Which facial filler should you use?

With so many facial filers now available, many patients wonder which one they should use?  Juvederm? Voluma? Restylane?

Some factors to consider in choosing which filler to use are:

1. where it will be used

2. how long it will last

3. cost

In the end, we want to choose the best product for the area that will provide the best value for our budget.  The best value is often the one that gets you the desired result and lasts the longest.

Where the filler will be used

From a provider’s standpoint who has experience using many types of fillers, some fillers give better results than others when used in certain areas.  For example, I like Juvederm Ultra when adding volume to the lips.  It has a soft consistency, so it gives a very natural result providing a feel very similar to natural lip tissue, and it lasts for a good amount of time.

On the other hand, I like to use Belotero for the fine lines that radiate out from above the lips and for the fine lines that get etched into the lower cheeks.  While this filler does not last as long as some of the others, it can be placed very high up in the skin without much risk of ending up with small bumps, so it can provide a very good fill for these superficial lines.

To add volume to the cheeks and temples, I prefer either Voluma or Radiesse.  Both are great for adding volume to the cheeks and temples.  Voluma lasts longer, but it generally costs more than Radiesse to get the same volume of fill.

How long the filler will last

Some fillers last longer than others, so it would seem that choosing the filler that lasts the longest would be the best value.  Unfortunately, that is not always true.

The longest lasting filers are Sculptra, Voluma, and Radiesse; however, these fillers cannot be used in all areas.  For example, none of them can be used to fill the lips because they all have a high risk of leaving nodules in the lips.  Similarly, Voluma lasts a lot longer than Belotero, but it cannot be used to fill lip lines or wrinkles on the cheeks because it is way too thick to be placed high in the skin where filler needs to be placed to correct these types of wrinkles.

Cost of the filler

Fillers are priced per syringe.  Most fillers come in a syringe size equal to 1 cc (milliliter) except for Radiesse which also comes in 1.5 cc volumes.  The cost of the product is more complicated than just comparing syringe sizes, though.  It depends on how much product we would anticipate needing for correction.  For example, we may anticipate needing 2 cc’s of Juvederm but only 1.5 cc of Radiesse to fill the nasolabial folds.

Also, sometimes a filler can be used in more than one area, so it would be less expensive than using two different fillers.  For example, we may want to fill the lips and put a small amount in the nasolabial folds.  We could use Juvederm or Restylane to fill both these areas.  If we chose Radiesse for the nasolabial folds, we would have to use another product for the lips.

Another factor that has not been discussed is that some patients just do better with one filler over another.  For example, some patients may digest one Radiesse faster than Juvederm or vice versa.

Summary

In the end, the best choice will probably be the filler that gives the best result and that finds the ideal blend between initial cost and length of results.

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Meet the Doctor

Lawrence Osman, MD

Lawrence Osman, M.D. is a board-certified dermatologist and liposuction surgeon in Los Angeles specializing in minimally invasive techniques such as liposuction using local anesthesia.He has offices in the Los Angeles area in both Northridge and Calabasas.Visit www.drosman.com to learn more.

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