Each year the plastic surgery industry has a newer, better, soft tissue filler. Most plastic surgeons are very skeptical about the newest product. The goal is always an injectable, affordable, long-lasting filler. We have recently witnessed a dramatic increase in the available fillers for use in perioral rejuvenation. Thus, it is necessary to discuss state-of-the art fillers now available, the techniques used, potential pitfalls in use, and results. Solutions to problematic areas in perioral rejuvenation are presented. There does not appear yet to be an ideal filler; instead most plastic surgeons have an algorithm for modest, moderate, and dramatic improvement in facial soft tissue needs. Our practice has more recently focused on various combinations of Alloderm™, fat, and hydroxylapitate injectable microspheres (Radiance™) to fill most of these needs. We strongly suggest that plastic surgeons become facile with three or four fillers to address a wider range of soft tissue needs. We present an in-depth discussion of the most common available fillers and show the risks and benefits we have experienced with each. KEYWORDS Nasolabial fold - vermilion - autologous - Radiance™ - augmentation
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Jansen et al. (2003) studied this question.