Q:  What is an injectable filler?  
A:  Simply put, an injectable filler is used to get rid of folds and wrinkles in the cheeks and lower face. They are different from Botox because Botox is used to paralyze certain muscles around the eyes and the forehead that lead to fine lines in these regions. The lines and folds in the lower face are not caused by muscle contraction and require volume replacement to hide them. For example, the folds that form between the nose and the corners of the mouth are great candidates for injectable fillers. Another area that is helped with injectable fillers is lip thinning. Injectable fillers can be used to plump up lips that have lost their shapeliness and fullness over time.

Q:  Is an injectable filler the first step in a facial rejuvenation? 
A:  It certainly can be. Often, the signs of aging begin as subtle lines and folds. These subtle lines and folds do not necessitate something as involved as a lifting procedure, such as a facelift.  Instead, injectable fillers can be used to temporize these subtle aging changes for a number of years. The great thing about these fillers is that they can be utilized quickly, without downtime or discomfort, and you can be back to work or home or fun immediately with little to no bruising or swelling.

Q:  How long do injectable fillers last?
A:  Each one is different. Typically, the temporary injectable fillers last between six to eighteen months depending upon which filler you choose and where it is placed. For example, the hyaluronic acid fillers (Restylane, Juvederm) and collagen (Evolence) last 6-12 months. These are great for lips and finer lines. Radiesse (hydroxyapatite) is great for the deeper folds because it has a greater longevity, but it cannot be used in finer lines or the lips, in my opinion. There are more semi-permanent fillers, such as Sculptra, which take longer to achieve volume replacement but give longer-lasting benefits. Sculptra is for patients with a great deal of patience who are willing to wait months for the results.

Q:  Is one injectable better than the other?
A:  Like I was saying before, each filler has pros and cons. Some work great in particular areas but last less time (such as Evolence). On the other hand, other fillers last a long time but are limited as to where they can be used (Radiesse). I spend a great deal of time with each patient going over these details so that the patient feels empowered with the knowledge that helps him or her to make the best choice.