Over time your skin loses collagen, looks less plump, and is more prone to wrinkles — dermal fillers help correct those aging effects by smoothing out and plumping up the skin. Newer fillers have a larger molecule size, which allow them to be placed deeper in the skin and last longer, says Suzan Obagi, MD, president of the Cosmetic Surgery Foundation and associate professor of dermatology and director of the Cosmetic Surgery and Skin Health Center at the University of Pittsburgh.
But now that the market is flooded with fillers, how do you know which one to choose? Doctors make their decisions based on which wrinkle filler will last the longest in the area to be treated, Dr. Obagi says. Here’s what you need to know about each of the popular choices.
Collagen is made from cow skin and treats fine lines, wrinkles, and facial scars. Doctors have been using this wrinkle filler since the 1980s, but today it’s being injected less and less. In 2008, collagen was used in only about 179,000 procedures, according to the American Society of Plastic Surgeons. On the other hand, Botox was used in more than 5 million procedures and hyaluronic acid, in more than 1.1 million.
- Pros: Collagen is the most affordable dermal filler. An injection may cost around $400, although the price will vary depending on where you live and the expertise of the surgeon.
- Cons: One of the biggest drawbacks is the risk for allergic reaction. Anyone who wants collagen needs to take a skin test before receiving the injection, which means it takes longer to get the procedure, Obagi says. Collagen also doesn’t last as long as other fillers — only up to six months.
Juvederm and Restylane are both made of hyaluronic acid, which is found naturally in the skin. Obagi uses these fillers for the thin skin underneath the eyes, the eyelids, and to lift deeper skin folds around the mouth and nose.
- Pros: You’ll see results right away and they last up to a year. Also, Restylane and Juvederm are liquid and can be mixed with anesthetic, which lowers the risk for bruising, Obagi says. However, Juvederm Ultra Plus, a longer-lasting variant of Juvederm, doesn’t mix well, she says. Because hyaluronic acid is found naturally in the body, it’s rare to have an allergic reaction.
- Cons: Although allergic reactions are rare, patients who have severe allergies, especially people who are allergic to bacterial proteins, shouldn’t use Juvederm. Also, both Juvederm and Restylane can cause some redness, tenderness, swelling, and bruising where they’re injected, but those side effects are temporary.
Radiesse and Sculptra
Radiesse and Sculptra are both made of calcium hydroxylapatite and are good for increasing volume. Once they’re injected, your body produces collagen around the molecules. These choices are better for filling in larger areas, such as cheeks, Obagi says.
- Pros: Results last up to two years and there’s a very low risk of an allergic reaction.
- Cons: It takes time for the body to produce the collagen around the fillers, so it may take a few months to get the full effect and see the final result, Obagi says. Both of these fillers can cause lumps, which is why Obagi doesn’t use them for the thin skin under the eye. Sculptra may also cause redness and bruising.
Choose an Experienced Doctor
When a trained doctor injects fillers, you’ll rarely see an allergic reaction and infection shouldn’t be an issue, Obagi says. So it’s important to find a plastic surgeon who has a good reputation for doing the work, even though that may mean paying more for that expertise.
As you research doctors, be sure to ask what dermal fillers they use, what their experience with the fillers is, and what their other patients say after they’ve been treated with the fillers, Obagi says. Getting the answers to those questions and going to a trained surgeon will give you the best results.