Dr. Alexander Landfield
Board-Certified Neurologist & Medical Director
At Rani Beauty Clinic in Renton, WA, my approach to filler injection is guided by principles I have developed through years of clinical practice and a deep understanding of facial anatomy. Here is the philosophy behind every filler treatment I perform.
The face is a three-dimensional canvas. When I assess a patient for filler, I am not looking at isolated areas. I am evaluating the entire face as a unified structure with proportions, angles, and volume distribution that work together. A cheek treatment affects how the nasolabial fold looks. Under-eye filler changes how the mid-face appears. Every injection point influences the whole face, and my treatment plan accounts for these interactions.
Restoration before augmentation. My primary goal with filler is to restore what time has taken away before adding anything new. Volume depletion in the temples, cheeks, and perioral area is the primary driver of facial aging. Restoring this lost volume produces the most natural improvement because we are returning the face to a version of itself, not creating something it never was.
Less is almost always more for the initial treatment. I consistently underfill on first treatments rather than overfill. Filler can always be added. It is more difficult to remove. Conservative initial placement allows us to assess the result, understand how your tissue responds, and add precisely where needed at a follow-up. This patient approach produces more natural results than attempting to achieve the final outcome in a single session.
Product selection is half the artistry. I match the filler product to the treatment area based on the physical properties needed. Lips need softness and natural movement, so I use a pliable, low-viscosity HA filler. Cheeks need projection and structure, so I use a firmer, more cohesive product. Under-eyes need smoothness with minimal swelling tendency, so I use a finely cross-linked filler designed for this delicate area. Using the wrong product in the wrong area is a common cause of unnatural results.
I treat to proportions, not trends. The ideal lip-to-face proportion, the optimal cheek projection, the ideal jawline definition - these are guided by your individual anatomy, not by whatever is trending on social media. A treatment that looks beautiful on one person may look overdone on another simply because their facial proportions are different. My job is to find what is ideal for YOUR face.
Safety is embedded in every decision. Facial anatomy includes critical blood vessels, and vascular awareness is paramount during filler injection. I use anatomical knowledge, aspiration technique, and appropriate injection planes to minimize vascular risk. Cannulas are used in areas where vascular safety is a primary concern. Having hyaluronidase available for immediate dissolution in the rare event of a vascular complication is standard protocol.
I listen more than I recommend. Before suggesting any treatment, I want to understand what YOU see when you look in the mirror. What bothers you? What would make the biggest difference in your confidence? Your priorities guide the treatment plan. I may offer additional observations based on my assessment, but the treatment is always driven by your goals.
Patience is a clinical virtue. The patients with the most beautiful, natural long-term filler results are those who build their results over multiple sessions, months, or even years. This gradual approach allows for continuous refinement, prevents overcorrection, and creates results that evolve naturally with their face. The best filler work is invisible.
