Question:
I feel as if fillers would be beneficial and enhance the appearance of my face. How often would I need to get this procedure repeated?
Answer:
The answer depends on what type of filler you choose and what area of the face to be injected. There are basically three different classes of filler available that are all temporary. Hyaluronic acid fillers such as Restylane, Perlane, Juvederm will last about 6 months in the lips and over a year when used in the lower eyelid tear trough for example. The longevity of the area depends on how much that area moves. The mobile area of the mouth has less longevity than areas that are stable, such as the periorbital area. The second class of fillers is calcium hydroxyl appetite or Radiesse. Radiesse is not a good filler for lips, but can be used other places. Radiesse tends to last a little longer than HA fillers. The third major class of filler is poly-L lactic acid, Sculptra. Sculptra differs from the other types of fillers in that it does not cause filling of the tissue, but rather causes the body to deposit collagen over time leading to a filling result. Sculptra needs to be injected over several treatment sessions and allow the collagen to build up, but once the result is achieved it will last 2-5 years.
Posted by Dr. Buckingham
Question:
What is Perlane and what can it improve? How long do the results last?
Answer:
Perlane is a cross-linked hyaluronic acid. It differs from say Restylane because it has a higher degree of cross-linking and is therefore thicker. Perlane is useful in most areas of the face that respond well for filling including the perioral area, jawline, cheeks, tear troughs and temples, although usually the tear troughs and lips are better treated with Restylane or one of the other hyaluronic acid fillers. The longevity depends on where it is injected and I believe that relates to the mobility of the area. So the tear trough and nose have great longevity, a year or longer, while the lips usually only last 6-9 months.
Posted by Dr. Buckingham
Question:
I’m looking for a way to add more definition to my cheeks. Are implants a good choice for this or are there any other options?
Answer:
There are essentially two options available to improve the definition of the upper cheek. Those are implants or fillers. The fillers can be injectable such as Sculptra, Radiesse, Juvederm or Perlane, or can be your own fat cells. The injectable fillers are performed in the office with minimal down-time, but time-limited results. Facial fat injections are the procedure of choice in middle-aged and older patients because they have usually lost fat in their face and we are merely replacing what has been lost. In younger patients, fat injection is an option, but they have to understand that large weight shifts later in life may have detrimental effects. In those cases an implant may be a better option.
Posted by Dr. Buckingham
Question:
I am a 26-year-old woman interested in an injectable filler for my lips. Which one (Juvederm, Perlane, Radiesse, Restylane, Sculptra) would be the best option for me?
Answer:
Any of the hyaluronic acid fillers are appropriate for lips. Those would include Restylane, Juvederm or Perlane. We usually will utilize Juvederm for the lips however as it has a slightly softer feel and perhaps more longevity than the other fillers.
Posted by Dr. Buckingham
Question:
I have been reading about the different injectable fillers (Juvederm, Perlane, Radiesse, Restylane) and don’t really understand their differences. What differentiates them, and how are they used?
Answer:
The fillers you have mentioned, Juvederm, Perlane, Radiesse and Restylane, represent two classes of fillers. Juvederm, Perlane and Restylane are all hyaluronic acid fillers. Juvederm is made by Allergan and Perlane and Restylane by Medicis. Hyaluronic acid is a naturally occurring molecule in the body. It is found in skin and joint fluid. As a filler, it is a clear gel which is easy to inject in all locations of the face and produces a smooth result. If for some reason the result is unsatisfactory, the filler may be reversed with an enzyme. Radiesse is made of calcium hydroxyl-apetite. It is also a naturally occurring molecule in the body however it is more associated with bone formation. When injected into the soft tissue however, it does not cause bone formation but merely soft tissue augmentation. Radiesse is a better filler for deep tissue filling like cheek augmentation. It is not good for the lips however it can be used for areas such as nasolabial folds and marionette lines. In some patients it has better longevity and hyaluronic acid, but not all.
Posted by Dr. Buckingham
