What is new in the world of dermal fillers you ask? A LOT! Let us explore some of our new options, shall we?
First, it is important to know that when it comes to fillers for the face there is no “one size fits all”.
Just like there is no one tool in the garage that fixes every home repair, there is no one filler in our aesthetic workshop that can conquer all needs. Some fillers help to smooth very fine lines and wrinkles while others aid in providing lift and replenish deep volume loss. The newer dermal fillers I am going to address are all Hyaluronic acid (HA) fillers but all are different because of the way the molecules are cross-linked despite the same key ingredient.
Let’s start with Restylane Refyne and Restylane Defyne manufactured by Galderma.
They have a nice ring to them, right? While we are beginning to talk about these products, I want you to keep the idea of memory foam in your mind. Yes, the soft bedding material.
Now, to keep me from getting into trouble, the official FDA-approved uses for these products are:
- Restylane® Refyne is for mid-to-deep injection into the facial tissue for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds, in patients over the age of 21.
- Restylane® Defyne is for mid-to-deep injection into the facial tissue for the correction of moderate to severe deep facial wrinkles and folds, such as nasolabial folds, in patients over the age of 21.
So… the word “deep”, in describing the wrinkles, is the only difference?
Well yes and no, I will explain.
Both Defyne and Refyne are made of a flexible HA. They use “XpresHAn Technology” which offers more gentle support and flexibility than prior fillers. Remember the “memory foam” reference? Memory foam beds tend to contour to your body and are not as stiff as traditional mattress beds but even they come in different levels of support. This is also true with these two fillers. Defyne and Refyne provide the structure and support we need to smooth the lines in the face we are trying to correct but do it in a way so that the face still moves freely and is more flexible. They are not as firm and limiting of movement as prior fillers from the same line. This provides a result that may appear more natural at rest and in motion.
The main difference between the two is that Refyne is used a bit more superficial for fine lines and is very flexible with soft support while Defyne is used a bit deeper, still flexible, but with more firm support. Both products allow for the appearance of more natural movement.
Fun Fact – Restylane Refyne and Restylane Defyne were first approved in Europe in 2010 under the name Emervel and have a proven safety profile with more than one million treatments worldwide.
Ok, healthy competition is good so let us talk about Juvederm Volbella and Juvederm Vollure.
These are the newest products manufactured by Allergan. Volbella received FDA approval in the US in October 2016. Juvederm Vollure received FDA approval in the US in March 2017. Both of these products, like their big sister Voluma, have been formulated with “Vycross technology” which blends high and low molecular weights of HA contributing to the gels longer duration. This technology provides firmness to fill a line well but soft enough to provide a natural appearance with facial expression.
Again, keeping me out of trouble, the official FDA-approved uses for these products are:
- Juvederm Volbella XC injectable gel is for injection into the lips for lip augmentation and for correction of perioral lines in adults over the age of 21.
- Juvederm Vollure XC injectable gel is injected into the facial tissue for the correction of moderate to severe facial folds (such as nasolabial folds) in adults over 21.
When I think of Volbella, I think of those pesky lipstick lines around the mouth and the fine smile lines that are more obvious with well… smiling. If someone wants a larger amount of volume in their lips, this is not the product for them, but if they are looking for a soft, subtle enhancement to help smooth out lip lines and give a soft hydrated look to the lips, this could be the one. The price point is usually a bit lower compared to its competitors but there is less filler in the syringe. It is clinically shown to last up to one year.
Juvederm Vollure is the newest tool in our aesthetic workshop. Compared to traditional Juvederm Ultra and Ultra Plus, it is softer and a bit easier to mold into shape. This can give a softer, more natural correction, mainly with facial expression. This product tends to not be as “hydrophilic” or “water loving” so we tend to see a bit less swelling with Vollure. Studies show this product can last up to 18 months which is about 6 months longer than prior Juvederm products.
Fun Fact – Juvederm Vollure has been approved in Europe since 2013 under the name Juvederm Volift.
Ok, I could go on for days about filler and could bore you to death with excessive writing!
It is one of the favorite parts of my job. You inject it and like magic, instant gratification! Do we still use older products like Juvederm ultra, Juvederm ultra plus, Voluma, Restylane-L, Restylane Lyft, Radiesse and Belotero? You betcha! We even mix and match the products quite frequently based on location, depths needed and desired outcomes. Remember: Each filler is different and awesome in its own capacity with various job descriptions, just like tools in your garage.
The best thing I can tell you is to find a provider that you can talk openly with about your desires and your expectations. Discuss what the immediate goal of treatment is and what the long-term goals are. Ensure that your provider has had sufficient training and education to back up the procedures they are discussing with you and always ask questions.
Really, we welcome questions and want you to be informed, comfortable and confident in the decisions you are making!
