Which type of dermal filler is best? Marionette lines, lips and tear troughs

Published September 16, 2021


picture of a woman

Dermal fillers can work wonders, but sorting through all the information online gets confusing fast. What dermal fillers work best? When are other treatments a better choice? And how soon can you get back to your day-to-day activities after treatment? 

We caught up with dermatologist Ronald Sulewski, MD, to answer these questions. Dr. Sulewski performs Botox, fillers, chemical peels and other various cosmetic procedures. To schedule a dermatology appointment, call 800.922.0000

I have marionette lines, lip lines and wrinkles all at once! What are the best wrinkle fillers to get rid of these lines?

Dr. Sulewski: Great question! Most patients would benefit from a combination of different fillers to address their needs. Usually, we use a softer filler for the fine lines around the lips. The best examples are Belotero, Restylane Silk or Volbella. Our patients' concerns around the mouth usually need to be targeted with a number of treatments besides just fillers. Options we use regularly are strong resurfacing lasers and NovaThreads. Of course, applying sunscreen daily can prevent lines from getting worse.

Which filler is best for the treatment of under-eye tear troughs?

Dr. Sulewski: Restylane is typically my first choice for treatments under the eyes. This is a delicate area of the face, and using thicker fillers poses a higher risk of side effects such as bruising and nodule formation – an unnatural look overall. Often I will combine the "softer" Restylane with a "thicker" filler in the central cheek for support. This combination leads to longer-lasting results with a natural appearance and less risk of side effects. 

What is the best injectable dermal filler (apart from fat) for under-eye hollowness? What about upper-eye hollowness?

Dr. Sulewski: The best filler for under the eyes is Restylane. Each patient is unique, though, so there are times when I consider using Belotero or Volbella. We also always consider treating the cheek area, as this can support the under-eye area and give patients great results. Upper eyelid hollowness is best addressed with surgical options as fillers may not be safe there, and it is difficult to get a natural looking result.

What treatment will cure a dark horizontal line on my nose?

I am a 25-year-old female that has had a dark horizontal line across my nose for about seven years now. Admittedly, it has become a lot worse within the past 12 or so months. Also, I do suffer from pet and seasonal allergies. I choose not to believe that there is no cure for this. Also, when I wear makeup, the foundation or powder that I wear seems to sink into the crease. I have tried prescription retina A and 8% hydroquinone. Please help!

Dr. Sulewski: This is a difficult line to "cure" but you definitely can work on it. Likely a combination of a soft filler to the area and Botox should improve it. Depending on your response, I would consider using Novathreads as well. All of these treatments will require some maintenance or repeat treatments to keep up the improvements.

Can I resume normal activities, such as exercising and riding my motorcycle, after Botox and Juvederm injections?

Dr. Sulewski: Most day-to-day activities are okay to continue immediately after Botox and filler injections. Walking, driving a car or riding a motorcycle are all fine. We usually ask patients to avoid exercise for 24 hours. With fillers, like Juvederm, you should also avoid dental work for two weeks to prevent some rarer adverse effects that can happen. All of these concerns are addressed during evaluation and treatment by your experienced cosmetic doctor.

Is exercise risky after filler injections for wrinkles?

Is there any risk of being highly active (as in running) after fillers are injected? I am a runner and fear that if I use a filler it will sag and "drop" beneath the skin due to running or other physical activity.

Dr. Sulewski: We like our patients to keep exercising after treatment, but we want them to hold off for 24 hours. Although it would be possible to move the filler, the bigger risk is bruising from pumping a lot of blood while your heart rate is up. We do discourage pressing on the areas that were treated, as this can definitely affect how the fillers appear. 

Are there dermal fillers for my chin or jawline?

Dr. Sulewski: I use hyaluronic acid fillers regularly for the jawline. Radiesse is another option which gives a little better structure, and it's a dermal filler made of calcium hydroxyapatite. 

Can dermal fillers help my acne scars?

Dr. Sulewski: Dermal fillers can treat acne scars, but it's not usually my first choice. We have a number of other treatments, including chemical peels and lasers. There's also a treatment called substitution where you loosen the scars from underneath the surface. When I do treat acne scars with a dermal filler, I use a softer filler.

Find the best dermal fillers for your skin concern
Schedule your cosmetic dermatology consultation at 800.922.0000.