When a nonsurgical remedy is needed to improve the appearance of an individual, the subject of fillers arises. Fillers are many and varied. One of the first approved fillers on the market was animal collagen. Collagen is complex protein found in all higher animals, and each species has its own specific type of collagen. Popular for many years as the only filler available, it has now been replaced by safer and more effective materials. The problem with collagen is that, because it is a complex protein, it is also “antigenic”, meaning that it causes an allergic reaction. This alone can create problems, but it also affects the longevity of the filler effect. In other words, collagen injections do not last very long.

In response to these deficiencies, science has developed other materials for the same purpose. At the present time the most popular fillers are the “hyalouronic acid” fillers, such as Restylane®, Restylane Lyft®, Juvederm®, Voluma®. Hyalouronic acid, or HA, is a relatively simple compound that is the main component of “ground substance,” which is the material that nourishes and bathes the cells of our bodies. As such, its main purpose is to humidify our cells.

When injected, HA works by absorbing up to 100x its weight in water. Hence, these fillers really do plump up wrinkles or folds. Also, being a simple compound, it is not “antigenic” and does not produce allergic reactions. As a matter of fact, all living creatures have the same HA. This means that commercial fillers can be reproduced in a lab by growing it from harmless bacteria. This allows for the safe and effective application as a filler in a number of areas.

This also increases the duration of effect, and at present these materials can last up to a year or so. I especially enjoy the use of HA  fillers to shape or enlarge the lips. In this application, no other type of filler comes close, though the advancements in fat transfer techniques may promise to eclipse even the results that come from the use of HA fillers.

Two other fillers that are both safe and effective are Radiesse® and Sculptra®. Both of these are longer-lasting materials with uses specific to that quality. Both must also be used as deeper injections to correct significant contour deformities and are not recommended in superficial injections such as the lips. They can also be used in situations where a more permanent filler such as fat may not be available, such as with a very thin person. While not the same material, both Radiesse® and Sculptra® are used in similar situations.