Shootout between fillers

In the December issue of the journal "Dermatologic Surgery" there was a head to head comparison of three different fillers, Radiesse , Juvederm and Perlane. The study assessed filling of the nasolabial folds and compared patient satisfaction, durability of the filler and the amount of filler necessary to achieve correction. Side effects were also looked at, but there were no significant side effects with any of the fillers.

Patients were given an initial treatment and then were brought back at 4 months for a touch up. They were then brought back at 4, 8 and 12 month intervals for evaluation. At each measurement point patient satisfaction was the highest with Radiesse (calcium hydroxylapatite) and beyond 4 months, almost all of the differences were statistically significant. Of the hyaluronic acid fillers, the Perlane tended to perform better than the Juvederm. At the 12 month point, 90% of patients were satisfied or extremely satisfied with Radiesse, while only 48% of those receiving Perlane and 7% of those receiving Juvederm expressed the same opinions.
When the photos were assessed by physicians who were blinded as to the filler given, the Radiesse was judged to produce better filling at 4, 8 and 12 months. All these differences were statistically significant. Furthermore the amount of filler necessary to achieve the desired result was less with the Radiesse, and again the differences were statistically significant.
This study only involved a single anatomical area, but one that is frequently filled. It confirms our impression that Radiesse fills better, for a given volume, and lasts longer than the hyaluronic fillers. That does not mean that the hyaluronic acid fillers (Restylane, Juvederm and Perlane) do not have a place. because of their different characteristics they are the preferred fillers for a variety of use, and many people will still want them for areas like the nasolabial folds.

Gerald N. Bock MD
Stockton, CA
California Skin Laser Center