Fillers: How Long Do They Last

When patients come to the office for filler injection, they frequently ask how long the correction can be expected to last. This is a reasonable question and should be able to be answered in a straight forward manner. However, the answer is more complicated than it seems, and new information is further clouding the picture.

In the past year there have been a number of head to head comparisons of filler duration. These types of studies have, in the past, been uncommon, because many of these studies have been supported by manufacturers and they are reluctant to pay for a study that might shine an unfavorable light on their product. However, it has become clear that Radiesse lasts significantly longer than the hyaluronic acid fillers, Restylane, Juvederm and Perlane.  BioForm, the manufacturer of Radiesse has now sponsored published studies that demonstrate that, after one, year patients are significantly more satisfied with the results from Radiesse than with the results from the hyaluronic acid fillers. Thus, the type of filler injected is an important determinant of filler duration.
For many years we've known that the location into which the filler is placed makes a difference in how long the filler survives. Generally the more the tissues in the area move, the shorter the fillers last.  Filler in the lips generally lasts half as long as filler in the cheeks
The new observation, that has recently been thrown into the mix, is that the timing of filler injections may play a significant roll in how long a filler lasts. In the June issue of the Journal Dermatologic Surgery the results of an ongoing study using Restylane in the nasolabial folds, the groove running between the corner of the nose and the corner of the mouth, were reported. In a blinded study, all patients had both sides treated initially. Then one side was retreated at 4.5 months and the other side was retreated at 9 months. In both sides the effect of the filler was still present at 18 months from the initial treatment. This is a durability is greater than would have been predicted from previous studies. It suggests that placing more filler, particularly Restylane at this point, before the effect of the initial injection has worn off, significantly prolongs the effect of the filler. One speculation is that this might work by inducing the body to produce new collagen in the area. This could be very important for patients. They may be able to get better and longer lasting results while at the same time save a significant amount of money.

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