In my effort to find the best filler experience for an individual, I am constantly evolving my injection filler methods and the preferred products that I use to accomplish those goals.  In the past, I was a big advocate of Restylane injectable fillers but of late have found a real passion for Juvederm Ultra Procedures.  Is Juvederm great for the entire face?  Absolutely not.  It tends to bleed into the surrounding areas much more than Restylane, which stays put more.  Is that a good thing then?  Well, depends.  Because I am truly designing very advanced areas that I would like to blend in more naturally with the surrounding tissues I have been liking Juvederm in specific areas where blending is more important:  outer cheeks, brows, temples, smile lines, buccal area, and anterior chin.   These are almost all the areas save the lower eyelid where I still believe Restylane is better but not ideal.  In the lower eyelid, I have found Bellafill(Artefill) permanent injectable filler to be the best solution for someone wanting a lower-eyelid filler because I believe hyaluronic-acid based products (Restylane and Juvederm) have several drawbacks that I don’t like:  Tyndall Effect (grayish visible color), lumpiness when overfilled and when smiling, more swelling, and a loss of some of the result after a week or so since the product moves a slight bit.  These are my latest thoughts that I am sure will be refined as I continue to think about the right product in the right area for the right patient.  These biases are not meant to be absolute since obviously they tend on how one uses the product and who is performing the procedure.  These biases are mine alone and should not reflect negatively on the physician who chooses to use one product over another or on the manufacturer of a product.

Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To schedule a consultation please call 972.312.8188. To Learn more about Dr Lams’ Injectable Facial Filler procedures or to ask Dr Lam a question please visit his Injectables and Fillers Forum.