Question from Manhattan, NY: I have a appointment to add a little bit of filler to my cheek and my doctor suggested using either Restylane of Voluma. I already had Restylane in my tear throughs with great results, but was wondering the difference between the fillers for adding natural volume to the cheek area and if one will give you better results.
Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers:
Great question! The pharmaceutical industry is producing a plethora of wrinkle rejuvenating injectibles and the FDA is approving them for use for different usages.
Restylane and Voluma are a sub-class of skin and soft-tissue injectible fillers using HA. They are made from the same molecule, hyaluronic acid, a normal constituent of the skin which reduces in quality and quantity with aging, photodamage and other medical syndromes. Including Restylane, Perlane, Juvederm Ultra, Juevederm Ultra Plus, Voluma, Belotero and many new-comers, the difference is in the linking bonds which make them thicker to inject and harder to break down by natural skin enzymes. It is this difference which makes them useful for epidermal fine lines, dermal wrinkles and skin folds. They are temporary “volumizers”, in effect “fillers” of the skin or soft tissues for the desired results and lose volume over 6-24 months depending on the amounts and quality of linking and amount of enzyme in your skin. If over-done, hyaluronidase, the same enzyme as in the skin can be used to reduce the fill.
I love Voluma, Juvederm Ultra Plus and Perlane for the fuller “apple” of the cheek and the same for the “Nike Whoosh” of the cheek bone.
Restylane is great for the “crow’s feet” lines not reduced by wrinkle reducers Botox or Dysport.
Other sub-classes of skin and soft-tissue injectibles unable to be reversed include:
- Stimulants such as Sculptra which provide a slow and steady stimulation of dermal molecules such as collagen, hyluronic acid, elastin and others without volumizing. Sculptra firms the skin rather than fill.
- Non-HA temporyary volumizers such as Radiesse which is made of calcium hydroxylapatite originated as a bone filler and is cosmetically used in microspheres to fill dermal lines or as volume.
- Permanent fillers such as Artecoll, Artefill, silicone and others are volumizers and are not fully broken down by the body.
Each fulfills a certain niche in the quest for skin rejuvenation.
Find the most skilled, well experienced injector to guide you through the maze of these and more evolving skin rejuvenation injectibles, procedures, lasers, lights and surgery to achieve your desires.
I hope this was helpful! All the best!
Dr. Dean Kane