What Is The Best Injectable Filler For Facial Aging?

Q: Dr. Eppley, I read your commentary on another website about ‘shrink wrap lipo’. I appreciated your honesty in regards to that liposuction technique. The issue about it on the Dr.Oz show claiming that it tightens the skin had me wondering the validity of that statement…nice to see that a plastic surgeon gave an honest opinion. What do you think of the benefit of Sculptra versus a filler such as Juvederm for facial aging?

A: In regards to the use of injectable fillers in the treatment of facing aging, they do have a role to play for some patients. However, it is very important to differentiate the various ways in which injectable fillers are used to treat the symptoms of facial aging. That distinction makes a big difference in what type of injectable filler would be most appropriate. I divide injectable facial rejuvenation into two categories; spot and global facial rejuvenation. Spot rejuvenation includes such areas as lip enhancement, softening nasolabial folds, or filling in orbital tear troughs. Given the low volumes of filler needed and sensitivity of the tissues injected, any of the hyaluronic fillers (such as Juvederm) may be used. They are soft, have little risk of any tissue reaction and are completely reversible. There only real differences are in how long they last and how much they cost. Global or volumetric facial rejuvenation is different because it is about adding soft tissue volume to fill out the face, reinflate it to some degree, and create a little bit of a ‘lift’. Given the volumes needed, the hyaluronic fillers are a bit prohibitive because of cost considerations. This is where the role of Sculptra comes in because it is a better ‘volumizer’ based on the way it is administered, works and persists…even though it takes a series of injections to create the desired enhancement effect.

Dr. Barry Eppley

Indianapolis, Indiana