In An Industry Plump with Choices, Basic Knowledge Aids in Smooth Selection Process

By Anita Saluja, MD

The skin aesthetics and anti-aging products available today can often produce incredible results, but navigating the many options can sometimes be stressful enough to cause a new wrinkle or two on its own.

Skin filler treatments are most commonly used to restore facial contours, enhance lips, and decrease the appearance of lines and wrinkles. Fillers are most often injected in the face, but filler injections for hands and the décolletage area are also becoming more common.

How can one decide the right product for the right area or issue? A specialized physician will be best able to guide patients in selecting a specific treatment, but a basic knowledge of the most common products can help start the conversation. It is important to note that all of the following treatments are medical procedures which should be performed under the direction of a specialized physician.


Juvederm XC

Juvederm XC is a smooth gel filler made of hyaluronic acid (HA), a naturally occurring substance that functions like a sponge to absorb water in the skin and therefore acts like the body’s internal moisturizer.  Once injected into the skin, the HA in Juvederm adds volume immediately. It is best used in the lines around the nose and mouth and can last up to one year.

Because Juvederm is infused with lidocaine, discomfort from the injections is usually not an issue. The most common side effects are temporary and can include redness, pain/tenderness, firmness, swelling, lumps/bumps, bruising, itching and discoloration; infection is rare.


Approved for lip enhancement, Restylane is ideal for someone whose lips may not be as full as desired, whose lip border is not as defined as desired, or who has lips that appear disproportionate.  While everyone’s ideal lip shape and size is different, the average upper lip comprises approximately 40 percent and the bottom lip about 60 percent of the smile.

For those who have a history of facial cold sores, medications may be required prior to Restylane lip treatment to reduce the risk of cold sore recurrence.

Restylane also can be used under the eye, in the tear troughs, to alleviate dark or hollow circles.

Side effects are the same as described above. Both Juvederm and Restylane are 100 percent reversible with the use of a reversing agent.


Radiesse is a rather thick filler made out of smooth calcium hydroxylapatite, a natural component of bone, which is suspended in gel. The filler provides immediate results when injected and over time, the patient’s own skin cells grow around the gel to stimulate collagen. This results in corrections that often last a year or more until the product is absorbed by the body.  Radiesse is often injected deeper into the skin and behaves almost like an “implant” to enhance cheeks, enhance the chin, lift jowls, lift corners of the mouth, and fine tune the nose.  Radiesse injections also are used to smooth the look of aging hands. Because of its thickness, temporary bruising, bumps, and swelling are more common.


Sculptra Aesthetic is a “game changer” in nonsurgical approaches to facial shaping and lifting. It has been available for injection since 1999, but the treatment process has greatly improved since it first came to market. There are no other injectables or non-surgical devices that work quite like it.

Because Sculptra acts as a catalyst for collagen production, the improvements seen by patients are not those of a fillern but are from their own natural collagen.  The end results are gradual and can take 12 to 16 weeks to fully see, but they are also long lasting.

The product is ideal for those who may have what is sometimes referred to as “facial deflation,” whose face seems unbalanced or older looking than desired, or for those who simply want to be proactive in prevention of facial aging. Sculptra is considered more challenging to inject properly so there is an added risk of side effects such as skin bumps.

Fillers are becoming more and more popular as a proactive way to slow down the aging process.

Using multiple skin fillers in the same treatment session can produce even better effects as multiple layers and areas of the skin can be improved at the same time.

If you are looking for an enhanced look with skin fillers, plan ahead.

Ideally, for best results, you need treatment at least 2 weeks before an important event.

Anita Saluja, MD is a board certified dermatologist practicing with MIMA since 2001. Dr. Saluja and her team can be reached at (321)757-5141 or