What are Dermal Fillers?
While botulinum toxin A relaxes facial muscles, dermal fillers lift up skin from underneath the surface. This allows them to change the appearance of your skin’s contour. Dermal filler injections can correct lines, wrinkles, areas of depression, and regions of volume loss in the face. They can also be used to lift up depressed scars, straighten the profiles of noses, extend weak-appearing chins, and increase lip volume.
At one time, we only had bovine collagen to meet these needs. Now, however, we have four different types of fillers that we can use. Interestingly, collagen is no longer one of them. Collagen fillers lasted a maximum of 4 months; they have disappeared due to better, longer-lasting options.
Let’s now look at each of the four classes of fillers now available to us:
Hyaluronic Acid-Containing Fillers
By far the most frequently used of today’s choices are the HA fillers. These products are popular because they last longer than collagen (6-18 months.) They are also “moldable” throughout their time under the skin. We can use these fillers in all areas of the face. We can also use the hyaluronidase enzyme to dissolve HA dermal filler treatments, if required. This means you could call this product reversible.
Restylane – the first family of fillers to gain FDA approval in the US
- Restylane Refyne – for fine lines and wrinkles
- Restylane Defyne – for deeper creases
- Restylane Kysse – for adding natural-looking volume to lips
- Restylane Lyft – for deepest lines and creases
- Restylane Contour – for cheekbones and chin augmentation
Juvederm – the most commonly used family of fillers in US
- Juvederm Ultra Plus – can be used almost anywhere. The “jack-of-all-trades” of Juvederm products
- Juvederm Volbella – for extremely fine lines
- Juvederm Vollure – falls between Volbella and Voluma
- Juvederm Voluma – for lifting and contouring
Revance – the best family of fillers for areas with a lot of skin movement
- RHA2 – for thinnest lines
- RHA3 – for medium lines and lips
- RHA4 – the thickest density of the Revance fillers, for deep lines
Radiesse is made by the German company Merz Aesthetics. Radiesse lasts an average of 10-12 months, ideally. (The range of duration is a very wide 4-24 months.) It is also relatively inexpensive per unit volume. Radiesse comes in the largest syringe size of 1.5 ml. This product is used mainly as a volumizer in regions like the mid-face (cheek bones, cheeks), temples, noses, and chins. The glabella (the region between the eyebrows) or the lips should not be treated with Radiesse. This product gets high marks for causing a secondary collagen-stimulating effect that can result in long-term skin thickening. Only Sculptra (PLLA) causes more collagen production stimulation than Radiesse.
Sculptra is a pure, long-term volumizer. It lasts more than 2 years. Some experts in our field believe that it never goes away entirely. Unlike all of the other facial fillers, Sculptra is injected as a series of 3-4 treatments initially. After that, we use single additional treatments to boost it every 1-3 years. Sculptra is often the best option for a thin, aging face. This is because it can improve that “gaunt” appearance that can be so frustrating for those with thinner faces. We’ve used this product many times over the years with excellent effect.
It’s not a new idea to use one’s own body fat as filler for hollow or low-volume areas of the face. The big advantage of fat use is that whatever survives the grafting or transplant process has a chance at becoming permanent dermal filler for its new location. A problem of fat use, however, is that the percentage of fat that survives the relocation process can be 20-80%. This makes predicting the final outcome an issue.
Here at Medical Cosmetics, we use all of the above filler methods except for fat grafting. We evaluate each individual situation and how much dermal filler we use in order to determine the cost of the treatment. Here are some of the most common dermal fillers that we provide:
- Lip Fillers
- Under-Eye Fillers
- Cheek Fillers
- Nose Fillers