Fill ‘er up

A question I get asked on a daily basis is “what filler do I need for here, and there, and here..?”

Thanks to good marketing by different aesthetic companies specializing in neuromodulators and fillers, like Allergan for example, and increased social media awareness, my patients are becoming more aware of the different options available when it comes to fillers. Fillers have commonly been referred to as Juvederm by a lot of patients, not understanding that Juvederm is simply one brand of Hyaluronic Acid dermal fillers of which there are many different types, but there are also a lot of competitive brands that also offer different types of dermal fillers, like Belotero, Emervel, Restylane, Radiesse etc etc.

I often use the analogy of car types with my patients (because I love luxury cars).
Asking for Juvederm is like asking for a Mercedes. Asking for particular types of Juvederm, like Volift, Voluma or Volbella, is like asking for a Mercedes C-Class, E-class, CLA, GLA etc.
So Juvederm is not one blanket filler but refers to a brand of different types of fillers. Just like asking for Belotero would be like asking for a Ferrari. But there are different types of Belotero, for example Belotero Balance and Belotero intense, just like there’s a Ferrari Spider or F430.

The decision of where to place different fillers in the face depends on what area is being treated as well as the expertise and knowledge of the physician performing the procedure.

In my practice I have a few different product lines that I like to use on different areas on the face, simply from my exposure to and experience with those particular products. If I don’t use a particular brand that the patient may have had in the past from another doctor it doesn’t mean I think there is something wrong with that particular brand. It is nearly impossible to offer all the different kinds of fillers available on the market today. I believe it is good practise to have a small variety of different brands and excel at injecting them.

Currently my favourite dermal fillers for lip augmentations are Juvederm Volift, Belotero Intense and Revanesse Ultra. The decision of which of those products to use is based on the aesthetic of the patient, the natural anatomy, and the desired outcome. This is where it is imperative to follow the sound advice of the physician you have chosen to perform the procedure.

For cheek augmentations, to achieve a youthful heart-shaped face or the sought-after V-shape, I like Juvederm Voluma for its amazing capability of achieving a beautiful lift, and Revanesse Contoure. For older patients or men requiring more volume I also like Radiesse, which is not a Hyaluronic Acid filler but contains calcium hydroxylapatite. These are also generally the fillers I choose from when volumizing the temples, that can appear hollow over time.

For chin augmentation, the non-surgical nose job and jawline reshaping I tend to use Juvederm Voluma, as it really delivers where a long-lasting lift is desired.

There are also fillers that are very thin in consistency, and are very useful in areas where softening is desired rather than dramatic lifting. Areas of the face that benefit from these fillers are the tear troughs or undereye hollows, and any fine lines that need softening, for example those annoying little vertical lip lines that form around the mouth. My go-to product for these areas is Belotero Balance, as it is very soft and subtle but very effective.

It is important to be aware of the different brands when choosing a cosmetic procedure. Patient education is an integral part of the process. Well informed patients have more control and autonomy over their procedures. When you combine this with a physician who is well trained and experienced with different injectable products and techniques, the results are a beauty to behold.

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