What do Fillers do?
Fillers provide volume enhancement for your face. They are commonly used to treat:
- Nasolabial folds (“parentheses”)
- Melomental folds (“Marionette lines”)
- “Tear trough” deformities (gray circles under the eyes)
- Nasojugal grooves (diagonal gray lines under the eyes)
- Midface descent (the cause of 1 to 4, above)
- Malar hypoplasia (small cheeks)
- Temporal concavity
- Lip hypoplasia (small lips)
- Perioral “smokers” lines
What are Fillers made of?
The majority of modern fillers are made of hyaluronic acid (HA). HA is a naturally occurring substance in the human body, found in your eye socket, the cartilage of your joints, and in your skin. HA is known as “the skin’s natural moisturizer.” It works as a humectant, which attracts and holds water molecules. Modern HA fillers are crosslinked to different degrees to achieve different thicknesses.
Your body’s natural mechanisms will safely remove HA over the course of many months, with the exact time course depending on the thickness. Although very rarely indicated, an enzyme can be used to dissolve HA over several minutes.
What are the differences between the Fillers?
Practically speaking, fillers are classified according to their thickness. This is relevant for two reasons:
- Different areas of the face are best treated by different thicknesses of fillers.
- Thickness affects how frequently re-treatments are desired.
Thin
We expect the FDA to approve fillers in this category soon. They are currently in widespread use internationally.
Medium (Restylane, Juvederm Ultra)
Made entirely of HA, this is the most versatile category and can be used almost anywhere that a filler can be used.
Thick (Perlane, Juvederm Ultra Plus)
Also made entirely of HA – but with more crosslinking – this is best when treatment is desired in deeper areas, such as the lips.
Ultra Thick (Radiesse, Voluma)
Radiesse is made of calcium hydroxyapatite, this is best used when treatment is desired in very deep areas, such as the cheeks and is inappropriate in certain places. Voluma is a new HA filler that is designed and FDA approved to be used in deep areas, such as the cheeks as well. The FDA has approved this filler to last up to 2 years and due to it’s make up is also inappropriate in certain places.
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