Which Filler To Choose

Picking a filler is a very daunting and arduous task, especially for those new to fillers. You have to figure out which filler is best for what you are trying to accomplish, and at the same time make sure the practice is not just picking something expensive for profit’s sake.

At Ageless MD, you don’t have to worry about any of it.

Dr. TJ Tsay is very experienced with all the different filler manufacturers. He’s ranked in the top 250 accounts in the entire country for Allergan, and is one of the top tier accounts for Galderma–makers of the Restylane family of fillers and Sculptra Aesthetics. He is an artist and does not see the face as just a grid or product or laboratory pipet.

Dr. Tsay utilizes all the fillers in different ways to arrive at the look you are trying to achieve. An artist that only uses 2 paintbrushes and 3 colors will never be able to match the creativity of an artist who has a spectrum of colors and a myriad of tools available to use to create his or her masterpiece.

This is where the science of medicine meets with the art of medicine. We will discuss the different parts of the face and which product best suits those needs.

If you were to divide the face into 3 horizontal segments, you would have: Upper Third, Mid Face, and Lower Face.

Upper Third: The upper third of the face includes the forehead and temples, and maybe even the under-eye area or tear trough deformity. The forehead is a source of concern for many individuals, because of the hollows which can give a “neanderthal” look with a prominent brow bone. The temples can also become more hollow after the third decade of life or from other causes such as accelerated weight loss, stress or illness. This can be filled in with a number of different fillers including any of the Juvéderm family of fillers blended with saline or any of the softer Restylane fillers such as Restylane Silk, Restylane-L, or Restylane Refyne. Sculptra Aesthetics, as well as autologous (from your own body) fat transfer, can also be used to fill these areas for a longer lasting and more natural result.

The tear trough or under eye hollows (also called “dark circles” or “eye bags”) is a very delicate area that needs special attention. This area is one of the most satisfying areas to treat. Eye contact is the most primal and immediate form of communication. When you meet someone for the first time, the other person usually looks at your eyes and the areas immediately surrounding it. Dr. Tsay prefers a very soft, non-hydrophilic and low cohesive filler for this area, such as blended Juvéderm Voluma XC, Juvéderm Vollure, Restylane-L, or Restylane Refyne.

Mid Face: In the mid face, fillers are used to restore volume, give projection, and give 3-dimensional contouring. In order to accomplish this, you want a filler that will withstand shear deformation and compression. It must be relatively viscous and have high rigidity. The desired filler should have minimal displacement and be able to keep and maintain the original shape as when it was first injected. In scientific terms, this translates into high viscosity, low elasticity, and high cohesiveness. The fillers one would want to use in this area would include Juvéderm Voluma XC, Juvéderm Vollure, Restylane Lyft, Restylane Defyne, Sculptra Aesthetics, or autologous fat.

Lower Face: There is a lot of movement such as laughing, smiling, talking, yawning, eating a large burger, etc. You want to use a filler that can integrate and stretch with movement, has minimal projection (no lumps and bumps), and can be easily moldable. Some good fillers in this area include Restylane Defyne, Restylane Refyne, Juvéderm Ultra, and Juvéderm Vollure. Part of the lower face includes the chin and jaw line. Dr. Tsay prefers to use a filler that is structurally rigid and can maintain the shape after injection such as Juvéderm Voluma XC, Restylane Lyft, or Sculptra Aesthetics deposited along the jawline. Both men and women desire to have a more defined jawline versus a nebulous and indistinct one. Dermal fillers and/or thread lifting can be used to accomplish this effect.