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Dermal Fillers

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 dermal 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 (6-12 months for all of them except Voluma, which can last up to 2 years). 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. Examples of this class are: Restylane, Perlane, Juvederm Ultra, Juvederm Ultra Plus, Juvederm Voluma, and Belotero.

Dermal Fillers Under Eyes

Juvederm Ultra

Juvederm Ultra XC is a Hyaluronic Acid dermal filler that’s used to treat thinning lips, wrinkles, and lip lines. Our clients report incredible, long-lasting results from Juvederm Ultra fillers. You can expect them last up to six months, though some patients report up to one year of diminished fine lines and wrinkles.

One of the many perks of dermal fillers is that they don’t involve surgery and are overall painless. Juvederm Ultra is typically used to eliminate laugh line (AKA smile lines), which are the wrinkles around your mouth. However, these injections also work to plump up and smooth out your lips.

Juvederm Ultra Plus

Like the Ultra version, Juvederm Ultra Plus is another Hyaluronic Acid dermal filler, but it’s a thicker gel-like solution that produces longer-lasting results. In fact, many clients report Juvederm Ultra Plus XC lasts up to a year or longer.

The Ultra Plus formula includes water, hyaluronic acid, and lidocaine, which is an anesthetic that eliminates any pain from the injection. Your skin will retain more moisture creating a softer more youthful appearance. These injections can be used for your lips, adding more volume and plumpness. Ultra Plus is the best treatment for stubborn lip lines, but it’s also one of the longest lasting treatments for fuller lips.

Juvederm Voluma

If you’re looking to eliminate cheek lines, Juvederm Voluma combines Hyaluronic Acid with a crystal clear gel that’s gently injected into cheek wrinkles. As signs of aging appear around your cheeks, using Juvederm Voluma can restore volume and smooth out these lines.

As the first and only approved FDA non-surgical option for cheek fillers, Juvederm Voluma is one of the best treatments for those with multiple problem areas around the mid-face. These injections will lift and provide a youthful curve to your cheekbones.

The Calcium Hydroxylapatite Containing Filler

This product, 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 many syringe sizes, namely 0.3, 0.8, and 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.

Poly-L-Lactic-Acid (PLLA)

Also known as Sculptra, this 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.

Dermal Fillers Treatment


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.

Allergan Platinum Member 2020Here 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
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