When we are talking about “injectables” what we are talking about are substances that can be purchased in a vial and placed into the face in different layers to soften a groove, enhance the lips or even “revolumize” and “reshape” the face. There exists a large variety of these substances and each has a particular characteristic which makes it ideal for certain areas and uses. I will not go into depth on all the available injectables – that would be way more than you would want to read- but I will give a few examples of what we like and use often. We will discuss the specific characteristics that make those particular injectables unique and preferred over the others.

Let’s start with the lips – this area is very important to treat with a substance that is soft and feels natural. We prefer juvederm^® for the lips because it is a soft, very silky injection that can be used to fill in the lips and perioral wrinkles. If you kissed someone with juvederm^® in the lips it would feel natural. We usually get an effect that lasts 9-12 months. I advise against use of permanent implants in the lips as these often look and feel unnatural. Juvederm^® is a hyaluronic agent – a substance that is already present in the skin. Hyaluronic fillers remain the most commonly used in the market today.

For the deep creases in the corner of the mouth (“marionette lines”) or the corner of the nose (nasolabial folds) I recommend injection with perlane^®, Perlane^® is a hyaluronic filler like Juvederm^® however it is thicker and has more lifting power. In these areas the effect with full correction typically lasts one year. I would note that recently we are decreasing the amount we use in these folds as we first want to re establish the youthful heart shape to the face by building up the cheeks and the malar region. Once we have accomplished this then we will fill the nasolabial or melolabial folds. With volumization of the midface there is typically an improvement in these folds as the lifting action of volumization occurs. For midface volumization we have moved away from fat injection which is very unpredictable towards use of Voluma^® or Artefill^®. Voluma^® is a hyaluronic acid filler similar to juvederm^® and perlane^® but it specifically made for midface volumization. It lasts a full two years. Artefill^® is unique in its ability to volumize the midface and softens the hollows that occur under the eyes. Artefill^® is a very nice substance to work with and it lasts five years. With Voluma^® and Artefill^® we usually inject over 2 or more sessions. We often find that our past facelift patients do not need another facelift at 10 years; rather they need some volumization of the face particularly in the cheek region to get back the nice, youthful appearance they desire.

As always, I invite you to attend one of our monthly seminars where we discuss all of the above and where they fit into options for rejuvenation of the face.