Often times, patients question which ancillary procedure is best for improving facial wrinkles/lines. The answer depends on the nature of the facial wrinkle that is in question.
Broadly speaking, facial lines either are static or dynamic. Static lines would include those that are present in complete rest, i.e. - without any animation. Examples of these would include, nasolabial folds, marionette lines, prior acne scars, as well as some deep frown furrows, forehead wrinkles, and crows feet lines that are present at rest (the last three can be exacerbated by animation, though).
Dynamic lines are those produced during facial animation - as true of crows feet, forehead lines, and glabellar (frown) lines. Dynamic lines are largely produced by the contraction of the underlying muscles, which in turn, "wrinkles" the overlying skin.
As discussed elsewhere, Botox cosmetic is an excellent option for dynamic lines, as it addresses the etiology - i.e. the underlying muscle. By paralyzing the muscle, one is not able to contract it, thereby overlying skin is spared of associated wrinkling.
Facial fillers, whether they be Juvederm, Restylane, Catique, Hylaform, Collagen, etc, etc, etc... - as there are literally countless many more - are used for, as the category indicates, "filling" in facial lines/wrinkles/folds. But realize that if the line is caused by the underlying muscle, then simply "filling" in the line is inadequate, as it is not addressing the etiology.
Also, it should be evident that the reason why there exists countless number of facial fillers is because no one filler is clearly the "best" for all situations. After all, if one was the "best" - why would there be a need for so many others? In general, most facial fillers are all temporary, and bring about an improvement in deeper lines, folds, or wrinkles. Most facial fillers come prefilled in a 1cc syringe, and depending on the line treated and degree of correction desired, may require more than one syringe.
Several other uses of facial fillers include:
- Lip augmentation - All of us have our own bias in regards to our "favorite" filler for this purpose. I personally like to use a different filler depending on the desired outcome - are we striving to DEFINE THE LIP OR TO VOLUMIZE THE LIP? For lip definition, I personally still like to use collagen, as I feel it is more precise in its delivery, but for lip volume, I utilize one of the hylauronic acids (Juvederm, Restylane, etc).
- Facial fillers can also be used to fill in the "lower eye bags" as well. For this area, I prefer the softer hylauronic acid gel fillers - they may last less, but for this area with thin skin, it looks and feels better. Once again, this is just my own preference, and not point of right or wrong.
The field of facial fillers are constantly coming up with new products, so ask your local health professional about it. Ideally, the day when one filler is more durable (i.e. more permanent), soft, and cost efficient will be the day when further fillers will not fill the 5 o'clock news as the "latest" and the "best."
