What is the best wrinkle filler to use?

How does it work?

Swimmergal

F, 38, California

There's no way to answer the question of "What's the best wrinkle filler." Different fillers are used for different procedures. Two very common dermal fillers are Juvederm and Restylane. Both are excellent products and both are formulations of the natural ingredient hyaluronic acid.

Because Juvederm tends to be smoother than Restylane, both products are used in different areas and offer different results. For example, Juvederm is excellent for lips and nasolabial folds. Aside from the physical consistency of the filler, other differences between fillers are longevity, the degree to which it "stays put" at the injection point, and the cost. Without knowing what your criteria for "best" is, there's no way to answer your question.

Many patients see the results of one or another filler online and want to choose that filler as if it's an OTC product or something to order from Amazon. My advice is to not focus too much on which filler is being used.

Remember, that injecting dermal fillers is half art and half science. As with plastic surgery, a big part of getting natural looking results is choosing a skilled and experienced injector. To get the very best results, I suggest meeting with an experienced dermatologist or plastic surgeon to discuss your goals. Be sure to review before and after photos and to tell your doctor what your individual concerns are and then let them recommend how best to approach your facial features accordingly.

There's no "one size fits all" approach to hyaluronic acid based facial fillers. The decision of which filler to use, how much to use, and precisely where to inject it are all specific to each individual patient. An experienced injector not only understands the subtle ways each product works, but also has a good understanding of facial aesthetics and knows how to get the best results for each individual patient.

There are many popular brands of facial filler. Juvederm, Restylane, Belotero, and Radiesse are all high quality products which have different uses. For fine lines we often use Belotero. Belotero is a newer filler and it has an excellent consistency when working with small, shallow facial wrinkles. For a deep wrinkle filler we often use Juvederm or Restylane, depending on the location. If we need to add a lot of volume we will use Radiesse as well.

Also, keep in mind that facial fillers are not the only option when considering non-invasive and minimally invasive facial anti-aging procedures. For forehead lines and crow's feet, Botox injections are an excellent option and can be used in conjunction with fillers. For treating wrinkled skin damaged by sun exposure, we have had excellent results with laser treatments. We often combine IPL treatment, which improves sun spots and skin discolorations, with facial fillers to treat wrinkles and restore volume.

Many patients learn about a specific brand of facial filler from a friend or a relative and request that filler specifically. The reality is that the same filler which did wonders for someone you know, may not be the right choice for you. I suggest you consult with a board-certified dermatologist before making any concrete decisions about what brand of filler you want. A skilled and experienced dermatologist will know which fillers make the most sense for your face -- and, in many cases, your dermatologist will recommend a combination of different fillers for different areas to achieve the best overall results.

Dr. Alexander Ovchinsky has 1 Fillers before & after:

Fillers before image performed by Dr. Alexander OvchinskyFillers after image performed by Dr. Alexander Ovchinsky

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There are many different types of injectable cosmetic filler and which one is right for you depends on which area of the face is being injected and which specific skin conditions or cosmetic issues are being addressed.

Some dermal fillers add volume. Some add definition. Some are best suited for the lips. Others work well in heavy creases and folds. There is no best wrinkle filler overall, but there is usually a "best choice" for whatever your goal.

For example: Restylane tends to be somewhat more cohesive than Juvederm. It stays in the area into which it is injected and needs to be carefully worked and molded into position. This makes it superior to Juvederm in specific areas, but potentially more troublesome in other areas where smoothness and diffusion of the filler are required.

Rather than researching different types of dermal filler, I would recommend researching the before and after portfolios of different dermatologists and choosing the doctor whose work best exemplifies the results you would like for yourself. Once your dermatologist understands your goals, they will be able to recommend the best filler to suit your specific facial anatomy.

Always remember to consult with a board-certified dermatologist or plastic surgeon for best results. 

Facial fillers are an extremely popular and low risk option for facial rejuvenation, wrinkle reduction, facial contouring, and younger looking skin. Because they are safe, well publicized, offer nearly immediate results, and have FDA approval, many patients assume that shopping for filler treatments amounts to shopping for a specific "brand" of filler.

I recommend you don't try to choose your own facial filler the same way you would choose beauty counter products. Rather than approaching a dermatologist or plastic surgeon and asking for "Restylane," I suggest you take your doctor's advice regarding which filler to use.

Facial fillers are extremely versatile and have a broad range of cosmetic uses which include plumping, lifting, adding volume, and creating definition. An experienced injector understands the differences between fillers like Juvederm Ultra, Restylane Silk, and Radiesse -- and knows where, and in what situations to use them.

Without a direct consultation, there's no way to know what your goals are or what you look like. The choice of filler is different for creating plumper lips than it is for correcting dark circles under your eyes or for adding definition to the jawline.

Remember that when you look for an injector, you are not shopping for skin care products. You are shopping for skill, experience, and a sense of aesthetics. Using the wrong type of dermal filler in the wrong place, or using an inappropriate amount, will leave you with results which aren't natural looking.

Remember to consult with a board-certified dermatologist for best results.

There is no "best" filler.  There are many FDA approved fillers and each is very good at a particular purpose.  The Juvederm and Restylane family of fillers are the most commonly used, but other fillers such as Radiesse and Sculptra have very good results in the right place.  You should have a personal consultation to find out what will work best for you.

Which filler to use depends on the location of the site to be filled an experience of the physician. Juvederm( a Hyaluronic acid is very popular and is most commonly used in my office. Radiesse may also be used when large volume is needed. Fat transfer may also be a good choice. PRP treatment with ( depending on the site to be filled) is turning out to be a good complement.