Q: Is Restylane Kysse or Juvederm Ultra better? I have had lips done before with just Juvederm. I went to a new practice for a consult and she recommended Kysse. What is the better option? What are the differences?
A: The hyaluronic acid (HA) gel filler wars are on and each generation provides a different character to HA fillers.
- All are dissolvable with hyaluronidase, a natural but synthesized enzyme.
- First generation Restylane (Classic) and Juvederm (Classic and Ultra) provides a medium volume associated with their attraction to water.
- 2nd generation: Restylane Lyft and Juvederm Voluma provide maximum fill and increased projection outwardly. These have been great for deeper cheek volume and large lip fill. My approximation is a 2-3: 1 fill volume.
- 3rd generation HA fillers are more elastic, integrating and bending with the adjacent skin. Both HA families include this type of filler: Galderma’s Restylane (Refyne, Kysse and Defyne); Allergan’s Juvederm (Vollure and Volbella) have different “weights” for different depth lines and folds. I find they fill with a 1:1 ratio.
- 4th generation and new to the US market is Revance RHA (2,3,4) which I find remarkable due to its fluidity and fill of epidermal and dermal crease lines. It is exceedingly useful for lip lines and vermillion skin laxity, forehead and crow’s feet lines, cheek and neck creases.
- If you have lots of radial lines or wish more pout, add a touch of “botox” for a “lip flip” as well.
- If you have thin tight lips, add “botox” and a large volume lip filler like Lyft.
- For down turned lip corners add another cc of Defyne or RHA 3 or 4 for fill and upward push to “turn that frown upside down”.
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This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.
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