Recent trend in the choice of fillers and injection techniques in Asia: a questionnaire study based on expert opinion

With recognition of the value of volume enhancement in achieving a more youthful appearance, there has been concomitant explosion in the soft tissue filler market. Given the vast array of filler products and techniques currently available, choosing the right product and technique can be overwhelming to those with little experience.

To evaluate the recent trend in the choice of fillers and injection techniques among leading dermatologists in Asia and offer guidance to those who practice facial fillers.

A panel of dermatologists, who are recognized as filler experts and key speakers in Korea were asked to fill out an in-depth questionnaire on fillers in 2012. The results of the 2012 questionnaire are presented and compared with the questionnaire results of the exact same group of doctors in 2011.

Those who participated in the questionnaire study practiced fillers for an average of 10.6 years with an average of 32.8 filler cases per week. Common indications for filler injection were midface augmentation and nose augmentation. Indications that most drastically increased between 2011 and 2012 were midface and forehead augmentation. For the nasolabial folds, the most preferred choice of filler product, needle, injection technique and injection depth was Radiesse®, 27G short needle, Layering technique and the Upper subcutaneous fat layer. For filler rhinoplasty, the preferred choices were Radiesse®, 27G short needle, Linear threading technique and the Mid-deep fatty layer. For dark circles, the favored choices were Esthelis Basic®, 30G short needle, Vertical technique and the SOOF (suborbicularis oculi fat) layer. For forehead augmentation, the most favored choices were Juvederm Voluma®, 23G cannula, Linear threading technique and Fanning and the Supraperiosteal layer. The physicians' satisfaction score for the nasolabial folds, filler rhinoplasty, dark circles and forehead augmentation was 71.5, 90, 84.5 and 87 respectively.

On general, filler experts preferred fillers with relatively high visco-elasticity for the nasolabial folds, nose augmentation and forehead augmentation but chose fillers with low visco-elasticity for dark circles. Linear treading technique (with or without fanning) was universally popular but Vertical injection was considered more useful for dark circles and the nasal tip.