Question: Do any fillers provide permanent results? Which provide the longest lasting results, and what can they be used for?
Answer: There have been and are currently materials available that could be used as a permanent filler. One of which is medical-grade silicone, which is not FDA approved to be used as a facial cosmetic filler, but many physicians still use it for this. Another is a product that is composed of methyl methacrylate, which currently, I believe, is not available but historically has been a filler that was approved for facial use and is considered permanent. I personally am not interested in permanent fillers for folds and wrinkles since I do not know what this patient will look like in 20 or even 40 years when this filler will still be in their face. In patients that want volumetric improvement of their face and want a permanent result, I typically would discuss implants with those patients. Other long lasting fillers are Sculptra and Radiesse; Sculptra lasting typically at least two years and many times much longer, Radiesse typically lasting one to two years; however, I have seen many patients where it did not last a year. I, therefore, typically recommend the hyaluronic acid fillers as these fillers routinely last nine to twelve months in most areas of the face. They are extremely safe and reliable, and if the need occurs, they can be reversed with injection of an enzyme. Essentially, the hyaluronic acid fillers are nearly a perfect filler material, and that is why I prefer these over the aforementioned other options.