Injectable fillers have dramatically improved since the introduction of collagen several decades ago. In the current market, hyaluronic acid (HA) fillers comprise the majority of the fillers used in the US with lesser amounts of calcium hydroxyapatite, poly L-lactic acid (PLLA), and the occasional use of microdroplet silicone. HA fillers have become dominant because they are biologically similar to the naturally occurring hyaluronic acid in skin, can be manufactured with differing characteristics, are easily stored at room temperature, and are stable over time. The filler chosen greatly depends on the area in which you’d like to be injected.
Hyaluronic Acid filler by area
There are several manufacturers for HA fillers and we use most of them at Beaty Facial Plastic Surgery. Juvederm, Restylane, and Teoxane RHA are our primary lines with additional lines coming soon. These fillers are quite versatile and offer differing amounts of flexibility, support, thickness and durability. HA fillers can be used in many areas of the face, including along the jawline for augmentation and better definition, in the midface for restoration of volume, in the nasolabial folds and marionette lines to soften, and in the tear troughs to smooth the transition from eyelid to midface.
Augmentation of the Jawline
For augmentation of the jawline, fillers with more cohesion and firmness such as Juvederm Volux are preferred as they can be used to sculpt the desired shape immediately over the mandible.
Midface Volume
For midface volume, Juvederm Voluma XC, RHA 4 and RHA 3 are most frequently used to naturally fill out the midface and provide support for overlying tissues.
Nasolabial Folds and Lower Face
More flexible fillers like Juvederm Ultra Plus, RHA 3 and RHA Redensity are best for the nasolabial folds and lower face as they move better with the tissues, creating a natural effect.
Lip Augmentation
Lip Augmentation can be done with a wide variety of fillers depending on the desired result including Restylane, Restylane Kysse, Juvederm or RHA Redensity.
Tear Trough
The tear trough is treated with Restylane L or RHA Redensity.
Special Mentions
Radiesse
Calcium hydroxyapatite (Radiesse) is sometimes used for augmention of the jawline or midface. Radiesse’s molecules provide immediate support to act as a filler. Over time, the breakdown of Radiesse stimulates the body’s natural collagen and elastin production over time. However, its most frequent use in our practice is in its hyperdilute form in which Radiesse is mixed with sterile saline solution. Hyperdilute Radiesse is used to improve transverse lines in the neck, to augment the buttocks, and to treat cellulite.
Sculptra
PLLA (Sculptra) is useful for augmenting broad based areas of volume deficit such as temporal hollows or in patients with atrophy of the parotid glands.
The wide array of fillers now available creates an opportunity for dramatic and natural-appearing facial volume augmentation. Consulting with one of our expert injectors is the best starting point to plan the best treatment for your needs. Ultimately, your injector will choose the right filler by area for you.
