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How to fill in hollow cheeks, nose to mouth line, and enhance lips!
Would you like to regain the 'plumped out' look you had when you were younger? You need a filler.
Injectable fillers are used for all kinds of problems - hollow cheeks - severe wrinkles and furrows, lip enhancement and plumping lips to eradicate lines around them (along with resurfacing treatments). They can be used to plump out hands too.
Temporary fillers
When most people think of dermal fillers, they think of collagen or one of the many versions of Hyaluronic Acid such as the various Restylanes, Captique, Perlane, Hylaform, Hylan B, Juvederm, AcHyal etc.
Particle fillers
There are also fillers such as Dermalive which leave behind small particles that are then encased in your skin's own collagen for a permanent filling effect. I do not recommend these. The collagen that is formed around the particles is scar collagen, and no-one can tell how much scar tissue will be formed. The result feels hard and tight and looks unnatural.
Silicone oil / Dermagen / Silikon 1000 / Adatosil 5000 / Silicex 350, 1000 & 5000
No no no no no no NO! This is all silicone oil or emulsion. You do not want it anywhere near you. Run far far away! The silicone molecules are so tiny they can migrate anywhere. Usually somewhere south of the place intended. Then they become lumpy and inflamed and need cutting out. This takes up to 50 operations to achieve. Why anyone would want to have silicone injections when there are so many safe fillers about is beyond me. You could buy a Freddy Kreuger mask instead - a lot cheaper and much the same effect.
Permanent fillers
These, such as Aquamid and Amazing Gel - polyacrylamide hydrogels, are my preferred type of filler. They are 97% water which is held in a polyacrylamide matrix under the skin. They don't migrate, shrink or cause scar tissue to form and they feel totally natural. Expect these fillers to take over the market in due course, with temporary fillers only ever being used to try out a new look.
Fat grafts
I do not like these because some fat always 'takes' and some fat always vanishes without a trace. It therefore goes lumpy. It looks horrible. I don't care how 'natural' and non-allergenic it is, very very few surgeons harvest the fat properly, centrifuge it gently or lay it down in the proper technique. Untill fat grafts are out of the realm of the experimental, and the results are reliable and predictable - I really wouldn't bother.
Isolagen
Isolagen is filler made by growing your own cells then implanting them. The potential problems are rather like with fat grafts. You don't know what will take and where, and how much it will thrive and how much it will fade away. Not as bad as a fat graft or a particle filler, not as good as an acrylic hydrogel.
Which is the best filler?
Hyaluronic acid (also called 'Perlane' or 'Restylane') is better than collagen in terms of how long it lasts and the amount needed, but these fillers are all temporary, so I prefer Aquamid.
I can see the point of a temporary injection if you are not quite sure whether you will like the result or not, say, for lip enhancement. Or you don't know how much you want something augmented. Or what you want done is simply a question of fashion and soon you might want it undone again. Or you are a dermatologist who likes getting paid over and over again for temporary relief of a condition that can actually be cured. But mostly temporary fillers are a complete waste of money. Depending on your age, you will be lucky if collagen even lasts a month.
Should I have a temporary filler first?
Say you have a problem that is not just one of the whims of fashion - very thin lips or cheek hollows so pronounced you look like you have a wasting disease? Perhaps deep nose to mouth furrows?
You can use a temporary filler first if you want, to see if you like your new look, but I'd consider it unneccessary. Who looks good with sunken in cheeks and nasolabial folds? Personally I'd just use Aquamid in the first place. In fact I did. My beautician wanted me to have a temporary filler first "in case I didn't like the effect", and you can't fault her for that - but I'd lived with that problem every day of my life for very many years. It was all I saw when I looked in the mirror. I was pretty certain I would not be wanting the effect back again.
Permanent filler in the US
If you want to get treatment in the US, it is not going to be easy to find. The best way would be to ask the cosmetic surgeons and beauticians who use Restylane, Perlane or collagen if they "have any Aquamid for off label use?" Sometimes they bring it in from Europe while on their travels there. If you keep pestering for it, they might bring it more often..
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