Volumetric fillers are injectable gels or compounds used to fill and smooth facial lines and creases. The most common type of injectable filler is a hyaluronic acid based gel which is composed of hyaluronic acid bound to itself and supported in water. Hyaluronic acid is a common substance in the human body; when used as a filler it is biologically produced and then cross linked to prevent rapid breakdown by the bodies own enzymes called hyaluronidases. The fact that the body breaks these substances down makes these types of volumetric fillers non-permanent which can be looked at as a down side, but dissolvable which is an up-side in the case of over filling or nodularity. The hyaluronic acid is preloaded into syringes and now commonly combined with lidocaine for its local anesthetic effects to improve comfort with injection.
There are numerous types and brands of hyaluronic acid fillers with the most common being Restylane® and Juvederm®. Both are FDA approved for injection into the face for correction of lines and creases, and both are safe and reliable with correction lasting about one year. The difference between the two are the consistency with Juvederm® Ultra Plus being firmer and more form stable, and Restylane® being softer and smoother.
Both have advantages and it is important to discuss your options with your injector.
- I like Restylane® for use in fine lines around the mouth and the smile lines because it is soft and smooth and can be injected more superficially without any risk of lumpiness or nodularity.
- Restylane® is very good for a softer definition around the lips in the case of lip augmentations.
- Juvederm® has been the work horse filler for lip volume, deeper creases and under the eyes, but may be losing its role in the cheeks with newer fillers like Perlane® and Voluma® in those areas.
It is always nice to have options, and in the case of a hyaluronic acid based filler there are multiple options, but some fillers have a better effect in certain areas and certain faces. It is not uncommon that two different types of fillers are used during one injection session if multiple areas are to be treated. It is important to know your options and discuss with your injector which filler is best to meet your goals. Dr. Trussler does all of the injections in his plastic surgeryAustin TX office and will take the time to discuss the advantages of one filler versus the other to help develop an individual minimally invasive facial rejuvenative plan for you.