The dermal line and wrinkle fillers have been increasing in popularity over the past decade. There are a variety of dermal filler options along with a lot of confusion. It is astonishing how many fillers we have today versus just a few years ago. Along with so many new fillers, comes the difficult decision of, which one is best for me?

Cosmetic dermal fillers include collagen, hyaluronic acid, fat and other substances. Dermal filler brand names include Juvederm®, Restylane®, Radiesse™, Sculptra®, Artefill®, and several others. Their purposes are to decrease lines such as the nasolabial folds (laugh lines) or marionette lines, or to add volume to cheeks or lips. Cosmetic dermal fillers are also used to reduce gauntness caused by illness or aging. Other lines that can be treated include perioral lines around the mouth, lip lines, glabellar lines, and acne scars.

Dr. Van Raalte believes that different fillers meet different needs.

Injectable Fillers Overview:

As our skin ages, the dermis gradually loses its major constituents: collagen, elastin and hyaluronic acid and other ground substances. Collagen acts as the major support protein for our skin, elastin allows ours kin to stay firm and resist wrinkles, and hyaluronic acid and the other ground substances help to trap water and add volume and shape to our skin.

Dermal fillers are one of the means to help reverse the changes associated with aging. Because the goal is to return the dermis to its original youthful state, dermal fillers can give a natural appearance.

A variety of dermal fillers are available in the United States today. The hyaluronic acid based fillers include Restylane® and Juvederm®. Sculptra® is a polylactic acid based filler, and Radiesse™ is a calcium hydroxyapatite facial filler. All types of filler materials can help improve the youthful appearance and fullness of facial skin, but there are differences in the way each behaves and the duration of time the filler will last. An important element to achieving successful results with dermal fillers is realizing that not one filler is ideal for all areas of the face. For example, lips tolerate fillers differently than the cheek areas do and not all fillers can be injected in the lips.

Collagen based products typically provide the shortest duration of results and are rarely used anymore.

The hyaluronic acid (Juvederm®, Restylane®, Perlane®, Hydrelle®, Prevelle®) fillers do best for the fine lines since the fine lines require injecting into the more superficial dermal layer and are also good for acne scars. They are also used for lip volume since the other fillers are more likely to cause lumps when used in the lips. Perlane® and Juvederm® can be used for the deeper lines. Juvederm® may last up to 12 months and the other fillers range from 3 months to 12 months.

Radiesse™ is calcium hydroxyapatite. It is best for deeper lines such as the nasolabial folds or marionette lines. It seems to have better support, and better correction for these areas. Radiesse™ is also good for volume, but is not used for fine lines or lips. It lasts 12 months or longer.

Artefill® provides the longest-lasting results, two years or longer. But it is the most expensive and best for deeper lines.

Sculptra® or polylactic acid is best for volume such as the cheeks. It lasts 18 months.

Of course your own fat can be used for deeper lines and volume as well.

Fillers can be premixed with lidocaine for numbing. Recently Juvederm® manufactured a premixed syringe with lidocaine that is useful for fine lines. The area to be treated can be pretreated with a lidocaine cream too. Sometimes a nerve block is best and the use of epinephrine with the lidocaine can decrease bruising.

Dermal fillers are minimally invasive and generally very safe. The most common post treatment events are swelling, bruising, and nodules. The rate of nodules has been reduced by post treatment massaging. Rare side effects are uncommon but can include limited allergic reactions (hypersensitivity), reactivation of an existing herpes infection, localized bruising, redness or swelling at the injections site; and in very rare instances, ulceration.

While researching the best dermal filler for you is very important, experts agree that getting good results has more to do with the injection technique than the type of filler being used. This is why it is critical to find a reputable, experienced specialist in your area who can provide you with the best in care and technique. Dr. Van Raalte has been using and injecting facial fillers since they were first FDA approved over 6 year ago. He has injected hundreds of patients with all the different fillers.


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