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Hyaluronic Acid Fillers: What goes where?

by: Holly Buchko, RN, BSN, MSN, ANP

There are lots of different companies that make lots of different hyaluronic acid (HA) fillers available on the market. This leaves many people confused about which product goes where, which product is the best fit for them , and how long it will last.

As I tell patients everyday, one of the first things to consider when choosing a filler is to consider the consistency of the hyaluronic acid gel and the anatomical region of the face where the product is to be used. Multiple companies make different fillers that range in consistencies, from what we like to call “Jelly” and all the way up to “Peanut Butter” type consistencies.  Jelly-like products are considered softer and lighter; peanut butter-like products are much firmer and more robust.

How does hyaluronic acid work? When the HA gel is injected, it immediately works to soften fine lines and restore facial volume in areas where fat, collagen and even bone structure are lost. Yes, that’s the bad news my friends; the face begins to sag and fall with age due to depletion of all of the above, and, oh yeah, gravity.

Several days to a week after the filler is placed, the product begins to soften by pulling in water from the surrounding tissues. This makes the product become more like the consistency of gelatin. During its life span, the product not only works to restore volume, but it also hydrates the skin from within. As your body breaks down the HA gel, it leaves behind a little extra collagen. Many scientists and injectors believe you will always age a little bit better with the use of HA fillers for these reasons.

Lighter Fillers:  Belotero, Juvederm XC & Restylane Silk

First, let’s talk about the ‘jelly’ HA fillers. HA fillers that are light and elegant do more to soften and meld right into the tissue, which makes the gel feel very soft and natural within a few days. These products are ideal to treat an area where filler is placed more superficially, or where you may be able to see or feel the product firmness. Ideal locations include the lips, fine lines around the lips, and under the eyes. These products are also ideal for someone with very fair skin or thinner skinned patients. Examples of lighter jelly like products include Belotero, Juvederm XC, and Restylane Silk. The downside to the lighter more elegant consistency is that your body will break down the filler a bit faster, resulting in less longevity. Typical duration of these fillers ranges from 6 months up to 1 year.

Thicker Fillers:  Juvederm Ultra Plus XC, Juvederm Voluma & Perlane

The thicker, more robust hyaluronic acid fillers are made to give the tissue more lift and are great for restoring lots of volume with less product. These thicker products are typically used in deeper plains in the skin. They are definitely a better fit for use in regions of the face where the product is put deeper and there is less chance of feeling firmness. These products will also pull in water and soften with time, but they are likely to feel a little firm for the first week or two. A great area to use this product is in the cheeks and outer periphery of the face. Naturally, with age and gravity, the cheek fat pad begins to fall and cause sagging in the lower face, and the cheekbone itself loses volume and structure. Other common areas to use a thicker gel include the deeper layers of the nasolabial folds and chin. Examples of ‘peanut butter’ products include Juvederm Ultra Plus XC, Perlane, and the newer Juvederm Voluma. When placed in the periphery of the face, you will find most HA fillers last longer due to the innate structure and strength of the overlying muscles, which results in slower degradation of the filler. Most HA fillers will last 1 year, and Voluma has an even longer lifespan, which is typically 2 years.

All of that being said, be sure to do your research about different products and HA fillers, but it is always best to discuss with your provider. If you have any questions or would like more information, feel free to come in for a complimentary consultation at Skin by Lovely.

Find out more about Hyaluronic Acid Fillers and our Topical Hyaluronic Acid product in the video below:

File Under:Anti-Aging, Belotero, Dermal Fillers, Juvederm, Lip Enhancement, Perlane, Restylane

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