What are the longest lasting fillers?

HIV patient interested in facial injections had them in previous years, looking for longer duration

This is a common question and definately a reasonable one! When fillers are skillfully done, by someone with a good aesthetic eye, they can truly bring some joy. Many patients feel like they “look like themselves again” or that they look more the way they feel inside. As many of you know, I’m not a proponent of aging gracefully, because too often that just means giving up on dreams, the future and vitality. I think of it more as aging VIGOROUSLY! And keeping in mind that as we age, we have much to contribute. Many of our greatest thinkers, scientists, artists, etc. produced some of their best work over 60. This can be done as long as the mind, spirit and body stay flexible and creative. I think that because we are visual creatures, looking more like we feel inside may be helpful in a small or larger way, especially if it enables confidence and self appreciation.

So to your question!

Some thoughts on long lasting fillers:

  • The longest lasting fillers are often also more stiff. This makes sense because you need denser, or more tightly packed crosslinking of hyaluronic acid fillers (HA fillers) to create slower reabsorption by your body
  • The “thinner” fillers tend to be softer and more pliable, and also last less long.
  • Sculptra is NOT an HA filler.  It is a collagen stimulator and because it builds your own collagen while it goes away, in my opinion, done well, it has the most natural look and molds the best to your actual underlying bone structure.
  • The longest lasting fillers technically last 2 years now.  BUT…..you don’t want your face going from full to zero and back again.  We want a facial stability.  So practically that means you need to “retouch” your filler at least once a year.

Think about facial dynamism:

  • Our faces move, and we want them to move naturally, right?  It just looks weird if they don’t, even if we can’t quite discern why.
  • So, when working more structurally, as with the framing of the face and lifting in general, the longer lasting, stiffer fillers are preferred.
  • If working with a dynamic area, like around the mouth, you would want filler that is “soft” and move sand bends easily.
  • This is why is doesn’t always make sense to use the longer lasting, stiffer fillers in some areas… even though they might last longer.
  • A great doctor/PA-C/nurse injector should have a a great “eye,” and a lot of technical knowledge, safety focus, and experience.

Specific fillers (fillers available in Europe, Canada, Asia, South America, etc. may be different):

  • It’s always good to ask, know and keep a record of what fillers have been used in your body.
  • In general, fillers like Sculptra, Voluma, Restylane Lyft, Restylane Defyne will last longer and are stiffer.  These are usually NOT good around the eyes, mouth and lips. There are exceptions.
  • In general fillers like Juvederm, Restylane, Belotero (I’m not a fan), Restylane Refyne, Volbella (not a huge fan of this either), will be better in areas with a lot of movement.  They will also need to be maintained usually twice a year, instead of once.  There are exceptions!

Hope this helps,  Dr. I



Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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