RADIESSE® and JUVÉDERM®
Fillers are materials used by physicians to help smoothen out wrinkles and depressed scars. Some can even be used to enhance skeletal features such as chins and cheekbones. Although there are many fillers available, I have whittled the list to three that I offer at my office: a patient’s own fat, JUVÉDERM® and Radiesse®.
The filler I use most often is JUVÉDERM®. It is a preparation of hyaluronic acid, a natural substance found in connective tissues. The manufacturer has added a local anesthetic to the injectable making treatments much less uncomfortable, even when used in the lips. JUVÉDERM® lasts at least six months and in many patients I have found it to last substantially longer. I use it for softening or elimination of nasal-labial lines, under the corner of the mouth, to make lips fuller and to eliminate lipstick bleed lines around the mouth.
Radiesse® is a preparation of calcium hydroxyapatite microspheres. This material is occurs naturally in bone. Although it can be used as a skin filler, I prefer to use it as a deep filler, placing it over bones to enhance the appearance of the skeletal framework. The two most common sites are the chin and the cheekbones. Radiesse® lasts for about one year.
The most “natural” filler is a patient’s own fat. Special cannulae and collection filters are used. These limit the damage to the fat cells harvested. The fat is injected in a special way so as to maximize the chance of survival of the graft. The advantages of fat are that it will not be rejected and that any fat that takes is there permanently. Disadvantages include the discomfort of harvesting the fat, protracted swelling at the injection site and variable take of the graft. Most patients find that swelling and bruising will result in time off work ranging from several days to a week.
A filler (other than fat) can typically be injected one day with the patient returning to normal activities the next day. Some minor swelling and occasional bruising are possible but these can usually be camouflaged with make-up.