Facial Fillers

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The concept of using injectable “fillers” is now accepted and standard procedure in the offices of all cosmetic surgeons and dermatologists who deal with age-related changes. While cosmetic plastic surgery is appropriate for sagging tissues, e.g. jowls and bag-like structures such as lower eyelid fat pouches, there is no better answer for grooves and depressions, particularly around the mouth and chin than the current fillers. While collagen fillers -derived from cow skin – initiated the practice of filling and plumping age-related areas of “natural shrinkage,” they have been supplanted by the products made from hyaluronic acid. Hyaluronic acid is a natural substance within a variety of human tissue. Skin, bone and cartilage all have, as a normal and natural constituent, this simple substance. One of the advantages of this product compared to the collagen predecessor, is that since hyaluronic acid exists normally in the body and is man-made – rather than manufactured from another animal species – there is no assumed potential for allergy. Hence no need to do skin testing to elicit a possible allergic reaction.

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The three most popular filling injections used today in the United States are Restylane and Perlane (Medicis Corporation) and Juvederm® (Allergan Corporation). Experienced injectors find that in some areas one product may be preferable but they are nearly identical and behave similarly in the body. All hyaluronic acid injections typically last four to six months.

While these fillers are temporary and not permanent, that is an advantage. Here’s why: If one is not happy with the results or does not feel that the injections are worth the cost, then there is neither a long-term presence nor long-term financial commitment. Patients should “test the water” when it comes to fillers. It should be noted that today, there does not exist a perfect nor permanent filler. In the future, technology will bring us products that will last longer.

Finally, I recommend that patients avail themselves of the most specialized “injectors”. While cosmetic plastic surgeons and dermatologists are trained and capable in such techniques, the accepted super-stars are those practitioners and RNs who perform injections exclusively. No surgery, no other medical treatments. Just injections. These “superspecialists” are the real pros; the ones you want.

There are a few fillers that last longer. Sculptra usually lasts about two years. There are some reports that say it can last up to five years. Artefill is known to last about 5 years or more. It is ideal for patients who do not want to continue returning for repeat injections.

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