Overall, the most versatile, long lasting, and effective filler currently is Juvederm. I like it because it comes in two concentrations, Ultra and Ultra Plus, that can be used for finer or deeper lines. After injection, this product has excellent longevity (upwards of 6 months), is soft and supple, and causes minimal skin reaction. It can be used anywhere, including the lips, and, worst case scenario, it can be dissolved with hyaluronidase.
Radiesse is an excellent choice for deep nasolabial folds, for ‘non-surgical’ rhinoplasty, and for deep injection augmentation of the cheeks and chin. It is unpredictable in the infraorbital region and definitely should not be injected in the lips.
Restylane is equally as versatile as Juvederm, with great short-term results, but perhaps only 10% of my patients still have results after 4 – 6 months. It generally lasts only 1 – 2 months in the lips.
For permanent results, Artefill is the one and only choice. Presently, I am using it only in the nasolabial folds and marionette lines, but with excellent results.
Sculptra stimulates collagen production, resulting in filling and overall volume restoration / augmentation over time (and requiring 3 – 5 injection sessions spaced 4 – 6 weeks apart). It is not a traditional, ‘what you inject is what you get’, filler. It works best for patients with criss-cross crepey wrinkles and diffuse lower face hollowing.
Juvederm or Restylane in combination with a very low dose of Botox works well for fine vertical lines extending from the lips, although CO2 laser resurfacing really works best.
