To Filler Or Not To Filler? Cosmetic Pro Nicole Frontera Breaks It Down & Shares Alternatives

"Skin, syringes, and self-care." That's the motto at Nicole Frontera Beauty, the chic and sunny Rockaway medspa helmed by its namesake founder, nurse practitioner and Queen of Injectables, Nicole Frontera.

An expert in the art and science of cosmetic treatments, Nicole has remained a trusted go-to for clients across the city. Not only due to her certified medical background, but also because she takes a refreshingly no-BS approach to providing procedures that best fit her clients' needs. In other words, she's not here to simply give people "Instagram face" or let them fall into the trap of aesthetic trends just because they saw something on social media.

Take, for example, her approach to fillers. Sure, we've seen them displayed in celebrity selfies for years now, but Nicole is careful not to pump the stuff when it's not actually necessary. Of course, her discernment comes paired with a trove of knowledge on cutting-edge alternatives.

"I almost pedal backwards and target the things that we can get rid of first, using more natural treatments, before I start adding fillers," she explains, noting that after 15 years in the biz, she's seen some of the long-term unwanted effects of adding too much to the face.

So, if you've been considering adding fillers to your beauty routine, read on for Nicole's thoughts on the matter. As it turns out, you may not need them after all!

Why do people seek fillers, and who are the best candidates for fillers?
Nicole Frontera: There are a million reasons why people seek filler, but sometimes it's a real reason based on someone aging, for example someone who’s 40+ and starting to see the volume changes that occur in the face. Naturally, we reabsorb bone, fat reabsorbs, our muscles atrophy, and all of these things cause volume depletion in the face. When you have volume depletion, you tend to sag - that’s the main reason people seek fillers. Then there’s the whole other side: young people seeking fillers, sometimes for the wrong reasons, like they saw something on social media, trends like making a jawline look more defined, wanting their lips to be fuller or something like that.

The best candidates for filler are people who have truly lost volume - people who have lost weight or as part of the natural aging process have lost volume in their face. People who are typically 40+ and sincerely have a volume depletion.

When and why do you not recommend filler for clients?
There are many times I don’t recommend it for clients, if people don’t actually need it, or if someone is thinking they want it because of a trend - that’s not a reason to give filler. We’re going to start to see a shift in the industry of providers using more natural products, products that make people develop their own collagen, as opposed to just fillers. I like to think of it as ‘the icing on the cake,’ when we can’t use the other tools in our toolbox to naturally give people collagen or volume, then we would turn to fillers to do so.

What are the most common places in the face people ask for fillers when they’re following trends?
It shifts, but lips are the first area people ask for. I would say the newest trend is the jawline because a lot of people want a sharper jawline. What a lot of people don’t realize is that in some cases a sharper jawline can be a more masculine feature, so we have to be careful of what we’re doing and how much filler we’re using. Sometimes instead of using filler to sharpen someone’s jawline, we would use a tightening device to try to tighten the skin around to make the jawline appear sharper without adding something unnatural. In some people, you may not want to add to that area, because it may lead to them looking more boxy or square in the jaw when that’s not the desired result.

What are your favorite alternative or less invasive treatments to try before turning to fillers?
One of my favorite things to do is Ultherapy which is a skin tightening device - it’s almost like using shrink wrap. It heats the tissue up and makes the area tighter and look more contoured. It’s not going to work for everyone but it can be an alternative.

For other parts of the face, I prefer to use another injectable that isn’t exactly a filler. One, called Sculptra, is like a sugar water that we inject into the face and the product absorbs in the skin and over about three months it helps the body produce its own collagen. It’s not serving as a filler, it’s serving as a biostimulator to stimulate your body’s own collagen production, creating a more natural result than the addition of something foreign. We can use it anywhere, I often use it in cheeks, temples, jaw - the only areas we can’t use it are in lips and under eyes. I use another product that works very similarly called Radiesse, which is a calcium product that similarly makes your body produce its own collagen, it’s just a bit of a different mechanism. Both products are really nice for people who aren’t ready for fillers and don’t need fillers yet, but I understand that they want a little something - then I would suggest one of these.

For under eyes, we can use PRP, which is when we spin your blood and inject it into the area to again stimulate collagen production. For lips, there aren’t currently many options of creating extra collagen in the lip area. I think the key there is if you’re going to use lip fillers, you have to be extremely conservative, otherwise it can migrate and look crazy.

For a younger person looking for filler, what’s something you would recommend as an alternative if you know fillers may not create the desired effect?
Lasers are always great to use to rejuvenate the skin. Some people may look at themselves and think they want volume, but actually what they want is just to look brighter. We have many lasers that are very effective at brightening up the skin and building collagen in the skin so the quality of the skin looks better.

Microneedling, or the Vampire Facial, where we take your own blood, spin it, and then microneedle the PRP back in is another way to brighten up the skin. For a young person in their late 20s or early 30s, this will also result in a tightening effect.

[Photos courtesy Nicole Frontera Beauty]