Plastic Surgery News & Information

Facial Fillers: What Works and What’s Safe

Recently in my practice I have seen an increase in demand for facial fillers. In our current economic climate patients are postponing surgical procedures because they can’t take time off from work and economic uncertainty has frayed consumer confidence to proceed with luxury expenses.

In spite of current conditions patients still want to do ‘something’ to look better, temporize and feel better about themselves. Fillers have a wonderful role to help achieve these goals.

With aging or just genetic bad luck, smoking or excessive sun exposure there are specific areas in the face that predictably deteriorate. The most common areas I inject are the naso-labial folds the lip lines, the lips, the marionette lines extending down from the corner of the mouth, and the deep lines that can develop between the eyebrows or forehead and the hollows under the eyes.

There are a wide range of products used by physicians to fill these areas. The two broad categories are temporary and permanent. ArteFill and silicone are permanent fillers. Silicone is not FDA approved but is used in an off-label manner. Suffice to say that these fillers can be problematic, with formation of permanent lumps, migration of lumps or granuloma formation. For those reasons I avoid their use in my practice. The semi – permanent fillers, Radiesse and Sculptra have similar issues therefore I prefer to avid them.

In the category of temporary fillers there is collagen and hyaliuronic Acid.. Collagen doesn’t last long enough to make it cost effective. This leaves us with the hyaluronic acid fillers of which there are many; Restylane, Perlane, Juvederm, Hyalaform, Elevess, Puragen, and Prevelle. I have found that for my patients, Juvederm and Restylane have worked the best and have a high level of patient satisfaction. In some areas it is combined with Botox Injection to assist in minimizing lines and creating a more rested, youthful appearance.

Like everything else in plastic surgery, injection of fillers have to be performed with skill and artistic tastefulness. Many offices relegate injection to assistants or nurses. I do it myself, and approach every patient for filler injection individually. We have all seen the “sausage” or “ducks” lips that denote a poor understanding of facial esthetics.

Fillers when performed well can offer great satisfaction both as a stand alone office procedure or as an adjunct to facial surgical procedures. It must be performed skillfully and safely, choosing fillers that are both effective and have minimal potential complications.

posted by Dr. Elliott - Plastic Surgery Blog

filed under: Facial Fillers, Juvederm, Restylane