No doubt you've heard some of the terms... Botox Cosmetic™, Cosmoplast, Restylane™, Juvederm™, Perlane™. The list of injectable fillers that can be administered in the physician's office continues to expand, since plumping up the hollows, wrinkles, and depressions of our aging skin is one of the fastest growing areas of cosmetic surgery (even though it is not surgery at all). Surgical procedures, such as face, neck and brow lifts, can lift sagging tissue, but they often can't restore missing volume. And it's volume, the fullness and softness of a face, that looks youthful. Fillers temporarily replace that volume.   Fillers are substances (either naturally occurring or artificially produced) that are that are injected into the skin to temporarily fill in and minimize the appearance of the “dreaded wrinkle”. The injection is done in the doctor's OFFICE and involves NO DOWNTIME or recovery period, though an occasional patient might have a little bruise or redness for a day or so. The areas on the face most commonly treated are the folds that run between the corner of the nose and mouth, called the nasolabial folds, the lips (to enhance fullness), the corner of the mouth (to lift it) and the 'dark circles' under the eye. Fillers provide volume in the hollows in the cheeks and add fullness and softness to the cheekbones, however it is important to remember that these fillers are TEMPORARY, realistically lasting a few months to a year or so. When you are evaluating temporary fillers, in addition to the skill and experience of the practitioner, you should consider how long that filler is expected to last, how natural it looks and its safety and efficacy track record.    The "ultimate" filler is your own fat (see our Fat Transfer page). It takes longer to inject, requires sedation, and has a longer recovery period, but is ultimately more cost-effective since the results are permanent. Some patients ‘try out’ temporary fillers before they undergo fat transfer surgery to see if they like the appearance. These are issues to consider when deciding on the appropriate procedure for you.   Though it often called a 'filler' and is the most widely recognized 'filler' in this list, technically BOTOX Cosmetic™ does not “fill out' a wrinkle, rather it weakens muscles that cause the skin in that particular area to contract - “wrinkle”. It also is temporary, lasting about 4 months, is injected in an office setting and has no recovery period, though it takes up to 10 days after injection to be fully effective. The most common injected areas are the creases between the eyebrows, “crow's feet” and forehead.   Many physicians and even medical spas offer 'injectables'. In addition to evaluating the experience and skill of the person who injects you be wary of deeply discounted products offered by unscrupulous practitioners. Some use grey market product, over-diluted product, improper dose or quantity of product, and out-of -date product (i.e., BOTOX Cosmetic™ should be injected within 1-2 days maximum once it is thawed/reconstituted). At best, you will be wasting your money. At worst, though very rare, the result could be fatal.