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  • Chris Thiagarajah MD

2017 Update on facial filler


This is a summary of the newest fillers that have been on the market for the last year. As a oculofacial plastic surgeon a large part of my practice involves facial fillers for patients. Denver patients expect knowledgeable injectors but it is always good to have a basic idea of fillers and what they can do. This is a guide meant to help patients get a basic sense of the best products that are now available.


What are the newest facial fillers and what do they do?

Most patients who revitalize their looks with fillers are often wondering about the newest fillers and products. These are the newest fillers to hit the market with an explanation of how they are different than previous products

Volbella

This filler has been on the market for several months now. I use it primarily to augment the lips and under the eyes for hollowing. It lasts 9 months to 1 year on average. This is my go to filler for under the eyes because it has minimal swelling and contours the best. It is great around the lips as well.

Vollure

This filler is similar to Voluma, a filler used in the cheeks to give volume and improve appearance. Vollure is used in the laugh lines and lasts up to 18 months. It is a great new product that can be helpful for a longer term improvement.

Refyne and Defyne

These fillers are similar to the Volbella and Vollure products by Allergan.

What are the older facial fillers and what do they do?

Juvederm

This is one of the classic fillers that has a great role in the entire face. Juvederm can be used all over the face (except under the eyes). It is one of the best fillers on the market. Over time different fillers have been developed that target specific areas (lips, cheeks, laugh lines) so it has decreased in some use but still plays a role.

Voluma

This filler lasts 18 months and is used for the cheeks to ad volume. Because it lasts longer, it is more expensive.

Restylane

One of the original fillers that works like Juvederm. It is better for under the eyes than Juvederm but not as good as Volbella.

Belotero

Another classic filler used all over. Similar to Juvederm.

How are fillers different from each other?

There are three things that differentiate fillers. First is their concentration of hyaluronic acid (HA). This is "medicine" that is in the filler that gives it different properties. Higher HA fillers tend to be more ball-like and lower HA fillers tend to be more syrupy. Second is "cross-linking". Cross linking makes filler last longer. Finally is the presence of lidocaine or not. Some fillers have lidocaine. Others do not. Lidocaine is a numbing agent that reduce discomfort during injection. Not all patients need lidocaine in their filler but some like it.

What is the take home point here?

The most important thing to realize is that there is not one product that works on the face (except the eyes but that is a different article). It is critical to have a doctor who is well versed in all the fillers and options so that they can offer the best options for you. As an oculofacial plastic surgeon it is critical to have all the tools at your disposal to treat patients. There is no “one size fits all” and what works on one patient will not work on others. Additionally, each product is effective for different areas. You wouldn’t hire an artist who uses only one color of paint to paint a picture of you. Why would you do that with a filler? Some doctors are going to have a preference with certain “lines” of fillers such as the Juvederm products over the Restylane products and vice versa but should be well versed in all fillers. In summary:

  1. There is no product that is one size fits all. Fillers now “specialize”

  2. A physician who is well versed in all the different products is who you need to see


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