What is the Best Dermal Filler for Anti-aging?

Looking for doctor recomendation of best injectable fillers (dermal filler or wrinkle filler) for face restoration/ anti-aging.  E.g. Perlane, Radiesse, Juvederm, Restylane

Doctor Answers 11

Fat Injections: The Safest Permanent Dermal Filler

Structural Fat Grafting: permanently restoring youthful facial contours. A number of 'soft tissue fillers' are available for temporarily improving facial areas that have lost volume or have developed deep lines and creases. Probably the most popular fillers currently are hyaluronic acid products like Restylane, Perlane or Juvederm which can be used to plump up thin lips and to fill out nasolabial folds (lines that run from beside the nostrils to the area beside the corners of the mouth) and marionette lines (lines that run from the corners of the mouth towards the jawline). The improvement generally lasts four to six months.

Some synthetic materials are available which can be used in an attempt to produce a permanent soft tissue augmentation. Unfortunately, the body treats such materials as foreign objects, and as a result the placement of synthetic materials may lead to inflammation, infection, migration and granuloma formation. In general, synthetic materials are less likely to produce a result that looks and feels natural.

For patients seeking permanent enhancement of soft tissue volume, the ideal material to use would obviously be something that is naturally-occurring and not rejected by the body or treated by the immune system as a foreign material. Whether the goal is to restore volume to an area such as the lips or the cheeks, or to fill in a crease or depression such as the nasolabial folds or marionette lines, the ideal material is quite clearly the material that one wishes was there in greater abundance in the first place: YOUR OWN FAT.

A relatively new technique has been developed called structural fat grafting, in which small amounts (less than 0.1 cc at a time) of fat are carefully microinjected in a series of discrete layers to gradually 'build' new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist. If this process of blood vessel ingrowth (neovascularization) does not occur, then the injected tissue cannot truly be considered a 'graft' and is instead just another 'soft tissue filler' of limited duration.

This is a procedure that requires specialized training and specialized surgical instruments, as well as patience and attention to detail on the part of the surgeon. When performed properly, permanent improvements in facial plastic surgery are possible. If enough fat resorption occurs following a fat grafting procedure such that the desired result is not achieved, a second 'touch-up' procedure can easily be performed to augment the result obtained from the first injection.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 120 reviews

Best dermal filler depends on the problem

There are many types of fillers on the market, which all seem to be effective for different regions of the face depending on each individual's goal. It is best to make a consultation with a facial plastic surgeon who is familiar with all the options and can provide you with a sound recommendation. Using more than one type of filler often gives much better results. I hope you find this helpful.

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 144 reviews

Best Dermal Filler for Anti-aging

We are truly fortunate to have a variety of fantastic fillers at our disposal.  The above being said, there is no single best dermal filler out there as dermal filler choice is dependant on patients' constitution, needs and goals as well skill of injector.  It is best to have thorough assessment with an expert injector.  All the best.

Praven Chetty, MD
Kelowna Physician
5.0 out of 5 stars 9 reviews

Injectable Fillers

Thank you for your question about which is the dermal filler for anti-aging. 
There are many different types and brands of injectable fillers. Some are made for increasing volume in a portion of the face (Voluma and Restylane Lyft) which will aid in softening lines in other areas of the face, others are for smoothing or "filling" lines (Juvederm Ultra/Ultra Plus, Restylane). There are many ways to use fillers in the face to achieve a youthful and natural appearance.

To achieve the results you are looking for, see two or more experienced, licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 183 reviews

Without An Exam- It's tough to recommend surgical or non-surgical options.

It’s not unusual for patients with facial aging to request plastic surgical consultation. Under these circumstances, a variety of surgical and non-surgical options are available for treating this problem.
The type of treatment recommended is entirely dependent upon the patient’s physical findings and aesthetic goals. In your case, it’s virtually impossible to make a recommendation without pictures or a physical examination.
Assuming you’re a good candidate for dermal fillers a large variety of injectable filler options exist. In most cases we prefer hyalronicacid fillers such as Juvederm and Restylane.
When patients are happy with this approach, patients often seek a more permanent solution. In this situation autologous fat and Radiesse are good choices.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Fillers vary based on your goals

Thank you for your question about the best dermal filler for anti-aging. I’m often asked this question in my practice and the answer can vary based on your goals. Every patient’s anatomy and needs can differ. Overall, I like using a combination of dermal fillers and Botox to achieve the best result. Hylauronic Acid (HA) dermal fillers like Restylane and Juvederm Voluma are reversible that allow patients control and correction to achieve their best results.

Many times the tear trough (under eye area) shows the first-signs of aging. I like to treat that area with Restylane. If you are noticing frown lines, Botox can help refresh that area, along with crow’s feet
or other vertical lines on the forehead. To address jowling or creases in the nasolabial folds, I like using Juvederm Voluma for it’s lifting and projection capacity.

David C. Mabrie, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 112 reviews

Best Dermal Filler for Anti-Aging

There is no one best dermal filler for anti-aging.  The best filler for a particular patient depends on the depth of the wrinkle, location and the facial anatomy of the patient.  There is a great deal of artistry that goes along with cosmetic facial injections.  What is more important is the technique of the dermatologist who is performing these cosmetic injections.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

Use these for a quick fix.

For a temporary fix, popular treatments are dermal fillers such as Restylane, Juvederm, Radiesse and Artefill. There are others as well, and which you use will depend entirely on the area you would like treated, and the overall objectives you’re looking for.

These objectives should be discussed with a Board Certified Plastic Surgeon, well versed in the art of using fillers. From there you can decide the best course of action to suit your unique needs, and treatments can usually be done in office, with effects lasting anywhere from 4-6 months.

Scott W. Mosser, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 9 reviews

Juvederm is number one

According to the numbers Juvederm(Allergan), is the number one filler used in the world. The hyaluronic acid fillers are very popular for office use, because of their ease of use, patients generally tolerate them well, and they can be reversed.

 For larger volumes fat transfer is a great treatment. I perform this procedure in the operating room.

Brian Maloney, MD, FACS
Atlanta Facial Plastic Surgeon
4.7 out of 5 stars 30 reviews

The best dermal filler is the one which gives you the...

The best dermal filler is the one which gives you the results that you are looking for.

In determining the best filler to use, several things must be taken into account:

  • Location: Not all dermal fillers can be used in all locations on the face. All fillers have some FDA indication. While off-label uses can be performed, some fillers are even restricted by the manufacturer for use in some areas.
  • Longevity: Not all fillers last the same amount of time. In addition, not all fillers last the same amount of time in all areas. I have found that in high motion areas such as the lips, fillers tend to last less time than they do in other areas.
  • Patient goals: For my patients who have not had facial fillers before, I suggest a hyaluronic acid filler. These are good for most areas of the face and the best part is that they can be removed with an injectible substance called hyaluronidase. In this way, even if the patient cannot tolerate the injected material for one reason or another, I can easily remove it and the patient does not have to live with the material until it dissipates.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.