Restylane and Radiesse are fillers used for softening the appearance of wrinkles and adding back lost volume in the ares around the mouth. Each has distinct advantages:
1. Restylane works very well for wrinkles and small concavities around the mouth. You can also stiffen the areas which are sagging slightly. I like the fact that in the unusual circumstance that a patient gets a lump, I can easily dissolve it with one injection of hyaluronidase.
2. Radiesse has the advantage of lasting longer, but must be injected more deeply to avoid visibility, so it is not as useful for fine wrinkles. It does work well for adding volume and for the nasolabial folds. The safety margin is less because it can't be dissolved once injected, but lumps are unlikely because of its smooth consistency.
3. Sculptra is excellent for adding volume to the face and camouflaging mild sagging. It helps refill the skin envelope of the face and replace what the missing volume. Adding volume to the cheeks almost always improves facial aging because so often this youthful volume is missing.
4. Cheeklift - Sometimes if you have loose skin around the mouth, you would be best served by a procedure to tighten this skin. A cheeklift is a medium-small procedure that will give you 7-10 years of improvement and probably cost less in the long run than repeated injections of the fillers. If you were to add up the amount of time you will be bruised after injections over the next 7 - 10 years the downtime is probably similar also. So don't exclude surgery just because of cost or down time. With a cheeklift both downtime and costs may be less overall.
See a board certified Plastic Surgeon who can offer all of the options to find out what you really need. I see patients frequently who need only fillers to correct mild sagging around the mouth. Unfortunately, I also see patients who were given tons of fillers by other doctors and are unhappy, because they really always needed a cheeklift or facelift. Remember, if you go to a doctor who only offers fillers, thats what you are probably going to get whether it is the best procedure for you or not.