Tammy,

Great question.  All of the fillers you mention, Restylane, Perlane and Juvederm hyraluronic acid fillers.  They are great all purpose fillers for the face.  They all inject very well, are smooth to the touch and provide great results.  They differ in manufacturer and thickness.  Restylane and Perlane are produced by one company, Medicis, and Juvederm (which comes in Juvederm ultra and Juvederm ultra plus by Allergen.  Restylane and Juvederm ultra are comparable and Juvederm ultra plus and Perlane are comparable.  The companies will define differences between there products by crosslinking, concentration etc, but for our conversation they are comparable.  Restylane and Juvederm Ultra are the best for filling superficial lines.  They are less thick and so therefore they can be placed through small needles and into a more superficial location.  They both last between 6-9 months (sometimes up to 12 months) depending on the location of injection.  Perlane and Juvederm Ultra Plus are thicker and more useful for filling up deeper folds or for volume augmentation.  They may last a little longer.  In general we tend to use Restylane and Juvederm Ultra for lips and superficial lines, Restylane for under the eyes and Perlane or Juvederm Ultra Plus for smile lines and marionette lines.  We also use a product you didn’t mention, Radiesse.  It is also a great filler for deeper lines.  It lasts a little longer, 12-18 months, but is a little more firm to the touch.

Ed Buckingham