A filler is a material that is injected under a wrinkle or hollow area to smooth and reshape it. Depending on the area to be treated, there are a number of different options available.
The Juvederm family of products is made of hyaluronic acid, a naturally-occurring substance in normal skin. There are currently five types of Juvederm available in the US. They vary from one another in terms of how they’re processed, which results in different characteristics once they’re injected. Juvederm Volbella is the least plumping of the products, perfect for filling in the superficial lines seen around the lips. It can also be injected into the lips for a very subtle augmentation. Juvederm Ultra is also used superficially to address wrinkles directly. It can be used to augment the lips as well. Juvederm Vollure is similar to Ultra, however its results last slightly longer. Juvederm Ultra Plus is placed a little deeper and is typically used to address a hollow area. Juvederm Voluma is the most plumping of the products and is intended to add fullness to an area of volume loss, such as the cheeks or to add structure to the chin. All of these products are injected in the office with typically only mild discomfort. Following the procedure, there is typically mild swelling for 24 – 48 hours and some bruising can occur. The results may last 9 months to 2 years, depending on the product used.
Belotero is another hyaluronic acid filler that is thinner than the Juvederm family of products. It can be used to address very superficial fine lines and works nicely in the tear trough, which is a groove along the inner aspect of the lower eyelid. In fine lines, the results last about 6 months, though in the tear trough the results can be longer-lived.
In some patients, their own fat may be used to fill in areas of depression or lines on the face. This procedure can be done alone, or may be combined with a facelift. During a fat transfer, liposuction is used to remove fat from another part of the body (the abdomen is commonly used) and this fat is then injected into the face. When fat is transferred, some of the fat will survive permanently, while some will be reabsorbed by the body. Fat transfer may be repeated, if desired. This procedure may be done in the office or in a surgical center under anesthesia depending on the extent of fat transfer being performed and whether another surgical procedure is being performed at the same time.
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