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Dermal Fillers

Find out why our fillers are so popular

Whereas botulinum toxin A relaxes facial expression muscles, fillers lift up skin from underneath the surface and thereby change the appearance of the skin contour. In this way, they correct lines, wrinkles, areas of depression, and regions of volume loss in the face. They can also be used to lift up depressed scars, straighten the profiles of noses, extend weak-appearing chins, and attractively increase lip volume. There was a time in the U.S. when we only had bovine collagen to meet these needs, but now we have four different types of fillers available to us. Interestingly, collagen is no longer one of them. Collagen fillers lasted a maximum of 4 months, and therefore have disappeared due to the competition of longer-lasting options.

Let’s now look at each of the four filler categories now available to us:

Hyaluronic Acid Containing Fillers – By far the most frequently used of today’s choices are the HA fillers. These products are popular because they last longer than collagen (6-12 months for all of them except Voluma, which can last up to 2 years). They are also “moldable” throughout their duration under the skin. These fillers can be used in all areas of the face. HA fillers can also be dissolved by the use of the hyaluronidase enzyme, if required. This means you could call this product reversible. Examples of this class are: Restylane, Perlane, Juvederm Ultra, Juvederm Ultra Plus, Juvederm Voluma, and Belotero.

The Calcium Hydroxylapetite Containing Filler – This product, Radiesse, is made by the German company Merz Aesthetics. Radiesse lasts an average of 10-12 months ideally, however the range of duration is a very wide 4-24 months. It is also relatively inexpensive per unit volume and comes in an assortment of size syringes, namely 0.3, 0.8, and 1.5 ml. This product is used primarily as a volumizer in regions such as mid-face (cheek bones, cheeks), temples, noses, and chins. It should not be used in the glabella (region between the eyebrows) or in the lips. Radiesse gets high marks for causing a secondary collagen-stimulating effect that can result in a long-term skin thickening improvement. Only Sculptra (PLLA) causes more collagen production stimulation than Radiesse.

Poly-L-Lactic-Acid (PLLA) – Also known as Sculptra, this is a pure, long-term volumizer. It lasts in excess of 2 years. Some experts in our field believe that it never goes away entirely. Unlike all of the other fillers, Sculptra is injected as a series of 3-4 treatments initially, and then boosted every 1-3 years with single additional treatments. Sculptra is often the best option for the thin, aging face because it can give prolonged improvement for that “gaunt” appearance that can be so frustrating for the thin-faced individual. We’ve used this product many times over the years with excellent effect.

FAT – Using one’s own body fat as filler for hollow or volume-challenged areas of the face is not a new idea, but periodically makes resurgence in popularity. The big advantage for fat is that whatever survives the grafting or transplant process has a chance at becoming permanent filler for its new location. A problem of fat use, however, is that the percentage of fat that survives the process of relocating can vary from between 20-80%. This makes predicting the final outcome with any degree of certainty an issue.

Here at Medical Cosmetics, we utilize all of the above modalities except for fat grafting.

Prices vary based upon how much filler is used for a given individual situation.

 

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