May 12, 2016

Fillers Up! Synergistic Use of Fillers

Editorial Voice
Fillers Up! Synergistic Use of Fillers - ZALEA Article Banner

In 2013, BOTOX injections reigned supreme as the most commonly performed non-surgical procedure among women, followed by hyaluronic acid (HA) injections, according to the annual survey of the American Academy of Facial Plastic and Reconstructive Surgery. BOTOX and HA-based fillers also topped the list of the most popular procedures for men.

"Advanced techniques with fillers and toxins provide patients with a short term alternative to cosmetic surgery, as well as an ideal way to enhance the results of surgical procedures such as facelifts," said Edward Farrior, MD, FACS, AAFPRS President. "Facial plastic surgeons are using combinations of fillers to safely treat lines and wrinkles, but also to plump and define lips, fill hollow areas on the face and lower eyelids, and lift the cheek area. The results can be subtle or dramatic, depending on the patient's goals and the fillers used, and can last from six months to several years."

In addition to the spectrum of products available -including Restylane, Perlane, Sculptra Aesthetics, Radiesse, Juvederm and ArteFill - fat grafting is holding its own as the volumizer of choice for many facial plastic surgeons. The filler pipeline is also robust with several new injectables.

Among those expected to receive approval from the Food and Drug Administration (FDA) in the not-too-distant future are two more hyaluronic acid gel fillers; Emervel from Galderma and Teosyal from Teoxane Laboratories.

On the toxin side, Revance Therapeutics is on the road to developing the first topical non-injectable botulinum toxin.

In 2013, we saw two blockbusters earn FDA clearance. The approval of Merz Aesthetics' Belotero Balance offered facial plastic surgeons a safe and effective choice for filling in fine lines and areas around the mouth and eyes. Allergan's Juvederm Voluma ushered in a new era in the filler revolution as the first designer or site-specific filler to hit the US. It volumizes (as the name suggests) the mid-face or cheek region. Other designer fillers, some already available in Europe, may also make their way to the US.

The most recent filler to receive the FDA's nod in 2014 is Restylane Silk for lip plumping and filling lip lines. It includes lidocaine to minimize the sting from lip injections.

"The two most popular areas for fillers requested by patients are undoubtedly the nasolabial folds or nose to mouth creases, and the lips. As we age, the lips thin out and the border of the lips tends to flatten and lose their attractive contour. By adding a subtle amount of hyaluronic acid or other substance, we can restore definition and a youthful appearance around the mouth and the lips," said Edwin Williams, MD, FACS, Group Vice President for Public and Regulatory Affairs for the AAFPRS.

This original article appears exclusively on

Editorial Voice
Mark B. Taylor, M.D. for the Editorial Voice - ZALEA Mark B. Taylor, M.D.

Every medical society has an interest in making their physician members look ‘good’ in the eye of the reader.  While plastic and facial plastic societies have contributed an enormous amount of credible information to the literature in terms of face lifting and other surgical options, it is the dermatologists who have been very much at the forefront of research, development and use of both neurotoxins and fillers. Thirty years ago, we dermatologists all remember performing the early collagen filler clinical research, at a time when our plastic and facial plastic surgeons as a group are somewhat new to the game. However, the beauty of these fillers and toxins is that all aesthetic physicians can now benefit from their development in order to give our patients the rejuvenation they desire. The social and economics of ‘looking your best’ have never been so important as in today’s world.

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