Dermal fillers are well-known to most of us and have had a long history of useful intervention in facial rejuvenation. From the early days of bovine collagen and no-animal-stabilized hyaluronic acid, a plethora of filling agents have become available. This immediately begs the question, which one should I use? And even more importantly, where should I use which filler?

This issue becomes more complicated if we also consider filling agents as not just dermal fillers but also facial fillers. To make things even more intriguing, we need to pose the question, can we use combinations of fillers in the same patient?

One of the difficulties in talking about fillers is that not all of them are available in every jurisdiction. Therefore, some allowances need to be made. Nevertheless, some general principles apply.

In using agents in my practice, I rely on four key elements.

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Source: PSP