Dr. Jo Herzog Discusses More Options For Cosmetic Fillers
This is another in a series of posts by Dr. Jo Herzog on various products and options for fillers and injectables.
Dr. Jo Herzog, M.D.
For the past few weeks, we have been talking about Dysport, Restylane, and Perlane, three products used on Jamie’s face at our recent Medicis lunch and learn. We chose these products, which are perfectly reasonable choices to do the job, because we were presenting Medicis products. However, the job could have been done similarly or differently with other products, some of which I will discuss in today’s post.
Dysport: Instead of Dysport, we could have used Botox. This is easy to discuss, as they are products that are almost equal when in the hands of an experienced injector. I can use these fairly interchangeably. Some patients, not all, prefer one over the other, with Dysport being the winner. I have no preference when using these for myself except in the area around the eyes. I think that Dysport does a better job in this area because it does seem to diffuse more and give a smoother look. There seem to be more coupons and company offered deals with Dysport. On the other hand, one must be a little more careful when choosing your doctor when using Dysport, as I do think that it is easier to make a mistake when not experienced.
Restylane: Restylane is my favorite for lips, but some prefer Juvederm. Both are “HA” fillers. Both of these can give you fairly equivalent results. I think that the Restylane gives one a lip that is a bit firmer, but some like them softer. Both of these last about the same time (you can read articles supporting one or other), but length of time will vary with amount used, patient metabolism, and depth of injection. This applies to the other categories of fillers as well.
Perlane: Perlane was used for our demonstration as a filler for fairly large amount of volume. This is where the big choices really come in, and we could do pages and pages of talking, but I will just give a few key points in this post.
Perlane is another HA filler. Since it is the softest of these fillers, it is an excellent choice for someone like Jamie who has thin fine skin or someone that needs just a little plumping. I also like it for first time filler patients, as it might last a little less long than some others. This lasts for only about a year to 18 months (may last longer in certain areas). Perlane can be dissolved after being injected if the patient is not happy with the results; however, I have not had to deal with this problem and have never had to do this.
Radiesse would have been another excellent choice on Jamie’s face, but this is a firmer and thicker filler. When you purchase a syringe, you get more volume (some would dispute this, as they say HA’s will absorb water and give same volume, but I do not think ends up equal). This filler is very supporting and is a very good volumizer. This also seems to last an average of about a year. Some need touch ups at six to nine months, and some are happy for up to 18 months.
I find that patients get the most out of fillers if they touch them up when the results start to disappear. As opposed to the HA fillers, Radiesse does help you form some new collagen. Because this is a thicker product, there can be more chance of bruising and in the wrong hands, clumping and lumping.
Sculptra is a product that offers a whole different kind of option. This product is a volumizer that can add large amounts of volume fairly easily. Like Radiesse, Sculptra builds collagen. This product lasts at least two years but has its drawbacks.
Sculptra is usually injected in multiple sessions and the results are not immediate. My average patient takes about 18 weeks until the final result is seen. However, with this product, you can replace the largest amount of volume at the least cost cc/cc. This is an ideal choice for the ladies that have lost bone and fat and have sagging faces and jawlines. It is also ideal for those that want to build a beautiful cheekbone and enhance their facial structure.
I would love to add a fair amount of volume to Jamie’s face and “fill it out” but would not have chosen Sculptra as my initial treatment, as it is a long process and brings about more change. Jamie just wanted a subtle youthfulness andto get rid of her tired look. I think that now she is brave enough to go for something more and longer lasting.
The drawbacks with Sculptra are the time it takes to be complete the job, and the need for a very experienced injector. This is the filler that needs to be injected by someone that can visualize what you want to look like and who can execute this without problems. This filler can cause lumping if either not injected correctly or if not massaged afterward by patient. Instruction is vital.
I think that all of these are safe and have used all of them on myself. This is all about how much correction you want, how long your time line is, and how much you are willing to spend. The bottom line is that you can lift and rebuild a face without ever going under the knife or missing a meal (unless you get stuck in a waiting room over lunch).
Take care, stay beauty savvy, and send any questions to me, and I will answer them in future Family Savvy posts.