Dermal fillers are substances which can be injected into the skin to replace volume. The ageing process leads to loss of volume in the lower face and cheeks, formation of wrinkles and loss of lip volume. Dermal fillers can address all these issues. There are many kinds of dermal fillers available. Some are permanent or semi-permanent and some are temporary. Some are composed of animal or human tissue and others are synthetic.
People often want to know which dermal filler is the best. The short answer to this is that there isn’t one – it depends on the situation.
This article will only address temporary hyaluronic acid fillers. These are by far the most popular type of filler with a proven record of safety and efficacy. Hyaluronic acid is a naturally occurring substance in the skin but is broken down within days by the body and replaced. Temporary hyaluronic acid fillers are manufactured so that the hyaluronic acid molecules are stabilised to prevent them being broken down so quickly. Depending on the product and the application, results can last for a few months up to 2 years. In addition, temporary hyaluronic fillers can be “dissolved” by a substance known as hyaluronidase. This is useful to address lumpiness, incorrect product placement or overcorrection.
There are three brands of hyaluronic acid fillers available in Australia and each of these brands has several products within the range. The products are Juvederm, Restylane and Esthelis. Products come in different sized syringes, some are thicker than others and some are mixed with local anaesthetic. Some of the products will stay pretty much where they are injected, whilst others tend to merge into the surrounding tissues. As a result, some products perform best in certain areas of the face and others in different areas.
Some products such as Esthelis, are very soft and can be injected close to the surface for superficial wrinkles. Thicker products could cause lumpiness or overcorrection in this situation. A product like Juvederm Ultra Plus is quite thick and more suited for treatment of nasolabial lines or the marionette area. Juvederm Voluma is even thicker Juvederm Ultra Plus thicker and is particularly useful for cheek augmentation. Thicker products also tend to last longer with reports of Juvederm Voluma lasting 18 months to 2 years.
It is not uncommon to use different products on the same patient. As a person ages the most suitable filler for them may change. A good example of this is with lip augmentation. Younger patients often want a dramatic result with noticeable enhancement whereas somebody in there fifties is more likely to want replacement of the lip volume they have lost over time. Therefore, the younger patient would be best served with a thicker filler whereas the older patient would benefit most from a softer filler.
It is important to match the needs of the patient with the characteristics of the product being used to maximise the patient outcomes and minimise potential problems. Therefore, my advice is to find a doctor that you feel comfortable communicating with and discuss your requirements with him or her. They should be able to explain which dermal filler they feel is best for you and why.