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    Global perspectives on cosmetic fillers

    Haasan I. Galadari, M.D.With so many new and exciting filler products in the U.S. pipeline, American dermatologists and their patients are in for a treat, according to Hassan I. Galadari, M.D., who presented “Up and Coming Fillers: Experience from Across the Atlantic,” on March 4 at the 2017 American Academy of Dermatology (AAD) Annual Meeting in Orlando, Fla., March 3 through 7.

    Dr. Galadari, an American board-certified dermatologist who practices in Dubai, says there are more than 80 companies that produce hyaluronic acid (HA) fillers worldwide.

    “…though not all will be approved in the U.S., the larger companies — those who push the envelope in the areas of research and development — will be introducing their products to the U.S. very soon,” Dr. Galadari tells Dermatology Times.

    A trend among filler companies is to focus on adding products that cater to certain parts of the face, he says.

    “In the U.S., doctors are made to dilute their fillers in order for them to safely use them in certain parts of the face — say the tear troughs under the eyes, for example. That will change with the introduction of newer softer products that have been approved for those indications,” Dr. Galadari says.

    Recent U.S. approvals for Restylane’s Refyne and Defyne (Galderma) fillers occurred long after the rest of the world began using those fillers. The newest Galderma HA fillers in the U.S. have been in use in other parts of the world since 2010, as part of Galderma's Emervel line.

    HA fillers are not the only potential new kids on the block. Non HA fillers will be entering the U.S. market soon. While not much has changed with poly-L-lactic acid (PLLA) and calcium hydroxylapatite (CaHA) formulations, a filler containing polycaprolactone (PCL) is in the pipeline to be approved in the U.S., according to Dr. Galadari.

    “PCL is a bio-stimulatory filler that comes in four different formulations of different longevities, without affecting its viscosity and no change in extrusion forces. The longest in the range, which can last up to four years, may be used for those with structural anomalies or defects, such as HIV lipoatrophy and even acne scars,” he says.

    Next: Avoiding, addressing potential complications

    Lisette Hilton
    Lisette Hilton is president of Words Come Alive, based in Boca Raton, Florida.


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