March 29, 2009
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Facial fillers are one of the most commonly used minimally invasive cosmetic treatments. Used in combination with Botox, the so-called “Liquid lift” can take more than 10 years off your face. The challenge remains to choose the right filler. There are currently many fillers on the market, some permanent, others semi-permanent, and still others, temporary. Filler longevity varies substantially from patient to patient. It can be based on the amount injected, the location, and on individual patient characteristics.
One should utilize permanent fillers with caution since they are less versatile, can interact with certain drugs, or can result in inflammation. The underlying mechanisms are not yet understood.
In my Westchester practice, I generally recommend that first-time users start with temporary fillers. If the result is not that which was expected, at least we will know that in about six months’ time, it will be completely gone and no permanent changes will have been made. Frequently my patients will ask “Will my face look worse once the filler is no longer present?” and the answer is NO.
At Park Avenue Medical Spa located in Armonk, Westchester we commonly use as temporary fillers hyaluronic acids like Restylane, Perlane, Juvederm Ultra, and Ultra Plus. These fillers are well tolerated, very versatile, and amongst the few that can be used successfully for lip augmentation. Ideal for superficial defects, they are safe and offer instant gratification. Complications are limited to temporary bruising or swelling.
Semi-permanent facial fillers, like Radiesse, a calcium hydroxylapatite, are more viscous, require deeper placement, and are commonly used for large-volume correction. Radiesse is used frequently for cheek or jawline augmentation as well as correction of nasolabial folds or marionette lines. It can be used with caution for correction of rhinoplasty defects involving the bridge or tip of the nose. Radiesse is also indicated to restore volume in aging hands.
Sculptra, a poly-L-lactic acid, is a semi-permanent filler and should be performed by an experienced injector. It works by stimulating collagen formation and requires multiple treatments spaced several weeks apart. The injections are deep and overcorrection must be avoided.
Permanent fillers such as ArteFill (polymethylmethacrylate/bovine collagen) and silicone can offer certain advantages, like cost and convenience. The real concerns remain, patient satisfaction, delayed complications, allergic reactions, and bacterial or viral infections.
The use of facial fillers can have dramatic results. While fillers can wipe away all those unwanted wrinkles, they can also result in complications. Search carefully for a physician, do not be afraid to ask questions, and plan your treatment carefully.