By: Shervin Naderi, MD, FACS
Although Collagen based fillers such as Zyplast and Cosmoderm had initially dominated the market, they fell out of favor due to their short lasting results and the potential for allergic reactions.
Over the last five to ten years, we have seen the Hyaluronic Acid dermal fillers become the predominant work horse for most Plastic Surgeons and Dermatologists. These are used for reduction of nasolabial folds (smile lines), Marionette lines as well as other wrinkles on the face. They are used for cheek enhancement as well as lip plumbing. Tear troughs under the eyes can often be reduced using these fillers. As with any filler, a properly trained and licensed injector with good judgment and technique is the key in success and avoiding complications.
Restylane gained FDA approval first in the United States followed by Juvederm. These two Hyaluronic Acid (HA) fillers have been the most versatile synthetic dermal fillers in the United States. Other HA fillers such as Hylaform, Captique and Prevelle never became as popular. Allergan plans on introducing a Juvederm with Lidocaine (numbing medicine) pre-mixed, in the near future.
However Hydrelle by Coapt is already here! This is an FDA approved HA filler with a higher concentration of HA molecule and Lidocaine added. The higher concentration of HA molecules mean that 1cc of Hydrelle will give you more HA and volume and wrinkle correction than 1cc of Restylane or Juvederm. The added numbing medicine means that patients who require several shots in the same area for fine contouring will have less pain and more comfort during the procedure.
There is no one great filler. Each patient needs a unique assessment and approach. For those who are happy with Restylane or Juvederm then I would recommend sticking to what you like and what works best for you. But for those who want to try something new, then Hydrelle may be worth a shot!