Fillers… What Kinds Exist?
Radiesse™ Injectable Filler
We are now offering Radiesse™ to treat deep lines, folds, volume replacement and scars. As we are writing this, it is currently under pre-market approval review by the FDA for the correction of Facial Lipoatrophy and Nasolabial Folds. Because studies have established safety with use in the facial skin tissue areas, we have now started use and are very pleased with the results. Radiesse™ lasts 9-18 months on average and is a welcome addition to our other methods of Injectable fillers – Restylane, Hylaform, Cosmoderm/Cosmoplast and Sculptra. Each Injectable Filler fits a particular niche and they are not mutually exclusive. For instance, although Radiesse™ can increase volume in the skin, Sculptra is still recommended for larger volume replacement and sagging skin. If you have sunken cheeks, or a gaunt appearance, Sculptra is most likely best for you! Set up a consultation with a Cosmetic Coordinator to determine which filler will result in the best cosmetic outcome for you.
Juvederm Ultra and Juvederm Ultra Plus were approved by the FDA. Because we were invited to be part of the JET trial (a post-approval introduction of the fillers to select members of the dermatologic community), we were able to offer this before its launch in the first quarter of 2007 when it will be available to all physicians. It is smooth and very natural looking and feeling. The Ultra Plus is good for volume areas and possibly more longevity than the usual 6-9 month window.
Perlane FDA approval?
The company says any day now, but have been saying so for a few months. We had used Perlane for larger volume defects and wrinkle reduction for a couple of years and we know what it can do, which is a lot! We are still waiting patiently.
There are so many different fillers on the market now, how to choose? There are 4 basic types: hyaluronic acids, poly-L-lactic acid, collagen and hydroxylapatite. Hyaluronic acids are the most widely used and have a tremendous amount of experience worldwide with no serious adverse events reported. Restylane was the first on the market and is still the leader in the US, and an important mainstay of our practice. It is a great all around filler and can be used in almost all areas. Juvederm was the next big hyaluronic acid filler to hit the market. The similarities between Restylane and Juvederm are much greater than the differences, in my opinion. Perlane has finally been FDA approved and adds a dimension to what we can offer you. It is a thicker filler and great for under eyes, nasolabial folds, marionette lines, lips and cheek augmentation as it provides tremendous volume and more longevity (usually 9-15 months). However, it isn’t good for areas of superficial wrinkles. Poly-L-lactic acid, Sculptra, is wonderful for overall volume loss and sagging, as well as the typical areas for fillers. These fillers provide a liquid lift (when achieved with hyaluronic acid, it may require more product) which can last as long as three years! Finally, hydroxylapatite, Radiesse, is also a robust filler for similar areas that Perlane is good for and similar longevity (however this filler should not be used in lips). Of course you don’t really have to know the differences as we will recommend what we think will be best for you at your consultation visit, but with so much press out there, many people want to understand the differences.