Wrinkles, Expression Lines and Folds

Restoration of Wrinkles and Volume

Which Filling Is Best for Me?

Wow! This is a common question in my eight years of clinical practice. Patients hear so much business advertising, friend recommendations, and information on the Internet that it becomes very difficult for them to classify all the contradictory information. I really try to make it easier for my patients, giving them the next scenario when choosing a filler that’s right for them.

* There are three main factors to consider when choosing a filler for lines, creases, wrinkles or volume:

  1. Security
  2. Results
  3. Longevity

Now, it’s simple, right? Almost so easy, but this is where we look at several other factors, the most important of which is what your doctor recommends based on the area you are choosing to improve with a filler. Some fillings are better for certain areas!

Here is my opinion, based on the following credentials to make these recommendations:

  1. I have performed more than 5,000 injections with multiple fillers in recent years.
  2. I have served as part of the school of education chosen by several of these large fillers companies.
  3. I constantly attend meetings and review studies involving product comparisons. NOTE: (like most doctors) I ONLY give credibility to studies that are done by independent physicians who are not paid for by large corporations that sell the products themselves.

The most popular FDA-approved fillers in the USA are Restylane, Juvederm, Radiesse and Sculptra. Here are some important notes about these products for my patients:

Voluma XC:

This is an exciting new hyaluronic acid filler that is exclusively used to get a durable volume replacement in the cheek area. Volume effects last up to 2 years! While Juvederm XC is for lines, wrinkles and folds, Voluma is entirely for rebuilding egg areas where fat or tissue has been lost.

  • Surprising substitute for lost fat on the face
  • Proven duration of up to 2 years
  • It is possible to return to normal activities in 24 hours

Tratamiento para combatir Arrugas, Líneas de Expresión y Pliegues

Restylane and Juvederm

  • I present these together because they are both called Hyaluronic Acid (HA) and are actually very similar (despite what the company and my patients say).
  • For every patient I have who prefers Restylane, I have another one who prefers Juvederm.
  • Both last from 4 to 8 months…. but wait, there’s more! These fillers last longer and longer after repeated injections. It is quite surprising but this is my experience: the first time, 3 to 5 months, but after the second and third injection the product can remain visible and keep the patient happy for up to a year.
  • Uses: labs, thin lines and wrinkles, eye bags.


  • Compuesto de hidroxiapatita de calcio
  • Dura mucho más. Los pacientes generalmente están muy felices con el producto por un año o más (de 10 a 18 meses en promedio).
  • Usos: un compuesto viscoso y grueso (más que Restylane y Juvederm) y por ende usado para los pliegues cerca de la nariz y como REEMPLAZO DE VOLUMEN.
  • En mi opinión este producto permite que los fisiólogos aumente realmente y mejoren el rostro y obtengan los resultados de un levantamiento facial líquido. El VOLUMEN es la clave para un look juvenil.
  • Usos: podemos usar Radiesse en todo el cuerpo! Incluyendo un sorprendente efecto en la parte trasera de las manos.


  • Ácido Poly-L-lactico
  • Realmente no es un nuevo compuesto. Fue formulado por años en Europa como “New Fill”.
  • Un relleno para volumen, no es realmente usado para rellenar arrugas y pliegues. Por tanto usamos este como usamos el Radiesse, para reemplazar volumen o perdida de grasa en el rostro.
  • Este procedimiento usa un proceso un tanto diferente. Sculptra viene en un cristal (polvo seco)
    This procedure uses a slightly different process. Sculptra comes in forma de crystal (dry powder) entonces agregamos agua para hacerlo líquido y aplicarlo.
  • El volumen de agua inicial rápidamente desaparece y luego esperamos 1 mes mientras estos cristales adquieren volumen (tu cuerpo crea colágeno alrededor de ellos).
  • Entonces el proceso con Sculptra es: 1. Inyectar 2. Esperar un mes 3. Re-evaluar.


Restylane Radiesse (antes Radiance FN) Juvederm
Composición: Ácido Hialurónico Hidroxiapatita de Calcio Ácido Hialurónico
Anestesia usada: Sólo local o tópica Sólo local o tópica Sólo local o tópica
Tiempo de Recuperación? No Not Typical No
Reacciones alérgicas Muy raras Muy raras Muy raras
Cuánto dura? 3-8 meses 1-3 años 3-8 meses