ABSTRACT
Each year the plastic surgery industry has a newer, better, soft tissue filler. Most
plastic surgeons are very skeptical about the newest product. The goal is always an
injectable, affordable, long-lasting filler. We have recently witnessed a dramatic
increase in the available fillers for use in perioral rejuvenation. Thus, it is necessary
to discuss state-of-the art fillers now available, the techniques used, potential
pitfalls in use, and results. Solutions to problematic areas in perioral rejuvenation
are presented. There does not appear yet to be an ideal filler; instead most plastic
surgeons have an algorithm for modest, moderate, and dramatic improvement in facial
soft tissue needs. Our practice has more recently focused on various combinations
of Alloderm™, fat, and hydroxylapitate injectable microspheres (Radiance™) to fill
most of these needs. We strongly suggest that plastic surgeons become facile with
three or four fillers to address a wider range of soft tissue needs. We present an
in-depth discussion of the most common available fillers and show the risks and benefits
we have experienced with each.
KEYWORDS
Nasolabial fold - vermilion - autologous - Radiance™ - augmentation