos
you will know that in order to get a stellar result you really need to use an
awful lot of filler to get there and that’s just because as we age everything
changes so your skull becomes smaller and it changes in shape the fat
compartments change in shape and sometimes shrink other bits get bigger
everything winds up falling and sort of sliding down the face so in order to get
something which I would consider to be a good result you really have to have a
way to tackle all these different issues separately and it’s very commonplace for
whatever reason patient doesn’t want to maybe make all those changes in one go
so what would I consider to be sort of the minimum that somebody would need in
order to get at least something happening generally speaking for me that
volume would be around 4 mils obviously in somebody who’s younger you’re not
going to need as much as somebody who is older so it’s very common in patients
who are maybe in their 50s 60s that to get a really really good result you’ll
have to use somewhere in the region of like 16 syringes of course you’ll see a
difference with for very often but these changes are cumulative and because so
much has changed about that person’s face those four mils they’re not really
going to cut it they won’t really touch the sides even
so you do have to be prepared to put more in so let’s go on over to our
patients if you guys have seen the videos before on the channel you will
probably have a really good idea of what I’m about to say but if you haven’t seen
them well let me just dive in here so of course the first thing that I’m going to
mention is this very very hollow in the upper lid and do you recall me saying
that this part of the eye here the a-frame in some people it becomes very
hollow with age and you get a lot of fat loss fat atrophy there and it makes this
distance appear longer which is aging some people treat this with fact some
people treat this with filler it really depends on how you’re coming at the
problem nevertheless this would be very high up my list of things to treat
because remember when you’re looking at a face for the first time we have to
look at what is downgrading that person’s face the most what is the least
flattering feature on their face and then that’s the thing that we treat
first to restore the facial harmony the second thing that I notice is these so
the brows apart from being very faint are very
very low it would be advantageous if there was I don’t know a magical way
like Botox maybe to raise them up slightly the third thing is these
temples here very very hollow and it’s really giving the face a more skeletal
appearance the fourth thing that I notice is this loss of volume underneath
the eyes it gives a sunken much more tired appearance then lower down my list
I’m looking at the jowls here lots of volume across the chin we do have some
vertical lip lines and you can see this platysmal band
down here as well just poking through so when someone comes in to see me even if
they’re coming in for a video I try and basically treat the areas which are of
concern to them and at the same time treat the areas that are of concern to
me and often they are not the same thing so often I’ll get patients coming in
saying you know what I really I can’t stand these vertical lines on my upper
lip or I can’t stand how dark my eyes are or the skin underneath my eyes or I
can’t stand my jowls they’re better usual ones it used to be oh I don’t like
my nose to mouth lines or I don’t like my marionette lines but it almost seems
like the focus has been taken away from those areas recently I’m not sure why
that is there’s definitely not so much of a trend these days of people
mentioning those specific areas but remember the dinner party rule guys if
somebody sat in a darkened room opposite you at a dinner party can’t see whatever
it is that you’re talking about like your vertical lip lines then the chances
are it’s probably not worth worrying about it’s much more common these days
to worry about the shape of the face and the overall global effect rather than
looking at individual lines and wrinkles so with that in mind I was kind of
restricted as to what I could do so let’s check out what I did this is a
first for this channel so I’ve never used Sculptra on the channel before I
think in this series I’ve got gosh maybe three videos or two videos coming up
where I do use a bit of Sculptra here she’s had just the one vial split
between the two temples actually in the clinic it’s not something that I use
very often because I find that people they don’t want to wait for their
Sculptra results they want something which is impactful
reversible and they want it now with Sculptra you have to do usually more
than one treatment session so you’re looking at doing maybe I don’t know two
or three treatment sessions and you don’t really get the full benefit of it
for about maybe six weeks post treatment because her cheekbones are already very
wide in order to get lifting which was one of her concerns I can’t add volume
on top of the cheekbones without filling the temples and in front of the ear it
will just look terrible because it will make her face look wider and then she
will look even more gaunt so instead what I did was views just a ml of
Juvederm Volift in front of the ear just to try and get some lift and then
the next thing I did was used some Teosyal redensity 2 which is specifically
designed for the under eye area just underneath the eye at the worst point
which was right here then I swapped 40s out ultimate to do the chin crease and
just underneath the chin so in total Sculptra measured a little bit
differently but I estimate that it’s around five mils that I’ve used okay
guys so let’s go over to the results and see what happened the answer is nothing
much because we really really need to add more volume in here
but let me talk you through it so first of all obviously I couldn’t do anything
with her upper eyelids unfortunately it’s a shame because that would really
be a hot area for me to treat ditto with the shape of the eyebrow as well there
has been a slight improvement in the under-eye region again really she needs
more treatment here in order to get a good result and I’d want to take it
further lateral as well because it will help to push up the outer corner of the
eye slightly and take it more into a youthful position there has been a
slight increase in the length of the lower facial third a wee bit for me it’s
not quite enough but what really stays
and out is we got to do more temple we have to I think at that rate she would
probably need to do another maybe another two treatments with the Sculptra
in order to get a good result I guess the take-home message for today
is you can’t expect miracles from a really small amount of product I know
five mils sounds like a lot but if you think about it those little ketchup
packets that you get when you get to take away they’re 10 mils so this is
half of that so it’s really not much that’s hardly anything to get a good
result you really have to be using something like 12, 16 maybe even up to 20
mils of product if you want to see something really really impactful of
course you do have other options so other cost-effective ways of getting
that volume in there might be to do fat grafting problem with doing fat grafting
is of course you need to have a secondary procedure in order to be able
to get the fat in the first place and you also can’t dissolve it there’s also
a bit of debate about the predictability of the longevity of fat grafts – okay
guys so that’s it for this week I hope you enjoyed the content and found it
informative let me know in the comment section below if you have any questions
about their procedures which I perform today and please also let me know how
many ml’s you’ve had in order to meet your aesthetic goals I’ll see you again
next week in the meantime please subscribe to the channel and like the
video bye


  • Alberto Leguina says:

    we want your 16 mLs !!! hahah looking amazing and great video =)

  • Spirit Medium Clayton Silva says:

    Check out Jeffree Star’s new video on being botched with lip filler and silicone. I’d be really interested to see your opinion. He just posted it today. 😊 love you Dr. Tonks!! You’re the best and love your videos so much!!!! ♥️♥️♥️♥️

  • Yolanda Phibbs says:

    I'm coming from New Zealand to London in May, I'm happy to be one of your you tube "models"' you'll be able to put 16mls in my 52 year old face 😂

  • Snutih says:

    Looking in the mirror this morning I think 100 ml would be the right dose for me

  • Marge Burkell says:

    16 syringes?!? And if I recall most commenters to that person’s other video liked her face before and not after…??? Lot of money for very little results in this video too. Disappointing and sad. 🤭

  • xptish says:

    Please react to Mariah Carey's face, she's almost 50 looking way younger!!! 😚

  • Agnes says:

    I'd love to hear your opinion on the new Jeffree Star video where Dr. Kirby fixed his lips!!

  • sunnysu says:

    More is more and less is bore!

  • a bains says:

    I have had 16mil in my jaw and and 2mil at the top of my cheeks. Very happy with it

  • Lucid says:

    In the USA 20 ML costs way more than a full face surgical treatment.

    I have about 4 at the moment and I have a very good result but I’ve also had an energy device treatment.

  • Lisa Lemmons says:

    Thank you for this video there were a few on here that I need to have done

  • Mary S says:

    And thoughts on radio-frequency & ultrasound (Exilis Ultra 360) As far as fillers I wished I could afford 16ml. Prices in the US are marketed much higher unfortunately

  • nadia montasser says:

    Hi Dr Sarah! I love your videos. I am obsessed with Salma Hayek! Did she have stuff done to her face? I hope I look like her when I am 52!

  • Sophie Kristiansen says:

    Would absolutely love an update on her a few treatments down the line, think she will look really good.

  • karyn daniels says:

    I love sculptra and am excited to see more videos with it. I am very thin and as I age what is the worst is how gaunt I look. When I that did it I had two vials at one time, then another vial for weeks later and saw Huge improvement. That was four years ago. I have had three more per the years to keep a fullness and it is great. I do other fillers for my lips and undereyes. My dream is to go to your clinic and have the beautifying treatment.

  • Alicia Schmalicia says:

    Im on 13mls so far this year – so excited to get my lips done with you next week – I cant wait to ask you what else you think I should fill if you had Carte Blanche and I had $$$

  • nathan fullen says:

    Could you talk about the cost on procedures? Im curious

  • CatherineZ says:

    I'm so loving your approach! It's all about not doing harm, not overdoing it, better safe than sorry, you'd rather do less than possible, than making something wrong – and in a good way, because the result is there, it's not like it's all for nothing. At the same time it's about making people more youthful or otherwise beautiful without making them into different people. And last, but not the least, you are about the general picture, you do bespoke tailored faces, with the best material suitable for certain issues; that's opposed to those who would just bloat everyone's lips and try to make same cheekbone illusion.

    Yeah. I'm the scaredy cat who won't dye her hair because I fear that they can make it nor how I like it. I have very long hair, it's a bigger risk compared to short hair, but still, I know people often dye their hair successfully. But if such doctor as Sarah was available to me, I would consider all this stuff, after all, I chose to wear braces as an adult to improve my looks (mostly to get rid of pain bc of teeth crowding, but still).

  • Dr. Quinten D Fourie says:

    Amazing how patient's think that they can get away with only 1ml and see a difference! This is an awesome video just confirming my suspicions around how much filler is really enough!

  • Maria F says:

    I love your approach 🤩😍♥️! I met you in the middle of January and i am so glad that you recommended radiesse instead of juvederm Voluma for lifting and filling my cheeks :)! The lifting effect was really nice. I definitively will come back for checking the results of my botox in the masseter muscle for slimming my face – i can already see a slight reduction of volume in this area but think i need a bit more! Love your work and that you are not afraid to use the right amount (which is something different than overfilling it) and go all in 🙏🤗😍 🙂 greetings from Vienna!

  • Cefaluni says:

    I love that we got to see you aspirate the needle on the temple ☺️ Hey haters– ya'll can chill–she knows what's up.

  • Lizabeth Johnson says:

    Great vid! When you say 2 mils, do you mean 2 full syringes of filler?

  • Veronica D. says:

    I get 2 vials of Restylane around my mouth and frown lines. I am pleased with it

  • annette fournier says:

    I think only surgery could help at this point. But I'm not that fancy, I'm not trying to keep a spouse or even date. I think the client looks better but a whole lot more needed in the hollow temples you think?

  • A X says:

    If only I had the ££££ 😩

  • joylittlesunshine says:

    I just love your videos! Saludos 🇲🇽🙋🏻‍♀️

  • Jennifer says:

    Volume deficiencies still very evident after the 5ml… wow, although I’m still amazed at the before and after. What a difference the 5ml made! I adore your channel. I have a consult next week for fillers, in a perfect world I would be seeing you on Tuesday. I need to have a friend take some photos of me straight on as well as my profile, would love to get your opinion as well. Would be interesting to see what the physician next week suggests vs what you think. ❤️xoxo

  • Jennifer says:

    PS…looking extra beautiful in this video btw!

  • kimberly6123 says:

    So expensive. Wish I could try it but too expensive. 🙁

  • Brittany Grillo says:

    Could you do a video on that technique for putting filler into cheekbones? I think that would really help me figure out where to apply highlighter…

  • N H says:

    How much per mil ? Would really love to know please if u recommend up to 20?

  • Rikkard Gustafsson says:

    You're a gem….such an aesthetic academic……! Impressive

  • Jan Marie Brunette-Hunyady says:

    I don't get hung up on mls used. I use what is needed to see the results that I want to see. I usually do 2 sessions a month apart. This allows me not to over do any one area. Last year I had the non surgical nose job and was stunned at how little filler was used to make a huge improvement. Unfortunately the person that does the fillers at my spa now will not do it. She says it is too dangerous. What are your thoughts on that? Also the patient has to be willing to treat the overall facial skin with products that hydrate and moisturize the skin from the outside.

  • Jill Brim says:

    Very informative

  • Fried Chicken and Flights says:

    Can you do a video on Jeffery Star’s lip revision

  • SkinFits says:

    This most definitely helped my understanding of mls in filler!

  • Ludwig Baier says:

    Toni Mahfud… King of fillers

  • Ludwig Baier says:

    You wrote once you do him? Why not???

  • clare pickering says:

    Would love to see how you do fat grafting, it sounds fascinating!
    Another fab video, thanks for the food for thought 😊

  • Sherry Viera says:

    Well, I don't want to turn back time, just address a couple of things that really bother me. My face has changed ALOT, I'm 51. But most of those changes don't bother me. Not trying to be twenty, or thirty, or fourty again!

  • Kumokun Domo says:

    I really like the pink hair 💕 looks great!

  • Fridaber says:

    Are there ways to prevent loss of volume in the A frame and under the eyes? I just turned 30.

  • Fridaber says:

    When will you do your next celebrity roast? Please do Miranda Kerr 🙂

  • Josie Mcdonald says:

    Hi could you recommend a colleague in the Manchester area who is a reputable consultant please obviously London is to far away to come to your clinic unfortunately

  • Kathy Jones Parry says:

    That was a really interesting video, thank you!
    What would be the estimated cost of having 5ml and 10ml of filler injected in the areas you suggested please?

  • Kat BeWitched says:

    Thanks for explaining the mil’s because I did not have a very good picture of that in my mind. Definitely a visible difference between before and after photo. However, you are right that when we are older it takes more to do more. I think women are smart if they can afford to get ahead of the curve by doing a little at a time so differences are gradual and they look well rested and healthy versus, “wow, you’ve had work done.” I agree that a couple more treatments would likely help her look more youthful. Nice job on the first treatment.

  • April Lemons says:

    I love your videos!! I have had lip filler and botox. I have had filler in my cheeks and at my labial folds right at the corners of my nose. I am going back to have more filler. I absolutely love the effects. I do think I had a little too much botox and my brows have lowered very slightly because I can tell when I'm applying eye makeup. My crease is a bit heavier on my lids. That can be avoided when it is time to go back in a few months. Wish I lived in the UK. I would love to visit your clinic!!!

  • Elizabeth Baraona says:

    Great video, thank you! I recently went to get fillers done by one of the top cosmetic doctors here in Northern California. I wanted my temples filled as a part of the full-face package, however, he said he doesn’t fill that area because it’s too risky since there are arteries very near that area. I’ve only heard you mention that it’s costly due to the amount of filler required. I really like the outcome from your patients after treating their temples.

  • Little Vamp says:

    Hi Sarah. Thank you for the video. I'm 47. I started having cosmetic treatments 2 years ago. I've had bottox to lift the brows, smooth frown lines and relax crows feet. 6ml juverderm voluma in the submalar cheek area for added fullness, 2 ml in my upper lip vermilion border and philtrum to add fullness and to lift the lip, and 3ml in my lower lip vermilion border and central body for fullness and anatomical balance. I've been absolutely delighted with the results but tbh quite disappointed with longevity of both the botox and filler. The filler only lasts approximately 8 months and botox 3 months. Is this normal Sarah? This cost of upkeep is killing me financially but i love the results. Thanks for all your advice. It's been invaluable. Kind regards. Tonia

  • Julia Fish says:

    This is the best yet! Coming to see you in March, can't wait x

  • Angie Black says:

    Awesome, I got 2mls and it defo wasn’t enough 😔

  • selina miranda says:

    As a 23 y/o I had very chubby cheeks in the lower third of my face around my jowls. It gave me a baby face look and I didnt like the way it made my side profile appear – my jaw line in particular i guess. I surprisingly found a huge difference with only 0.5ml of voluma in each cheek (giving me a shadow under the cheekbone ive never had before haha) and also 2ml in my chin to add length and projection as I have a receding chin. Im already loving the results of just 3ml and am due for my follow up tx soon. Feeling like I still need some help with the jawline.. and predicting I will be recommended 1m for each side for the angle of the jaw. So I guess 5ml of voluma in total (maybe more!). Im just so happy that already 3ml has made such a difference to the shape of my face! I feel like chins and jawlines are the new 'in' thing hahaha

  • Michelle Kaylan says:

    How I wish I could find someone with your aesthetic sense in my area!

  • Emma Chase says:

    Can anything be done to help the appearance of the buccal fat pad area of the face being full. I had to take Prednisone two years ago, and while the 'moonface' subsided, I was left with chipmunk cheeks.

  • Elisa Huffman says:

    Sarah do you ever do a model where you decide what is going to be done?

  • Missy Mimi says:

    Sarah looking as fabulous as ever! This video really makes me understand the filler in a better way and I love that you show someone who really needs it but she really looks better after the 5ml so I hope she comes back to you so we could see the finished result😊

  • Amusegirl1980 says:

    I am 38 and maintain my whole face with 2ml a year, I get 1ml every 6 months.

  • kelvin ehigie says:

    I love your channel but let’s be realistic not everyone can afford 20 ml , that’s 17,000 -20,000. At some point you have to do what works for you . I’m not bashing you , I’m just saying it is crazy expensive

  • D B says:

    If people are asking you do you really need all that filler then they obviously have not seen your videos. I was probably one of the most skeptical, after having 3 minor heart attacks, a stroke and my entire colon falling out of my backside after seeing how much filler you were using. I am now on the other side of the fence. Why put 2 or 3ml in and get a minimal result. If your gonna do it go Carte Blanche.

  • Suzanna says:

    Love your videos!! Do you have one about the effectiveness of lasers for wrinkles and skin texture?

  • Clara Fischer says:

    Would you review Fillerina? It sounds really interesting to me, and I'd like to know your thoughts:) I'm sorry for mentioning it if you've already covered it – I just haven't come across it.

  • Sooo random says:

    is there a down time to the face sculpting ?

    I`m pretty sure i need more then 16 ml… more like a face transplant! haha

  • chess valenti says:

    Love your videos!!!! The best! Can you do a segment on La Mer please?

  • Miss La says:

    Could you do a video on restoring the curve to the upper lip please? It would be so nice to see a natural youthful curve restored rather than the duck lips you so often get.

  • Ordningsmakten says:

    Please Sarah, could you touch on the topic of fillers and malar bags? Thank you, you are great!

  • occasional otaku says:

    I find your videos so helpful! You have given me to confidence to know what to look for in a local professional (Australia) and have a consultation! Thank you, Sarah 🌟

  • Frank Gyori says:

    Have you ever thought of inviting a follower of your channel (or even a woman and a man) to have you do a makeover?  I know I would be the first to volunteer.

  • Carine Barrs says:

    16 syringes….$600 to $800 or $900 the syringe….time 16……… vow!!!! So much money ….you might as well have the surgery….especially when considering fillers result do not last …..1 year…2 years and then what….all over again……which brings this affordable only to “filthy rich” or celebrities…..I’ve done juverm and voluma….love it but I usually stop at 2 syringes…….

  • Ali V. says:

    Hi Sarah,
    What are your thoughts on Ellanesé?
    Thanks for another informative video,

  • Jo Collins says:

    Very very interesting!!

  • Helen Brown says:

    Just wish filler was cheaper. I get 1mil in my lips, it's all I can afford

  • apyrrhic says:

    What about getting surgery for under eye area? It would be cheaper than fillers long term.

  • Old and Still Here says:

    Without watching yet, I’m pretty sure my answer is, “all of it!” As in the person coming after me will need to reschedule.😘😘⭐️

  • Glitterbug says:

    Can we send in photos or have paid consultations for your opinions with fillers? I'm in the US but would still love your assistance somehow

  • StrawberryBigMac says:

    Isn't that like 5 grand already?

  • Jacinta Andrews says:

    As if anyone (that's sane) will pay 10-20k for 20ml that's going to last like a year!

    That's craaazy

    Filler seriously needs to get more affordable. It's crazy compared to surgery that lasts a much longer time. And Filler takes 1 person like 1-1.5hours

  • Karen Taylor says:

    GREAT hair Sarah 😃

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