Our faces lose volume as we age. Both the bones and the soft tissue become smaller over time. We lose about 1% of our collagen annually from age 20. Fillers are a non surgical method of restoring volume. They are injected into the area of volume loss and last approximately one year. The most common one is hyaluronic acid. Typical brands of it are Juvederm, Voluma, Restylane, Lyft, Belotero and newly Revanesse.
How to choose one over another depends on the area to be injected. Some fillers attract water, i.e. Juvederm and fill themselves out over time. That would be problematic under the eye as no one wants swelling there. Others are stiffer and provide more lifting, i.e. Voluma or Lyft. These help lift up the mid face where sagging and flatness occurs. Still others are very soft and flexible, i.e. Belotero or Silk. These work well in the lips and perioral area, where it’s important to have mobility.
One of the most reassuring features of the hyaluronic acid fillers is that they are reversible. There is an injectable medication called hyaluronidase that dissolves them. It would be rare for a person to want to dissolve a filler that was just injected. But it occasionally happens.
I’ve not seen any allergy or infection associated with injecting fillers over the 15 years I’ve injected them. The worst side effect I’ve noticed is bruising, which can last several days. It’s best to time filler injections to avoid that possibility the day before an important event.
There are additional types of fillers, i.e. Radiesse and Sculptra, that contain other substances and I’ll write about them later.