Every artist has their medium. Caravaggio found light in oil on canvas. Dürer celebrated details in watercolors. Bourgeois brought humanity to marble and bronze.
Alexiades, Idriss, and Subbio sculpt with botulinum toxins and illuminate with hyaluronic acids. They probably won't make it into Janson’s History of Art, but they’re three of the many dermatologists and plastic surgeons who are reimagining the planes of the face (and areas south) with their syringes. When injectables first arrived on the scene, they were viewed as a means to a "liquid face-lift." Today, they’re a way to control light and shadows, to chisel angles, to round curves. And some of the doctors using them to the best effect have credentials beyond medical school. Exhibits A through C: Macrene Alexiades, a New York City dermatologist, is a trained sculptor; Shereene Idriss, also a New York City dermatologist, has a living room adorned with her own abstract paintings; and Christian Subbio, a Philadelphia plastic surgeon, almost headed to art school.
Inside the artist-injector’s toolkit, you’ll find skin-shaping fillers (hyaluronic acid and others), muscle-relaxing neurotoxins (like Botox and Xeomin), fat-sapping deoxycholic acid (aka Kybella), and needles and cannulas of many dimensions — finer points for discreet detailing and blunt tips for broader strokes. With a syringe or two of hyaluronic acid filler, injectors can carve a new jawline, alter the shape of a nose, and build lips to new proportions. By harnessing the collagen-growing potential of Sculptra (poly-L-lactic acid), they can subtly restore lost volume. Tapping into the reductive nature of neurotoxins and deoxycholic acid, they create negative space, tapering the lower face and streamlining the silhouette. And if faces appear overstuffed, they can clear the canvas of too much hyaluronic acid with an enzyme called hyaluronidase. We asked doctors famous for merging imagination with medicine to explain how they’re elevating injectables to an art form — and turning patients into masterpieces.
The "liquid nose job" is perhaps the most impressive example of shape-shifting with hyaluronic acid fillers. "Nonsurgical rhinoplasty is the ultimate optical illusion," says Lara Devgan, a plastic surgeon in New York City. In reality, of course, augmenting the nose with filler renders it bigger, not smaller. "But by creating a highlight down the center of the nose, and a delicate point of light at the tip, we can make the nose appear more diminutive and proportionate." (The nose is a vascularly complex area for filler, so it’s best to choose an experienced rhinoplasty specialist to do this.)
The artist-injector also shines when tasked with redefining the lips. Anyone can blow them up like a balloon, but Devgan stresses that an elegant lip augmentation "is not just a volume game — it’s a structure and shape change that you want." Her approach: Use a medium- to high-viscosity hyaluronic acid filler (like Restylane Refyne, Restylane Defyne, or Versa) to build the height of the top and bottom lip to showcase more of their pinkness. "By injecting tiny strands of filler vertically into the lips, I can make them turn out slightly," she says.