IDENTIFYING THE RIGHT FILLER FOR YOUR FACE IS A SCIENCE

Dr. Jeffrey R. Raval weighs in on Restylane, Perlane, Juvederm, Sculptra, Collagen & Artefill

Denver, CO - Ideal isn’t just a subjective determination when it comes to finding the injectable filler that’s most appropriate to treat creases, lines, wrinkles and other facial flaws. “The ideal filler would be safe, easy to inject and lasts a long time—up to five years,” predicts Dr. Jeffrey Raval, facial plastic surgeon with offices in Denver and Lone Tree, Colo. “A nice feature would be if there were an ability to dissolve the filler in the case that the patient wasn’t thrilled with the results,” he added.

The filler that’s come closest to resembling Dr. Raval’s imaginary ideal filler is the newest generation of Juvederm. Juvederm, according to Dr. Raval, a cosmetic surgeon who concentrates on the head and neck areas in his practices. Juvederm is safe, easily injected and it’s dissolvable. But it only lasts one year, notes Raval, whose medical distinctions are MD, FACS.

Restylane and Perlane are recommended for use around the eyes; Juvederm is most effective when used on the lower portions of the face. Radiesse can last up to 1 ½ years, but it’s both more firm and non-dissolvable, says Dr. Raval of the injectable filler that he prefers to use on patients who have test-driven another filler, one that doesn’t last nearly as long, before determining for certain that they want the continued benefit that fillers deliver.

Radiesse is recommended for the deep nasalabial folds on the sides of the mouth between the nose and chin, sometimes referred to as marionette lines. The downside, adds Dr. Raval, is that the extra firmness doesn’t feel as natural as Juvederm.

Artefill is the most permanent of all injectables developed to date, and is a filler that Dr. Jeffrey Raval declines to administer. “Polymethyl methacrylate (PMMA) or poly (methyl 2-methylpropanoate) is the synthetic polymer of methyl methacrylate. According to Wikipedia, this thermoplastic and transparent plastic is sold under the tradenames Plexiglas, Limacryl, R-Cast, Perspex, Plazcryl, Acrylex, Acrylite, Acrylplast, Altuglas, Polycast and Lucite and is commonly called acrylic glass or simply acrylic. The material was developed in 1928 in various laboratories and was brought to market in 1933 by Rohm and Haas Company.

The problem with Artefil, says Dr. Raval, is that patients can develop a reaction to the synthetic resulting in an infection—up to 10 years later. That in itself is reason enough to not use it on his patients, Dr. Raval says. “That means the patient is always at risk,” Dr. Raval says. In fact, if an allergic reaction develops, the patient has to undergo surgical removal and risk possible scarring in that case.

Collagen remains a sort of natural injectable as it’s produced in the body. The younger you are, the more aggressive collagen regeneration is. As we age, the collagen we produce on our own occurs less and less.

Sometimes the right injectable is a volumizer versus just a filler, adds Dr. Raval. Sculptra is one such volumizer that stimulates collagen reproduction once it’s injected into the skin. Increased collagen then generates a fullness to the face that helps to rejuvenate and refresh the face by adding back the lost volume.

“At the end of the day, Juvederm still comes out ahead for most uses and in particular for deep injections, into one of the multiple layers of the skin.

For information, go to www.ravalmd.com or call the office at 303-744-2300.