Injectable maze

Everyone, from beauty editors to your best friends, seems to be talking about them.

Even your mother is contemplating getting them. What's the big buzz about? It's about injectable fillers. It seems everyone is considering them. Are they right for you?

According to Metairie, La., dermatologist Patricia Farris, M.D., "Facial fillers serve two purposes in helping people achieve a younger, more toned look. They help fill in individual lines and wrinkles, and they can help add volume and contour to areas that have lost that youthful 'fullness.'"

PLUMP IT UP Dr. Farris explains that fillers such as collagen and hyaluronic acid, which go by names such as Restylane, Juvederm and Hylaform, are excellent when used for individual lines and wrinkles, but are not the fillers of choice when it comes to replenishing lost volume.

This lack of volume can often be seen in the cheeks. Restylane, which lasts about three to four months, is also an excellent choice for helping to fill out lips that have gotten thinner with age.

Adding volume back to sunken cheeks is of real benefit to some women, helping them to regain a more youthful look.

"We now recognize that as you age your face loses fat, causing it to look hollow in certain areas," Dr. Farris says. "I refer to the 'cone of youth' when talking to patients. If you can imagine a triangle with its base stretched over the cheeks, tapering down at the chin in young people, you have what typically defines faces in the teens, 20s and 30s. As you age, you develop an inverted cone where the volume has sunk to the jowls and the upper face becomes thinner and sometimes hollow in appearance."

This inverted cone of youth is the way the face ages. Many doctors now use a filler called Sculptra off label to restore facial volume. It adds back a lot of the volume that makes the face look younger and more vital. The only downside to this, Dr. Farris explains, is that it requires multiple treatments and touch-ups - usually three to six treatments at monthly intervals. The effects, however can last about 18 months to two years.

JUST ON THE MARKET New to the filler market are Juvederm ultra and Juvederm Ultra Plus, which are hyaluronic acid fillers.

Both were approved by the Food and Drug Administration in June 2006. Juvederm Ultra is a formulation that provides more versatility in contouring and volumizing facial wrinkles and folds. Juvederm Ultra Plus is a more robust formulation for volumizing and correction of deeper folds and wrinkles. Both contain the highest concentration of non-animal hyaluronic acid of any dermal filler now available. Sustained results last up to six months or longer.

Another new filler to discuss with your dermatologist is Radiesse. Radiesse is an innovative filler made from calcium hydroxylapatite particles. When injected into the skin, these particles act as both a filler and a stimulator, meaning this filler restores volume and also stimulates the production of collagen. Radiesse is longer-lasting than most fillers and will show improvement for up to one year.

Whichever route you choose, make sure you find a qualified doctor - one who is trained in the technique for the selected filler (dermatologists often have to be trained by the drug manufacturer, as each filler requires using specific injection techniques). Don't be afraid to ask questions. The more you know, the better you will be equipped to make a decision that produces the best results.