There are so many brands of facial fillers on the market these days, many find it hard to decide which is most suitable for them. My two cents’ worth below– hope it helps!
This is a USA FDA approved facial filler, so I guess it can be used as a control to compare all the others. I absolutely love to use this brand of filler on the tear troughs and lips because its range e.g. Vital Light is soft and natural enough for these areas. Perlane and SubQ are harder types suitable for other areas of augmentation, but I find SubQ is far too hard for a good result in the nose or chin. Vital has also been very effective in the correction of nasolabial folds.
A very popular and well known brand that is definitely USA FDA approved. More costly but well worth its price. Its range of Ultra Plus and Voluma is suitable for areas like the nasolabial folds, cheeks, nose and chin. From experience, Juvederm for nose augmentation tends to give a bit more swelling in the first week but settles quickly without any problem. Voluma has been known to last slightly longer for a hyaluronic acid based filler. Its range also includes Juvederm Ultra, Ultra Plus, Vobella and Volift. It is my favourite brand of choice and used widely in my clinic because it has never, in my experience, caused any permanent lumps or scarring.
3. All other brands of hyaluronic acid filler.
Generally, this ingredient has a very good safety profile as long as it is approved by HSA Singapore. Revanesse is a relatively low profile brand made in Canada, widely used in the UK and has a number of worthy clinical studies to back it. Its range Ultra (Plus) is versatile and gives good results for nasolabial lines, nose, chin and cheeks (in that order of preference). Surprisingly, it gives very little problems– seldom cause lumpiness or migration, and settles very well to give a most natural result. Perhaps the only shortcoming is it doesn’t give as great a volumising / lifting effect as Juvederm Voluma or Radiesse. Other similar brands include Belotero and Esthelis.
I absolutely love the effect this filler gives for the cheeks. The lifting effect is lovely and immediately visible even with a very little amount, as long as it’s in the right place. I find it best in the cheeks and in fact, gives the face a glow soon after treatment.
Disappointingly, I find its effect on the nose more variable – it may occasionally give a better lift and definition for the nose bridge as compared to hyaluronic acid fillers, but at other times, it may spread and disappear faster than hyaluronic acid types. Also, post treatment with Radiesse on the nose, top up for nose filler is trickier due to fibrosis under the skin and can predispose to lumps and uneven augmentation during top up. Many people also may think it lasts longer on the nose but I have found it to be untrue – it is actually rather variable in its duration of effect for the nose. Only a handful find that it really lasts up to or more than 1 year. Many find it may have much reduced in a few months, either due to spread or natural dissolution. After all, the manufacturer does promise that it is only supposed to last 12 months like the hyaluronic acid filler. It is not considered a semi-permanent filler anymore.
My recommendation: keep it to the cheeks. I will recommend it for nose augmentation only in very specific conditions according to the individual.
An almost permanent filler that can last 2-5 years cos it’s a plastic gel. Considering the cost vs the length of time it lasts, it’s easily the most economical filler. The obvious pitfall is, of course, the risk for lumpiness, as with any longer lasting filler. In the event of lumps, it cannot be dissolved easily like the hyaluronic acid based fillers. You can wait it out or massage it down or opt to remove it surgically. However, in my years of experience using this brand of filler thus far, I have yet to encounter any lump formation after use with Aquamid.
There is a new filler in town called Ellanse, or also popularly named as 女儿针, made of polycaprolactone. It is not applied in microdroplets all over the skin like 水光针 or 婴儿针, but is used just like any other filler to volumise facial areas that have lost the fullness of youth. As a relatively new filler in the local market, few doctors can claim to have too much experience with it. The usage of Ellanse is like a hybrid of Sculptra and Radiesse – used like Radiesse in ease of injection, but the effect is like Sculptra so it may last between 2 to 3 years – yet to be seen in actual practice. Its indications are for sunken cheeks and temples, as well as nasolabial folds.
Filler choice varies, depending on your specific requirements, budget and desired area of treatments. There is no “one size fits all” in this regard. It’s ok even if you may need different fillers for different areas of treatment as they seldom cross react with one another. It’d be worse if you try to force a certain type of filler in an area it is not suitable for. Discuss with your aesthetic doctor what you are looking for and get the best recommendation for you! 🙂
Dr Tiffiny Yang
(post updated on 24 Oct 2016)