October 21, 2015 – Let’s face it, we all age. Maintaining a more youthful appearance

is probably the driving factor for most people who decide to have cosmetic surgery.

Erasing those lines around the mouth and eyes, filling in areas of the face that have

lost collegen over the years or having fuller lips can be accomplished with minimally

invasive procedures using dermal fillers rather than having a facelift. But not all

dermal fillers are the same, and it’s important that your cosmetic surgeon knows not

only which dermal fillers work best, but which ones work best for each procedure.


A recent article published in the current issue of Plastic and Reconstructive Surgery

from the American Society of Plastic Surgeons discusses the importance of matching the

correct filler for each procedure. Dermal fillers are now rated by their cohesivity,

elasticity and other factors on a scale called the Gavard-Sundaram Scale. In short,

some dermal fillers stick together better than others while some flow better than

others and are rated on a scale of one to five points.


This new rating system for hyaluronic acid-based gel dermal fillers is based on a

study where cosmetic surgeons dyed the fillers, dispersed them in water, stirred and

studied how well they stuck together. The article explained that hyaluronic based

fillers are used most often because they are natural products, very silimar to what

our bodies produce and very compatible with tissues.


Hyaluronic dermal fillers that maintain a high level of cohesivity are often best used

in more shallow placement (closer to the skin surface) for procedures to erase lines

around the eyes and mouth. Dermal fillers that have a lower level of cohesivity are

thought to be better used in deeper placement to add volume and fill out an area.


With over $1 billion spent on dermal fillers in the United States last year (2014),

both patients and cosmetic surgeons should be doing some research on which products

work best for which procedures. As always, never be afraid to ask questions if you are

considering having cosmetic surgery and make sure your surgeon is board certified. The

goal is to eliminate those facial lines, not create more.