Are there any fillers that provide permanent or longer lasting results and what can they be used for?

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Question: Are there any fillers that provide permanent or longer lasting results and what can they be used for?

Answer: Historically, there were permanent fillers available in the United States under the name of ArteFill and I believe these are coming back out once again at the time of this blog. These are made of methylmethacrylate, which is a similar chemical to superglue and it is an extremely small bead-like spheres that are in gel matrix that can be injected into lines and folds. Other possible permanent fillers are injectable silicone, which is not FDA approved for injection in the face, but can be used off label for this purpose. My personal philosophy with permanent fillers is that I try to avoid them at virtually all costs due to the fact that they are truly, literally permanent. What I mean is that they do not just last 10 or 20 years, these products last for the rest of the patient’s life. I certainly do not know what some of my patients are going to look 40 years or 50 years from now and I therefore do not want to place a filler that will still be present that many years from now. It would be great is the filler was available that could last for around 5 years and there certainly is one, called Sculptra, that can do this, though the only drawback I see with Sculptra is that you rely on the patient’s inflammatory response to give the volumetric enhancement and you therefore cannot use it like the other fillers where you see what you get immediately. I think Sculptra is great for overall volumetric enhancement of the cheeks, but I personally would use it cautiously in other areas of the face. Otherwise, for the cost, ease of use, safety, and efficacy, I feel that the hyaluronic acid fillers are by far and away the best fillers at this time.

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