Restylane, Juvederm and Perlane are hyaluronic acid (HA) fillers. HA is a natural sugar compound found in all living organisms that provides volume and fullness to the skin. When injected, the HA molecules draw in water and cause the tissue underneath to swell. They're made of biodegradable non-animal HA and, unlike collagen, pose no risk of allergic reaction or being rejected by the body. Radiesse, on the other hand, is composed of tiny crystals containing calcium hydroxyapatite, a substance found in our bones and teeth. It, too, is manufactured synthetically so there's no risk of having an allergic reaction and thus no need for skin testing before having the product injected.
What the four have in common is the recovery/down time -- itching, redness and/or bruising may occur at the injection site(s). Swelling may last for up to 7 days. And the basic procedure/pain factor: Usually a numbing cream (typically lidocaine) will be applied to the areas that will be injected, but most patients still experience moderate pain while being injected -- especially around the mouth.
Next: The 4-1-1 on Restylane
Photo 4/7
Restylane
Restylane has been used in Europe since 1996. The FDA approved it for use in the U.S. in 2003.
It works best on: Nasolabial folds (from the nose to above the lips), smile lines, forehead wrinkles, hollows beneath the eyes and sculpting/plumping lips.
What to expect: A numbing cream will be applied to the areas to be injected but most patients still experience moderate pain while being injected -- especially when using it to plump lips.
How long it lasts: Individual results may vary but six months is typical.
One expert's opinion: Dr. Simona Arcan, co-owner of Skin Savvy in Hermosa Beach, Calif., thinks that Restylane is a great "starter" filler. "If you're looking to plump up but only temporarily, say for a high school reunion or an anniversary cruise, it's great. You can "try on" the look without the long-term commitment of the longer-lasting products."
Reader review: Total Beauty reader Joy told us on Facebook that she did Restylane one time and loved it. "It covered all the wrinkles around my mouth and filled in all the areas that were getting sunk in. I would have it done again but the cost factor prohibit[ed] me."
Next: All about Perlane
Photo 5/7
Perlane
Manufactured by the same company, Medicis Aesthetics, Inc., Perlane is Restylane's bigger-particled sister.
It works best on: Because of its larger molecular structure, Perlane needs to be injected deeper, so it works best in the cheeks, chin, eyebrows and around the mouth.
How long it lasts: Perlane is marketed as lasting from nine to 12 months but many pros contend that the duration depends on where it's injected -- an area that doesn't move as much, like cheeks, will reportedly last longer than one that's constantly in motion, like marionette lines (those that run from the corners of your mouth down to your chin).
One expert's opinion: "Perlane is like bread dough," says Dr. Arcan. "It's dense and beautifully moldable so it holds its form and allows you to spread it into the space you want it to go."
Reader review: Total Beauty reader Audrey told us that she had Perlane injected into the "abyss" -- what dermatologists call crevices that occur around the corners of the mouth. "It worked like a charm to plump them back up and lasted for a really long time!"
Next: The info on Juvederm
Photo 6/7
Juvederm
Juvederm is made by Allergan -- the same guys that brought us Botox. On February 1, 2010, Allergan announced that the FDA approved Juvederm XC, a "new formulation that contains the local anesthetic lidocaine, which numbs the treatment area within seconds from initial injection for enhanced patient comfort." The new product, which is great for wimpier types, is already on the market in some cities.
It works best on: Moderate to severe wrinkles and folds, especially the nasolabial "parentheses" folds.
How long it lasts: Juvederm is approved by the FDA to last up to one year.
One expert's opinion: Dr. Arcan says that she loves Juvederm. "It has the consistency of a smoothie. It lays down very nicely and gives a great, natural look."
Reader review: Total Beauty reader Leann told us on Facebook that "Juvederm is the best for plumping lips" and that despite the fact that it "hurts like hell," she'll "definitely" keep doing it.
Next: The scoop on Radiesse
Photo 7/7
Radiesse
Radiesse, the filler that's made with calcium hydroxyapatite-containing crystals, purports to increase a "process called collagenesis, stimulating your body to produce new collagen and encouraging collagen to grow around the injection area."
It works best on: Smile and marionette lines, and pre-jowl sulcus (the areas on each side of the chin) by adding volume back to those spots.
How long it lasts: Radiesse can reportedly last up to a year.
One expert's opinion: Dr. Fields says, "I like Radiesse in the hands [editor's note: fillers are sometimes used in the hands to make them appear less bony, which in turn makes them look more youthful] and it looks great in cheeks." She also affirms, "If someone does not get a good take with a hyaluronic filler, I switch to Radiesse."
Reader review: Total Beauty reader Kat told us on Facebook that she used Juvederm and Radiesse, and had "very positive experiences with [Juvederm], but not Radiesse. "It's too thick," she wrote, "and left knots in my lips."
Have your "fine" lines begun to etch a deeper groove into your skin -- not to mention psyche -- and started morphing into (cue sinister music) full-blown wrinkles?
Let's be Zen about it. Take pride in each furrow as it represents a hardship overcome. Find joy in every crease as it is like a smile remembered. Ugh, who are we kidding? Let's plump those suckers up!
"The new world of fillers is tremendous for the consumer," says noted dermatologist Kathy Fields, co-founder of skin care brand Rodan & Fields. "[With them], we refresh faces, removing hollows, sags, dents and lines. We can't make anyone a 20-year-old again but we can make people look great for their age."
OK, so you decide you're game for a non-surgical skin treatment like Juvederm, Perlane or Radiesse, but you're wondering which one to use. The advent of safer, longer-lasting injectable fillers has made grandma's gold-standard collagen go the way of the dodo, but with such a glut of choices, women today are like kids with those dang Webkinz -- our minds beleaguered by what to choose and why. Here, we'll explain what the most common non-surgical facial fillers are, and share feedback from readers and doctors on whom they're best for and the pros and cons of each.
