It’s All About Volume
Today I’m going to talk more about fillers. I’ve hit on that topic before, but I’m going to get a little bit more into the nitty-gritty of why I use the fillers I do.
First- Why do so many fillers exist? Back in the booming days of cosmetic surgery (i.e. the 1980s) we had collagen. This was largely derived from bovine sources (read- cows), although there were some human options out there. The biggest problem was that patients had to have an allergy test every time they received filler, a month ahead of time. Not exactly convenient if you wanted to get rid of a few wrinkles right before your son’s wedding.
Obviously fillers are a lucrative market, and a plethora of new options have developed. There are more types of filler, and sometimes multiple options within the same type of filler. So I’ll give you the basic breakdown.
There are three main filler types that I use.
- Hylauronic acid fillers contain a slippery, clear substance called hyaluronic acid (HA), which is chemically the same between all animals, and is a major component of the fluid around joints. Because it is identical between species, no allergy test is needed before treatment. Juvederm, Restylane and Belotero are all hylauruonic acid based fillers, and essentially vary in the size of the HA particles and how they are linked together. This basically changes how thick the filler is, and possibly how long it lasts. The HA fillers are the only ones I use in the lips, and they are also great for fine wrinkles.
- Radiesse is made of hydroxylapatite, a mineral found in bone. Because it is a mineral, it is obviously firmer and stiffer than the HA fillers. For this reason, it does not work for fine wrinkles or in the lips. I use it for deep wrinkles or to add volume, especially over the cheekbones.
- Poly-L-lactic acid is the main component of Sculptra. Sculptra was initially approved for HIV-associated lipoatrophy- that very thin, wasted-looking appearance that patients who are on antiretroviral medications sometimes have. It is meant to add overall volume as opposed to treating specific wrinkles, and it works by stimulating collagen production as the product itself is slowly metabolized to lactic acid. It is now approved for cosmetic use, and oit appears to be semi-permanent; follow-up studies demonstrated results at two years.
If you’re thinking about getting a filler, here are some questions to consider:
- What are your goals? Do you want fuller lips, to get rid of wrinkles or to add volume? (Note that sometimes the way to improve wrinkles is by adding volume, so don’t be surprised if your surgeon suggests this.)
- How long to you want results to last? The HA fillers and Radiesse last anywhere from 6-12 months (I caution patients to expect results on the lower side of the spectrum, just so they aren’t disappointed if fillers don’t last as long as they expect).
- What is your budget?
Do you have any questions about fillers?