Dermal fillers are an enormously popular, minimally invasive cosmetic treatment for facial rejuvenation and sculpting. However, unlike plastic surgery which causes permanent changes, fillers are a temporary solution. If you want to maintain the results, you have to go back in regularly for touch ups. In one way, this is a good thing. Patients who are not satisfied with their treatment can wait a while for the effects to fade and try a different filler (or a different plastic surgeon). On the other hand, repeated treatment with dermal fillers can be pricey. Because of this, some patients prefer longer-lasting fillers that don’t require frequent maintenance injections.
Dermal Fillers Aren’t All Alike
There are currently about a dozen dermal fillers on the market in the United States. Each type of dermal filler persists in the skin for a different length of time. The amount of filler injected and the location and depth of injections can affect how long it lasts. In addition, each patient’s body may break down and absorb the filler material at a different rate. Here’s an overview of how often you need a “refill” with some of the most popular products.
Juvederm, Restylane & Perlane
These are the three best-known brands of hyaluronic acid dermal fillers. They are used for treating nasolabial folds (the deep lines running from the corners of the nose to the corners of the lips). These fillers can also be used for other facial wrinkles, to plump up the lips, and to fill in acne scars. Each of these HA fillers persists from six to 12 months in nasolabial wrinkles (usually closer to six months). They generally last only three to six months when injected around the lips.
Captique, Elevess, Hylaform, Puragen & Prevelle Silk
These are less well-known brands of HA dermal fillers. They are used for the same purposes, but may tend to require more frequent maintenance treatments. Puragen may actually be longer lasting than Restylane, but this data still needs to be confirmed. Prevelle lasts about six months. Captique, Hylaform and Elevess may fade after three months, or they may last significantly longer. You might be wondering why there are so many different HA fillers. The consistency (stiffness and molecule size) of each filler is slightly different. In addition, they aren’t all created from the same source materials. This can be an important distinction for patients with sensitivities to certain ingredients. Some fillers contain Lidocaine which can make injection less uncomfortable. Cosmetic surgeons all have their own preference regarding which type of filler to use for achieving a specific result.
LaViv
This is actually the name of a patented process for creating a dermal filler from a patient’s own cells. The substance stimulates tissue generation and provides a very natural-looking result. Creating the filler is an involved process done in a special laboratory. It may take as long as 22 weeks to create enough of the product for injection. Patients generally undergo three treatments about a month apart. The results may last six months or more (this is still being investigated). There is no chance of allergic reaction since the patient’s own tissue is used. However, the high cost of treatment makes this one of the least commonly used dermal fillers.
PMMA (Artefill)
This filler is unique in the U.S. market for two reasons. First, it is the only dermal filler still available that contains bovine collagen. Second, it is the only filler that is considered “permanent” (lasting longer than five years). This doesn’t mean you only need one treatment. Since treatment isn’t readily reversible, PMMA must be used with great care. Most patients receive several injections over a period of time to avoid overfilling. Artefill hasn’t been available long enough to say whether the results are truly permanent. However, it has been shown to be very long lasting. It is a stiff filler that is used for nasolabial folds but usually not for other facial wrinkles or lip augmentation. Not all cosmetic surgeons will use this product because of the risk of an unsatisfactory outcome.
Radiesse
This calcium hydroxylapatite filler is injected between the lowest part of the dermis and the subcutaneous layer (under the skin). It is used for “all-over” facial recontouring in the cheeks, temples and deep wrinkles. The calcium component lasts for as long as a year. However, the carrier gel that makes up 70 percent of the filler volume tends to be reabsorbed after about six months. This means the level of correction may decrease over time as the filler “wears off.”
Sculptra
Technically, this poly-L-lactic product is a sub-dermal filler. It is injected underneath the skin layer to stimulate collagen production. Patients receive two to three treatment sessions at least one month apart. Because of the way it works, it takes longer than dermal fillers to show results. However, maintenance treatment may only be needed once per year. Some patients experience longer lasting results (two to four years).
Additional Considerations for Dermal Fillers
Keep in mind that frequency of maintenance treatments is only one factor in determining which filler is right for you. Many patients choose to try temporary fillers to see if they like the results before moving on to more long-lasting solutions. Discuss the various options with your cosmetic surgeon to create a customized treatment plan based on your preferred outcome.