FILLERS OVERVIEW

Facial fillers are substances which are injected into the face to fill in lines and restore volume.  Facial fillers are injected at different depths depending on the type of filler and its purpose.  Some fillers are designed for deeper injections to restore larger amounts of volume, while others are meant to literally fill in the lines. 

Facial fillers can be temporary, intermediate, and permanent.  While a permanent solution may seem appealing to this problem, it has several drawbacks.  A permanent fillers can lead to a permanent problem.  If the filler is injected in the wrong location, the patient has a permanent lump.  Additionally, many permanent fillers can lead to reaction by the body including nodules and granulomas, which are very difficult to treat.  An example of a permanent filler would be silicone.

An intermediate filler lasts for several months.  The main drawback is the need for repeated injections.  However, if the patient does not like the filler it will resorb over time.  Most of the intermediate fillers are made up of natural substances, such as skin gel (hylarounic acid) or bone (hydroxyapatite).  The benefit of injecting with natural substances is that there is much less reactivity and the body seems to tolerate these fillers much better.  Examples of intermediate fillers are Restylane, Juvederm.

A temporary filler lasts three months or less.  The need for repeated injections is an even bigger drawback.  These fillers are lighter in consistency and can fill in fine lines.  Currently, collagen is the main filler in the USA for this purpose.  Several fillers are being developed and are being used in Europe for fine lines which last longer.

Typically patients will need intermediate fillers every four to six months.  I actually hink that some filler persists in the body past one year.  So, there is a cumulative effect with each injection placing more filler than the previous session.