As everyone knows, more and more patients are looking to physicians to help them achieve a more youthful appearance. One of the cornerstones of facial rejuvenation is the use of dermal fillers. By selecting and using the correct dermal filling agent, folds can be softened, lines and wrinkles made much less noticeable, and the face sculpted in such a way that the face looks much more youthful. In this newsletter, we will review the most commonly used dermal fillers so that our patients are better informed regarding how these materials are used.


Juvederm and Restylane


Juvederm and Restylane are very similar products containing hyaluronic acid as the filling agent. The hyaluronic acid is produced under controlled laboratory conditions, does not use any animal or human sources, and is chemically identical to the hyaluronic acid found in humans. For this reason, no allergy testing is needed. The hyaluronic acid in Juvederm and Restylane, in addition to acting as a filling agent, has also been shown to stimulate new collagen formation.


Juvederm and Restylane are used to treat mild to moderate lines and wrinkles, improve skin folds, and augment the lips. After injection, Juvederm and Restylane will last for five to six months.


Perlane and Juvederm Ultra Plus


Perlane and Juvederm Ultra Plus are very similar dermal fillers that, like Juvederm and Restylane, also contain hyaluronic acid produced under controlled laboratory conditions without using any animal or human sources. Again, since every human being has hyaluronic acid in his or her skin, no allergy testing is needed prior to using these fillers. The hyaluronic acid gel particles in Perlane and in Juvederm Ultra Plus are larger than the gel particles in Juvederm or in Restylane. This gives these dermal fillers enhanced lifting power, allowing them to easily fill deeper lines, wrinkles, creases, and folds. For this reason, Perlane and Juvederm Ultra Plus are ideal fillers for the correction of moderate to more severe facial wrinkles and folds, with Juvederm and Restylane used for the shallower wrinkles and folds. After their placement in the skin, Perlane and Juvederm Ultra Plus will provide correction for approximately 6 months.



Cosmoderm is a dermal filler that contains human collagen. The collagen is grown under controlled laboratory conditions. Because the collagen in Cosmoderm is chemically identical to natural human collagen, no allergy testing is needed prior to use. Cosmoderm is used to soften superficial and mild lines and wrinkles, and to augment the lips. After placement, it will last for three or four months. Cosmoderm is unique in that it is the filler that can be safely placed closest to the skin surface.




Radiesse is composed of microspheres of calcium hydroxylapatite suspended in a gel carrier. Calcium hydroxylapatite is completely biocompatible. Again, since calcium hydroxylapatite is found in every human being, no allergy testing is needed. The calcium hydroxylapatite microspheres serve as a lattice into which new collagen grows. Therefore, Radiesse produces its effect not only by acting as a passive filling agent but also by stimulating production of new collagen. Radiesse is injected deeper in the skin than Juvederm and Restylane, and is most commonly used to treat relatively deeper folds and lines. In addition, Radiesse can be used for facial sculpting to augment the cheekbones or jaw line. After injection, Radiesse will last for approximately one year.




Sculptra is poly-L-lactic acid, a material that has been used in absorbable sutures for years. Because lactic acid is a material found in humans, no allergy testing is needed prior to using Sculptra. Sculptra is injected into the deeper layers of the skin. Following its placement, Sculptra stimulates the production of a patient’s own new collagen. It is this new collagen that ultimately produces the improvement in the appearance of the skin that results from Sculptra. Sculptra is used to treat skin creases, wrinkles, depressions, and folds. Generally two or three treatment sessions every four to six weeks are required to obtain the optimum result. After completion of the treatment course, Sculptra results will last for up to two years in most patients. After that, the result can be maintained with minor touch-up treatments.


The currently available filling agents are truly outstanding, with unsurpassed safety and efficacy. When properly used, they provide completely natural appearing facial rejuvenation. Any of our patients who have not tried these fillers before and have an interest in rejuvenating their face are invited to call our office and make an appointment for a cosmetic consultation with either Dr. Amerian or Dr. Anterasian.