With so many facial fillers available, how do you decide which one to choose?!

Non-invasive procedures have been on the rise, and facial fillers are one of the most popular across all age ranges. They can be used to plump lips, fill cheeks, and vanish wrinkles. With so many options available, I often have patients ask about which filler is right for them.  I like to break the products down into groups with regard to where they are used and how long they last. 

Lips are one of the most common locations, patients want to have augmented. Some want as large as possible wanted to be like celebrities; while others just want to restore what their lips to what they used to look like, so their lipstick does not run in newly formed lines around their mouth. Most desire a natural augmentation for a fuller and more feminine appearance. 

The most popular products are hyaluronic acid (HA) based, which is naturally in your own body so you cannot be allergic to it. Additionally, it can be dissolved.  Juvederm and Restalyne are two of the most popular product lines and both have multiple options within them.  Just as Coke has Cherry Coke, Diet Coke, Coke Zero, etc. Juvederm Volbella is the thinnest and most natural, and is perfect for a first timer. I have never had a patient not like it; but almost all come back wanting more. Juvederm Vollure gives a natural fullness and has the added benefit of lasting up to 1.5 years. Vollure is most often what I personally use.  Juvederm Ultra Plus is great for prominent pout.  Restalyne has many similar products; however just cam out with Restalyne Kassie - designed specifically for lips.  The actually researched it by asking spouses how natural their partner’s lips felt when kissing!  

Lastly, one other option is Silikon 1000 which is a permanent option.  It uses free silicone which is injected via micro droplets that in turn actually stimulate the body to form more collagen.  This option should be thought of as more of a treatment, which will need to be repeated on average four times. Each time the lips with slowly “grow” larger until the desired result is achieved. I often recommend that patients try a temporary option first to ensure satisfaction.

After lips, cheeks are the second most common location that my patients desire filling up.  Although many patients may actually complain about the parentheses around their mouth or marionette lines extending in front of their jowls, I educate them that by filling the cheeks up with volume, you can actually lessen the visibility of these other lines.  As we age we all lose volume in our faces on the inside (think bone and fat), so darn gravity pulls down the skin on the outside creating those unwanted lines and wrinkles. Therefore, if we restore some of that volume with filler, we can lessen the appearance of those lines. 

Since our goal is volume, I like to use a more robust product such as Juvederm Voluma, Ultra Plus, or Restalyne Lyft from the HA products. Voluma is great because it is the longest acting HA filler, lasting up to two years.  Another semi-permanent filler, is called Bellafill. I call it semi-permanent because it is made of a combination of bovine collagen and poly-methyl-methacrylate (PMMA).   Your body absorbs the collagen, and then the PMMA stimulates you to produce more of your own collagen. It was studied for five years, and at the end of five years still had an 83% satisfaction rate. After the cheeks (and sometimes even temples) are filled, then I like to address the rest of the lines.  I like to use a slightly softer product and smooth what remains.

Filler can also be used in areas wear patients are desiring bony changes.  For example in lieu of facial implants, such as a chin implant, filler can be injected along the mandibular border to help in both a verticals and horizontal orientation with essentially no down-time.  Also I am commonly asked at Cosmetic Surgery Affiliates to perform a “liquid rhinoplasty”. Filler can be used to hide the hump of a patient’s nose or even turn up the tip of the nose when injected in the appropriate locations. For these options, I like to use a longer acting filler such as Juvederm Volluma or Bellafill.  

Lastly, one other facial filler option is fat. Unlike the other filler, a small procedure is needed in order to have liposuction performed. The fat is then filtered and injected into the face. What is nice about fat, is that you are essentially just rearranging your own inventory. Another benefit, is that instead of having to purchase a product by each syringe, you can have as much fat harvested as you have available and need. We know that now all the fat that we transfer survives the process, so we recommend over filling slightly. Although this option does have a slightly longer recovery time, it provides long lasting results. 

I hope this helps to clarify some of the different options in filler that exist in the market. If you still have questions, we offer complimentary consultations for all cosmetic surgery related needs at Cosmetic Surgery Affiliates in Oklahoma City.