Wrinkle fillers: There is no one clear winner, nor do we want one

In Europe, it has been reported that there are 128 soft tissue fillers available to physicians.  Obviously, this speaks volumes to the point that there is no one filler that stands out so above the others that it is capable of quashing the competition.  In the United States, we have nowhere close to the numbers of soft tissue fillers that are found overseas due to the FDA‘s stringent process of approval.  However, we can expect more to eventually make it into our marketplace. 

Of the soft tissue fillers that are available, I must say that the clinical judgment, talents, and skills of the physician and nurse injectors are as important as the chemical and physical properties of the various soft tissue fillers.   The personal choices of the injector will obviously prevail as to what soft tissue filler he/she chooses in each given clinical setting. There is no one clear winner, nor do we want one.

A good injector (whether nurse or physician) is knowledgeable about all of the various wrinkle fillers currently available and is able to recommend a specific product for a specific area. In addition, more and more injectors are using multiple products and layering them to create a more comprehensive result.

Deep volumization can be addressed using products such as Sculptra or Radiesse, while more superficial contouring can be achieved using Juvederm (Ultra vs. Ultra Plus), Restylane, or Perlane.

Other factors to consider when determining which filler to use include desired amount of downtime, budget, and desired length of effect.