Best Facial Filler for Those over 65?

For the lines of the lips, I like Juvederm. It lasts for up to 1 year. For the deep naso-labial depressions between the nostril and the corner of the mouth, I like Radiesse. It lasts for up to 18 months. The only problem I have had with either is bruising. I think your mom will be very pleased with the results and the minimum downtime (if any).

Hi FacCheckers,

For patients over 60 I like to use Radiesse as a filler in the nasolabial folds. The cheeks should be injected with Radiesse first to add volume to the face. This will "lift" the nasolabial folds, and less product will be required to fill the fold. Radiesse should not be used in the lips; we prefer Juviderm or Restylane in the lip area.

I believe that when used properly, Sculptra is another product that will add volume to the face of elderly patients. I must emphasize that the product is very user sensitive and the technique must be done precisely. Sculptra has been associated with adverse complications in the past when used improperly. As the injection protocols are worked out and followed, I believe that Sculptra will become a most popular filler in the next 5-10 years.

I have found that fat transfer works best in patients younger than 65.

Happy Valentine's Day (and Mother's Day as well).

Dr. P

FacCheckers,

There are many very good fill options on the market today, and their ease and simplicity make them attractive to patients. The age of 65 is relative today, as some will have very good skin tone, texture and thickness. Along the aging curve, we do experience thinning of the skin and fatty layer of the skin, loss of muscle support, and even subtle bone loss. Indeed the face changes on many levels.

Fillers, such as Juvederm, are effective in plumping the layer just under the skin called the dermis. They can fill folds or smile lines, and smooth fine lines in the lip. The skin must have reasonable firmness and elasticity, especially in the folds for results to show. In thinned skin that is loose and lax, the fill can become palpable, or even visible in larger volumes and be a poorer choice.

An alternative to fill materials is structural fat grafting. With this technique, small amounts of fat are harvested elsewhere, often abdomen and hip, and prepared for retransfer into needed areas as small droplet grafts which can build up and restore tissue, which is thinned and aged.

Larger volumes are available than in typical filler treatments. The tissue is softer, blends well and potentially carries stem cells to repair aged and damaged area, cheek or lip. In an individual who is further along the aging curve, this softer fill may be a better choice than an off the shelf filler.

Just to mention Botox, when patients have aged significantly, Botox may not be a good choice as well because it will be ineffective on the accumulated static lines developed over time. Botox is perfect for dynamic lines.

Best of luck!