Today’s dermal filler options continue to grow with new products, new indications and new FDA approvals. Here’s what to know about the latest in the world of fillers.
Although they all fall under the umbrella of “filler,” not all injectables work the same. Each product has its own unique characteristics— from what they’re made of and how long they last, to where you can place them—and there’s a lot to know about each one and how they address specific facial concerns.
The First FDA-Approved Under-Eye Filler
While under-eye filler has been available off-label for years, there hasn’t been an FDA-approved product for use in that area until now, and Juvéderm Volbella gets the honor of being the first. “There are a handful of fillers we’ve been using off-label to treat the under-eye area, but this is the first one to be approved by the FDA,” says New York dermatologist Marina Peredo, MD. “It is highly cross-linked, so patients should know there is a risk of nodules forming.
Be sure to consult with your expert injector on what will work best for you.” The under-eyes are considered an injectable “danger zone” due to the risk of vascular occlusion, which happens when dermal filler is either injected into an artery or around an artery to the point that the blood flow is reduced or completely stopped. “Tear troughs are an advanced area for treatment, and you must see an expert injector with ample experience to avoid getting blue discoloration called the Tyndall effect, puffiness or other undesired results,” explains Campbell, CA dermatologist Amelia K. Hausauer, MD. “If you find a boardcertified aesthetic doctor or another highly credentialed provider who is familiar with this region, you can achieve the most elegant and refreshed results.”
Sculptra’s New Label
The new label approved by the U.S. Food and Drug Administration includes higher dilution, the addition of immediate use reconstitution, new injection techniques and the optional addition of lidocaine. These changes provide aesthetic injectors with even more options to administer Sculptra safely and effectively
“Sculptra is a non-dissolvable filler made of poly-L-lactic acid, which is a substance similar to that of dissolvable sutures that works to amplify the body’s own collagen production mechanisms,” explains Dr. Hausauer. These changes occur over six to 12 weeks and may require several sessions, but by placing stimulatory filler under the skin, it can slowly improve tone and texture.
“While we are excited for this development, we have used Sculptra Aesthetic off-label for full facial contouring for more than a decade,” adds New York and Naples, FL oculoplastic surgeon Irene Gladstein, MD. “We love working with collagen stimulants—they are the future of nonsurgical aesthetics.”
There are a handful of fillers we’ve been using off-label to treat the under-eye area, but this is the first one to be approved by the FDA.” — Dr. Marina Peredo
Long-lasting Radiesse is made of calcium hydroxyapatite gel that can last from a year to 18 months in the body. A new companion filler Radiesse (+) is now available with a slight difference than the original. “Radiesse is approved to treat deep wrinkles, like nasolabial folds, and the newly approved Radiesse (+), which comes with lidocaine, is best suited for use along the jawline,” says Dr. Hausauer. “Just as collagen declines over time, we also lose bone mass, including in the jawline and chin, meaning the tablecloth, or our skin, can become too large for the table or the bone structure. While I do like using robust hyaluronic acid fillers, it makes sense to build back and contour the jawline with a calcium-based filler, as it is stiff enough to look natural and also has biostimulatory effects, which amplify the body’s production of collagen and elastin.”
RHA Redensity for Lip Lines
Adding to the group of popular lip enhancement options is RHA Redensity, the latest FDA-approved treatment for perioral rhytides, or lip lines, with results lasting up to a year. “I love the RHA collection of fillers,” says Dr. Peredo. “I typically use RHA 2 for lip lines, but the newly approved Redensity will be better suited for this. The company is also changing the syringe design to make for better application.” Expect RHA Redensity to be available at doctors’ offices during the second half of this year.
“This is a good product to smooth the barcode lines around the lips,” adds West Palm Beach, FL dermatologist Kenneth Beer, MD. “It has a nice duration, it’s soft and it looks natural.”
Skin Boosters Arrive Stateside
Popular overseas, highly anticipated skin boosters are finally stateside, and Allergan’s new SkinV and Profile are pending FDA-approval. “Skin boosters are not concentrated, very thin and many times will have vitamins added,” says Dr. Beer. “They’re not meant for anything except stimulating collagen. They don’t fill, lift or sculpt. They just boost the appearance of the skin.”
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