Navigating the varied landscape of dermal fillers can be complex. This guide simplifies that process, offering insights into the diverse types, components, and applications of fillers.
Whether your goal is to smooth lines, replenish lost facial volume, or redefine your features, you’ll find information here to help you select the most suitable brand and formula for your needs.
What are Dermal Fillers?
Dermal fillers are injectable substances used to restore or add volume to facial features. Primarily used in dermatology and plastic surgery, these fillers help to smooth out wrinkles, fine lines, and creases in the skin, particularly around areas of the face that are most susceptible to signs of aging.
Most fillers work by temporarily filling in lost volume. These are often used to tackle issues like nasolabial folds, smile lines, and even to augment the jawline. Newer fillers like Sculptra and Radiesse also stimulate natural collagen production in the skin, thereby not only filling but also rejuvenating the skin over time.
Types of Fillers Explored
In the ever-advancing field of cosmetic dermatology, dermal fillers stand out as a favored solution for mitigating signs of aging or addressing issues like acne scars. Depending on your goals—be it reducing fine lines or recovering facial fullness lost over the years—there’s a filler for you.
Hyaluronic acid fillers
Hyaluronic acid (HA) is a substance that holds many times its weight in water and attracts water molecules to keep skin looking plump and hydrated. It’s also the primary ingredient in many of today’s leading filler brands.
Popular fillers in this category include Juvederm and Restylane, two well-known families of cosmetic injectables. These fillers are highly adaptable and used for addressing myriad concerns in different areas of the face.
Because hyaluronic acid is a naturally occurring substance in the body, HA fillers generally have a good safety record and a lower likelihood of causing side effects and allergic reactions.
Collagen is a crucial protein in our skin, bones and other connective tissues. It’s biodegradable, which means it dissolves gradually over time. While collagen fillers aren’t as popular as they were in the past, some brands such as Bellafill still contain a bovine collagen base.
Calcium hydroxylapatite filler
The main ingredient in Radiesse, calcium hydroxylapatite (CaHA), is a substance similar to minerals found in human bones. Radiesse is a thicker filler formulation, ideal for tackling deeper wrinkles and adding volume to facial areas such as the cheeks. Given its consistency, CaHa filler offers durable results and is often suggested for sculpting facial features.
Poly-L-lactic acid filler
Poly-L-lactic acid (PLLA) is a lab-made, biocompatible and biodegradable material found in Sculptra Aesthetic. Like Radiesse, Sculptra is a collagen stimulator and well-suited for treating larger areas where volume loss has occurred, such as hollow cheeks and nasolabial folds.
Getting Sculptra is a multi-appointment process spanning several months. The results take time to show, making this a long-term approach to facial enhancement.
Polymethylmethacrylate, or PMMA for short, is a synthetic material that doesn’t biodegrade. PMMA microspheres are the collagen-boosting ingredient in Bellafill, a brand that addresses deeper facial folds and acne scars and can be used to sculpt the chin and jawline.
Bellafill combines PMMA microspheres with a collagen gel for both instant and lasting results. Given its longevity—possibly up to five years—it’s vital to seek treatment from a qualified, board-certified injector to ensure the best possible outcome.
Filler Treatment Areas
One of the biggest factors determining which filler you should get is the area you’re looking to enhance. Here’s a breakdown of how different areas can be targeted, from the upper face down to the hands.
Under eye filler
The tear trough, or area under the eyes, is prone to dark circles, hollows and puffiness. These issues can make you appear more fatigued or older than you are. By adding volume, fillers can smooth out hollows and improve the appearance of dark circles, resulting in a refreshed, youthful look.
Belotero Balance, Restylane Eyelight, Juvederm Volbella XC are FDA approved to treat this area, but other products are sometimes used off-label.
As the under-eye area is particularly sensitive, it’s crucial to consult with a board-certified dermatologist or plastic surgeon experienced in this type of dermal filler injections to ensure optimal results.
The cheeks are a central aspect of your overall facial aesthetics. With age or weight loss, volume in the cheeks can diminish, leading to a sagging or flattened appearance.
Restylane Lyft, Restylane Contour, Sculptra and multiple products from the Juvederm family can be effectively used to restore or enhance cheek volume. These fillers not only lift and add fullness to the cheeks but also improve facial contours, creating a more youthful appearance.
The lips are one of the most popular areas for filler treatment, especially for those looking to achieve fuller, more defined lips.
HA fillers with a firm consistency such as Juvederm Volbella, Juvederm Ultra XC and Restylane Kysse are often the go-to choices for lip augmentation. These fillers can enhance the shape, structure and volume of the lips while maintaining a natural look.
Softer products like Restylane Silk address issues like vertical lip lines, which can occur due to aging or repeated muscle movement.
Lower face and jawline filler
The lower face includes the jawline, chin and areas around the mouth such as nasolabial folds and marionette lines. Different types of dermal fillers, from hyaluronic acid to calcium hydroxylapatite, can be used to address these issues.
Radiesse, Belotero and multiple Juvederm and Restylane products are FDA-approved to treat deep wrinkles and folds in this area. Restylane Defyne is specifically formulated to enhance the chin, while Juvederm Volux recently became the first HA filler specifically FDA-approved for jawline enhancement.
The backs of the hands are another area where fillers can be beneficial. Age can result in loss of volume in this area, making veins and tendons more visible. Restylane Lift and Radiesse + are both FDA-approved for hand rejuvenation.
Alternatives to Fillers
Though facial fillers offer a convenient and minimally invasive way to address various cosmetic concerns, they’re not the only option available. Here are some alternative cosmetic procedures that can enhance your facial features and combat the signs of aging.
RF skin tightening
Radiofrequency (RF) skin tightening is a non-surgical procedure that uses radiofrequency energy to heat the deeper layers of the skin, stimulating natural collagen production. This helps to tighten loose or sagging skin and can result in a smoother, more youthful appearance.
It’s often used on areas such as the neck, jowls and cheeks but can be applied to other parts of the body as well. RF skin tightening typically requires multiple sessions for optimal results and offers a less invasive option for those not ready to commit to surgical procedures.
Botox and other neurotoxins
Wrinkles on the forehead and around the eyes should not be treated with fillers because of important blood vessels in that area. Instead, experts recommend Botox Cosmetic, a popular wrinkle reducer that operates differently from fillers.
Instead of adding volume to the skin, Botox Cosmetic temporarily paralyzes targeted muscles to reduce the appearance of dynamic wrinkles, which are lines and folds that occur with facial movement.
Botox and other brand names such as Dysport and Jeuveau are ideal for addressing frown lines between the eyebrows, horizontal lines on the forehead, and crow’s feet around the eyes.
Autologous fat grafting is a cosmetic surgery that involves removing fat from one part of your body and injecting it into areas that require volume. This offers a more natural approach to restoring facial fullness and is considered semi-permanent as some of the fat will integrate with the existing tissues.
While liposuction is primarily known for removing excess fat, it can also play a role in facial contouring. For example, removing fat from the jowls or neck can create a more defined jawline. However, liposuction is a surgical procedure and comes with its own set of risks and a longer recovery time compared to injectable treatments.
A face lift is a type of plastic surgery that focuses on the lower two-thirds of the face. It is effective for treating deeper wrinkles, significant volume loss, and sagging skin. While the results are more enduring compared to fillers, a face lift is also more invasive and requires a substantial recovery period.
The Bottom Line
Keeping track of the many types of dermal fillers available can seem like a daunting task, but it’s possible to narrow them down based on your desired effect and area you’d like treated. From hyaluronic acid fillers designed for subtle hydration to more robust options like PMMA for sculpting, there’s a solution to fit nearly every cosmetic need and area of treatment.
As with any medical procedure, consultation with a board-certified dermatologist or plastic surgeon is crucial for determining which treatment best aligns with your goals. With personalized guidance, you can achieve the aesthetic improvements you desire, whether that’s reducing the signs of aging or enhancing your natural features.