How to Choose the Right Filler

Fillers are great treatments for fixing lines and wrinkles and some scars, but there are differences between fillers that make some more or less appropriate for different circumstances. There are different thickness fillers; some fillers are distinguished by, are they naturally found in the skin, like collagen and hyaluronic acid, or are they foreign to the skin like silicone. And some fillers are distinguished by either the presence of some local anesthesia in the filler to help make it less uncomfortable or there not being any local anesthesia in the filler. Today we’re going to talk about matching the right filler with the right problem or right line based on the size of the filler. So patients come in to me and usually and appropriately say, “I have this line or wrinkle. I’d like you to fix it. I think I need a filler treatment.” And they’re correct. Then they go on and say, “Oh by the way, I’d like to use,” and they name a particular filler and the reason they do that is because they have a friend who had a wonderful result and a really good experience with that filler or they saw or read an advertisement for that filler. But the reality is, the filler needs to match the actual size of the problem, and that’s something that the doctor has to decide for you. So if we have a very thin line or wrinkle like this, you want to use a thin filler like this, because you want the filler to match the size of the defect or the wrinkle. It fills it up nice and smoothly, it’s nice and flat, a beautiful result. However, if, for this same line, a thick filler like this is used, look what happens? It sits on top, it doesn’t fit in properly, you get a lump, it’s not smooth, this is not the right filler for this problem. Let’s take a look at a deeper or wider line or wrinkle, somewhat analogous to what we would see over here in cross-section next to my nose. It’s wider and it’s deeper. If I use a thin filler here, I can keep putting filler in until the cows come home, but we’re not going to get this filled up properly, it’s not going to be a good correction, but if I use a thicker and size-appropriate filler like this one, it fills it up very nicely, you get an excellent, excellent result. So we have different fillers that have different thicknesses which are appropriate for different problems. Thin fillers are Zyderm, Cosmoderm, and then there are very thick fillers like Perlane and Sculptra and Evolence like this and, in between these two, we have other fillers of an in-between thickness like Juvéderm, Restylane, Cosmoplast and Zyplast. So, if you have a line or wrinkle that you’d like to have fixed, by all means, go see your dermatologist, but discuss it with your dermatologist and let him or her tell you which filler is most appropriate to give you the perfect result that you want every time.