What’s the difference between all the facial fillers now on the market?

Q. I’ve been considering trying facial fillers and possibly a Botox-like product. However, I’ve consulted two different doctors and received very different recommendations regarding which products to use. What would you recommend for me?

A. It’s common to encounter differing opinions when it comes to facial fillers and neurotoxins because these products serve different purposes.

Two widely used types of fillers are hyaluronic acid (HA) fillers and biostimulatory fillers. HA fillers, such as Juvederm and Restylane, are popular because they offer immediate, predictable results and are reversible—an important advantage in case of dissatisfaction or complications, such as accidental injection into blood vessels. They are ideal for areas like the lips, cheeks, and under the eyes, providing a smooth, hydrated appearance.

Biostimulatory fillers, such as Radiesse (CaHA) and Sculptra (PLLA), work by stimulating your body’s collagen production. These fillers are often used for deeper lines and more significant volume restoration, such as in the cheeks or jawline.

They are also used in non-surgical body contouring, like buttocks enhancement. While they provide longer-lasting results, they take time to show full effects, are not reversible, and sometimes lead to an overly puffy or “pillow face” due to unpredictable collagen production.

In my practice, I tend to prefer HA fillers due to their consistent results and reversibility.

As for neurotoxins like Botox, Dysport, or Daxxify, the choice often comes down to the injector’s preference. These products differ in how long they last and how they spread, but the most important factor is that your injector is comfortable and experienced with the product.

Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email questions to him at Cwolf@miamiplasticsurgery.com