There are so many different filler options available that choosing can be very confusing. Can you detail the main fillers out there and what they are most appropriate for treating?
There are four main classes of syringe fillers available in the US. Hyaluronic Acid (eg. Juvederm, Restylane, Restylane Lyft), Calcium Hydroxyl Apetite (Radiesse), poly-L Lactic Acid (Sculptra) and Poly-methylmethacrolate (Artefill). The hyaluronic acid fillers can be used anywhere on the face safely including the lower eyelids and lips. They provide instant results with little down time, last between 6 months and 18 months depending on the injection location and are fully reversible with an enzyme injection. Radiesse also provides instant results with little down-time, but cannot be used safely in my opinion in the lips or under the eyes. It is not quite as soft and versatile as Juvederm and Restylane, but is an excellent deep tissue filler for say augmenting cheeks. Artefill provides instant results from the bovine collagen in the product and then as that dissolves a more permanent result from the PMMA beads that the body encases in collagen. In our experience however, the result is not a 1:1 ratio. You also must be careful since the results are permanent so are the complications. Sculptra is an excellent filler for replacing volume loss in the face. It is different in that it requires the body to form the collagen that the filler induces. Because of that it takes 2-4 injections over that many months. The results last at least 2 years however. It is the best filler for overall volume replacement. It is however in my opinion not as good as fat and fat is more permanent. Fat injection is however a surgical procedure and carries with it a recovery period that is not possible for some patients. If a patient can tolerate the recovery period though, fat can be injected anywhere in the face, with excellent results and longevity.
Posted by Dr. Buckingham