Today we are gonna go over different facial fillers types and what are the best facial fillers.
If you’re wondering is Botox a facial filler, the answer is no. There are two main types of injectable treatments today: neurotoxins, like Botox and Dysport, and facial fillers.
Neurotoxins are used to weaken muscles that create wrinkles, muscles like the glabella. Forehead wrinkles as well as crow’s feet wrinkles are best treated with a neurotoxin.
Fillers are used to fill in lines or wrinkles or plump areas up. They are like liquid skin. You inject it into areas that you want to plump up.
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The original filler was collagen and a couple decades ago collagen was very popular as a way to fill in lines. The newest fillers are typically hyaluronic acid based and these are much better than the old collagen because they last longer and they are reversible.
If you inject the hyaluronic acid into let’s say a part that you don’t like, or you get a lump from it, or it goes into a blood vessel, you can inject hyaluronidase, which is an antidote to it that will melt it away. That’s a super important.
If you’re gonna get facial injectables, go with a hyaluronic acid based injectable. With one exception and I’ll go over that in just a little bit. The hyaluronic acid fillers are going to be these safest.
What I’m gonna do in this article is I’ll just go from the top down because there is so many questions like “what’s best for the cheeks, what’s best for the temples?”
Every doctor has their own opinion and I’m not going to tell you that my opinion is the best for everybody. But I’ll give you my opinion.
Once again, if you’re looking at forehead wrinkles, if you’re looking at wrinkles of the glabella or the crow’s feet, Botox is the way to go. Or Dysport. That’s what I would recommend first for those lines.
Table of Contents
Different Types of Facial Fillers
Under Eye Fillers
As we go down the face, a common question is what do I do to fill in my under eye hollows.
I am gonna go over what I recommend for these specific areas so that you know what is best for you.
If you’re looking at under eye hollows, the filler that I recommend for that is Restylane-L. This is a hyaluronic acid filler.
If you’re injecting under the eyes, ideally you want your doctor to inject small amounts. Usually if you have one syringe of Restylane-L, that’s more than enough to fill the under eye hollows. 0.4 cc on each side is usually enough for most people.
The risk of getting the under eyes filled is lumpiness. You have to be very careful there. There are fillers I don’t recommend under the eye. If you go for anything, go with the traditional Restylane-L for the under eyes.
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The reason why I recommend that is because it has a lower risk of lumpiness, unlike some of the other fillers that may absorb moisture and plump up after you inject it. Restylane-L does seem to stay about what you see. So what you see is gonna be what you’re gonna get.
If you inject it into the lips, if you inject it under the eyes, it can get pretty good longevity, some people
get over a year when it’s injected under the eyes.
Let’s go up a little bit, actually I forgot the temples.
This is an area that a lot of people forget about when they’re looking at injectable fillers. The temples are an area that really can thin in so many of us as we get older. It’s an area that a lot of us don’t really realize.
There are many people that say “there’s something about my face, I feel like my face is too thin, but I don’t know where to fill.” Quite often it’s temporal wasting, where this area gets thinner and thinner.
What I recommend for that, which is the easiest, is Sculptra. I mentioned earlier that hyaluronic acid fillers are the ones that I typically recommend for most of people.
The only non hyaluronic acid filler that I recommend is Sculptra. It is poly-L-lactic acid. It’s like a powder that you mix with water. You inject that mixture into areas of the face and what it does is for a day or two, that water may stick around and then the water dissolves away and the Sculptra powder, that’s left under the surface, will interact with the surrounding tissues to increase the collagen content and to gradually fill that area out.
The negative with Sculptra is it does typically take two to three treatments for maximal effect. The positive of Sculptra though is that results can last two years or even longer and for those people who really want a very gradual change, Sculptra can get that for you.
The reason why I feel Sculptra in general is safe compared to some of the other non hyaluronic acid fillers is because it’s injected in a very dilute fashion. Even if it’s accidentally injected into a blood vessel, the risk of it clogging that blood vessel is lower than if you get some of these other thicker fillers.
So if you’re looking at the temples, Sculptra is a very good treatment. It’s one poke and what they do is they make a 1 poke all the way down to the bone, believe it or not. Don’t worry, it won’t go into your brain because there’s bone in the way.
It is injected very deep right on top of the bone, below the muscle in the temple area and that helps to gradually fill that area out.
You could consider a different type of a filler. Restylane-L like I mentioned earlier that could also be used in the temple area. You could also use a filler like a standard Juvederm.
I’m not as big of a fan with the hyaluronic acid fillers in the temple just because there’s a big blood vessel that comes right through that area and I just don’t want there to be any chance that they could accidentally inject the filler into that blood vessel. For that reason, for the temple, I recommend Sculptra.
Once again you’ll need typically three treatments to get maximal effect, sometimes more, sometimes less.
What about the cheeks?
Related: Facial Fat Grafting Versus Fillers
The cheeks are a very popular area to inject. The cheeks are one of the areas of our face that lose volume. The main area, in my opinion, that loses volume and that can really benefit from fillers are the cheeks.
About 15 years ago, the only real good filler we had was fat.
Now that we’ve gotten a number of injectable fillers that are FDA approved for the cheeks, doctors are doing a lot less fat grafting than before.
Now the top choice typically for injecting the cheeks is Juvederm Voluma.
It is a nice filler that is very similar to regular Juvederm. It has a different type of a cross-linking pattern to it and the great thing about Juvederm Voluma is that it lasts a long time. You can get upwards of two years, usually a year and a half to two years. Voluma is typically recommended for plumping up the cheeks because you get such good longevity from it.
The negative of Voluma is that it’s a bit more expensive than the other fillers and some people who are a bit on a budget may opt for the Restylane Lyft. It is another very good filler, it is FDA approved for the mid-face, basically to plump up the cheeks.
The benefit of the Restylane Lyft over Voluma is that it is less expensive. The negative is I don’t think it lasts quite as long.
If you’re thinking about having your cheeks injected and you’re not sure that you’re gonna like it, maybe it’s best to go with the Restylane Lyft as a way to try it out. If you want something longer-lasting, then you may want to try graduating to the Voluma.
A final option if you don’t want to spend a lot of money at one time, is Sculptra. It is a great filler for the cheeks as well. It’s great for people who don’t have the budget to spend on, let’s say, two syringes of Voluma or two syringes of Lyft, but can spend less each time and come back a couple of times to do Sculptra.
You can definitely use Sculptra for the cheeks. I think it’s a very good filler for the cheeks. It just takes longer. Typically you need three treatments, maybe more, maybe less. They space those out every six to eight weeks. For those people who are okay with a gradual filling out, then Sculptra is a way to have that done. You spend less each time. Maybe instead of spending $2,000 in one shot, you spend $500, but you do it three or four times.
Nasolabial Folds Fillers
As we go down the face, nasolabial folds are the most popular areas to inject.
The nasolabial folds are these static lines that go from the corner of the nose to the corner of the mouth and the majority of injectable fillers are FDA approved for that area, but not all of them are the best for that area.
Let me show you what I recommend.
Juvederm Ultra Plus is a workhorse for the nasolabial folds.
The reason why I like this is because it has good longevity, it can last a good year or so, it’s a very nice and easy injection, and it’s very moldable so you can massage it at the time of the treatment to reduce any potential lumps and that type of thing.
You can use Juvederm Ultra Plus in so many different parts of the face. The only place that I recommend you definitely not have it injected is under the eyes, but otherwise you can use it for the cheeks, for the lips and that type of thing.
Juvederm recently-released Volbella. It is another great filler for the nasolabial folds.
I would use it in a patient where the folds aren’t quite as deep. I would use Ultra Plus in a patient where the folds are deeper.
I do believe that Juvederm Ultra Plus has a bit more of a lifting capacity then of Volbella, whixh is a bit of a softer injection.
If you have the folds that are a little bit softer, you want something a little more moldable, a little less stiff and in this case Volbella may be a better option. But if you’ve got a deep nasolabial fold, you want to consider Ultra Plus.
What else can you use?
Restylane Defyne is a very popular product. It was originally used in Europe and still is under a different name called Emervel.
This is specifically made to be injected into parts of the face that move because the filler will actually move with the parts of the face.
One of the things that a lot of people are concerned if they have injectable fillers is getting, let’s say, stiff appearance afterwards. Restylane Defyne is used to inject into those areas and allow those areas to still look and feel soft and mobile. This is great if the nasolabial folds are really, really deep.
If it’s a real deep one, then once again Ultra Plus is good and then I should also mention you can use Restylane Lyft in the nasolabial folds if you’ve got deep folds.
How about the lips?
The lips are super popular to inject and unfortunately people are having them injected too much, as you can probably see in photos and videos from people in Hollywood.
There are a lot of fillers that you can use for the lips.
Juvederm Ultra Plus gives a really nice plumping effect to the lips and it lasts a good amount of time, 6 to 12 months or so. It’s a powerful lifter so you can really fill the lips out nicely. It does a really good job with outlining the lips and it lasts quite a bit of time. The negative is you may get a little more of a dramatic result with this.
If you’re looking for a softer result, you can consider Juvederm Volbella. It is a softer filler that is FDA approved for injection around the lips. It is a much softer filler that is made specifically for the lips. Lasts anywhere from 6 to 12 months.
If you are you looking for a real pouty, more of a dramatic appearance, this may not be the best one for it. But if you’re looking for just a modest, soft change, then Volbella maybe a good one for you.
Another one is Restylane Kysse. This also is FDA approved for the lips and is a great filler for filling out the lips.
Another one is Restylane Refyne. It is the cousin Restylane Defyne. This does not quite have the lifting ability of Defyne. It is softer, it is mobile
The only question is do Refyne and Volbella (two really soft fillers) last as long as Juvederm Ultra Plus or Defyne. Maybe not. We do see some people where they do seem to disappear a little bit more quickly.
That may be a bit of the negative of going with the softer, less powerful lifters for the lips.
What about fine lines around the mouth?
Fillers For Lines Around The Mouth
These are really hard to treat because in so many people these lines are so fine that it’s hard to get a needle to inject and fill them.
But if they’re deep enough, then what I recommend for those types of lines, is Restylane Refyne, because it’s very soft and you can inject it into these tiny little wrinkles. Another one that’s really good for that is Volbella.
Marionette lines are another area very commonly treated. It’ll be the same things that I would recommend for the lines around the mouth.
A lot of people want to have their chin injected. Very commonly, a filler like Restylane Lyft is used for the chin. It’s a good filler that is injected right on top of the bone, underneath the muscle, to enhance the chin.
These are all different facial fillers types for all the parts of the face.
A couple other things to keep in mind.
The number one complication we want to avoid is intravascular injection of the filler. That’s why you do really want to be choosy on who does this. Even if they use a hyaluronic acid filler, the worst thing that can happen is it’s accidentally injected into a blood vessel. That can cause horrible complications, ranging from scarring to even blindness.
So having an injector that is very experienced, that has the backing or is a board-certified plastic surgeon or dermatologist, is super important.
Make sure it’s a hyaluronic acid filler. Make sure they have hyaluronidase available. It is the antidote. A lot of times you want to have this injected right away if that complication happens. Ask your doctor do you have hyaluronidase available if something bad happens.
Finally one thing that I recommend whenever possible is that they use a cannula. These are long blunt needles that they inject the fillers with. It costs them a little extra. It’s not a guarantee that you won’t get into a blood vessel with it, but it lowers a risk of that happening.