Your Guide to Injectable Dermal Fillers

As we age, the fat, muscles, bone, and skin in our face begin to thin, often leading to a sunken or sagging appearance. Dermal fillers have gained popularity for their ability to quickly and easily restore this lost volume without downtime. In fact, nearly 2,677,000 dermal filler injections were performed in 2018 alone.

If you have ever been curious about dermal fillers, including their composition, uses, and the various brands available, this post is for you.

What are dermal fillers?

Dermal fillers, also called facial fillers, are gel-like substances that are injected under the skin to restore lost volume, improve static lines and wrinkles (those visible when the face is at rest), and lift sagging tissues. In addition to rejuvenating the skin, dermal fillers are commonly used to accentuate certain facial features, like the cheekbones and jawline; augment the buttocks and lips; rejuvenate the hands; and correct a cosmetic nasal deformity (a treatment known as non-surgical rhinoplasty). 

Dermal fillers are gel-like substances that are injected under the skin to restore lost volume, improve lines and wrinkles, and lift sagging tissues.

How long do dermal fillers last?

On average, dermal fillers remain beneath the skin for approximately 6-12 months, depending on their ingredients and how they were formulated. Learn more about how long individual types of filler last below.

What are dermal fillers made of?

While dermal fillers all provide volume, lift sagging tissues, and increase collagen, they differ slightly in their mechanism of action and how they are formulated. Additionally, some fillers are composed of naturally occurring substances while others are synthetic. Here is a list of the most popular dermal fillers organized by their primary active ingredient:

Hyaluronic acid fillers

Hyaluronic acid (HA) is a gel-like substance that naturally occurs in the body and helps keep our skin looking plump, hydrated, and youthful. Most hyaluronic acid fillers last for 6-12 months before naturally integrating into the body. The following brands of dermal fillers all utilize hyaluronic acid to enhance different parts of the face and body:

• Juvéderm® fillers include Juvéderm XC, Ultra, Ultra Plus, Vollure, Volbella, and Voluma. Juvéderm XC and Vollure are ideal for “filling in” nasolabial folds (the lines that run between the nose and mouth). XC can help restore lost volume in the chin and mouth, while Voluma and Ultra Plus are meant for deep injection into the cheeks and chin. Vollure can help with marionette lines, a.k.a. the “parenthesis” that form around the mouth. Ultra is often used to augment the lips, while Volbella is great at improving vertical lip lines.
• Restylane® fillers include Restylane, Restylane Silk, Restylane Lyft, Restylane Refyne, Restylane Defyne, Restylane Kysse, Restylane Contour. Restylane Refyne is ideal for improving more subtle nasolabial folds and marionette lines, while Defyne is great for smoothing deep-set folds around the mouth. Contour is most often used to correct sunken cheeks. Kysse was formulated specifically for lip augmentation, and Silk is ideal for correcting vertical lip lines and wrinkles around the lips.
• Belotero Balance® is a thicker filler specifically designed to improve the appearance of moderate to severe nasolabial folds.
• Revanesse Versa® can also be used to treat moderate to severe nasolabial folds, as well as parenthesis lines.
• Revance’s RHA® collection of fillers is the first and only line of fillers that are FDA-approved to treat dynamic facial wrinkles and folds (those that move with your natural facial expressions) and includes RHA 2, 3, 4. RHA 2 is ideal for treating vertical lip lines, glabellar lines (a.k.a. the “elevens”), and crow’s feet. RHA 3 is used to correct nasolabial folds and the corners of the mouth, as well as to augment the lips. RHA 4 is the thickest of the RHA fillers and is used to correct severe volume loss in the cheeks, chin, and jawline. “RHA” stands for “resilient” hyaluronic acid because these fillers are designed to smooth even the most dynamic and wrinkle-prone areas of the face. 

Calcium hydroxylapatite fillers

Calcium hydroxylapatite (CaHA) is a mineral-like compound found naturally in our bones. Calcium hydroxylapatite filler is thicker than hyaluronic acid fillers and typically lasts around 12 months for most patients.

• Radiesse® is the only FDA-approved calcium hydroxylapatite filler. It is made of CaHa ‘microspheres’ that are suspended in a gel to provide structural support for skin and underlying tissues. Radiesse is typically used to correct deeper lines and wrinkles associated with more advanced facial aging, as well as to rejuvenate the hands. 

Poly-L-lactic acid fillers

Poly-L-lactic acid (PLLA) is a synthetic filler. Instead of sitting beneath the skin like other fillers, poly-L-lactic acid stimulates your body to produce its own collagen, meaning that final results will develop gradually over the course of 4-8 weeks and last for about 2-3 years.

• Sculptra® Aesthetic is the only FDA-approved poly-L-lactic acid filler. It was originally developed to treat severe fat loss in the face. Sculptra uses PLLA microparticles rather than a gel to replace lost collagen and reinforce skin’s structure. It is commonly used to reverse advanced volume loss in the face and for augmentation in the buttocks.

Polymethylmethacrylate fillers

Polymethylmethacrylate (PMMA) is a synthetic, biocompatible substance that has been used in reconstructive surgery for decades. As a filler, polymethylmethacrylate is recommended when a more permanent solution to facial wrinkles is desired, as results can last indefinitely.

• Bellafill® (formerly known as Artefill) is the only FDA-approved polymethylmethacrylate filler. It combines polymethylmethacrylate with collagen to create microspheres that become encapsulated within new collagen fibers, providing continued support for tissues. Bellafill is typically used to smooth deep wrinkles and folds, as well as to fill out pitted scars. 

Fat injections

Also referred to as fat grafting or fat transfer, autologous fat injections are an alternative to dermal fillers for those who desire a natural, long-lasting filler. During this procedure, fat is harvested from the hips, buttocks, or stomach via liposuction, then purified and injected into the face to help restore volume and contours. Fat injection can also be used to augment the breasts, hands, lips, and buttocks (a.k.a Brazilian butt lift surgery). Results can last for many years as long as a stable body weight is maintained.

How much do dermal fillers cost?

On average, hyaluronic acid fillers such as Restylane and Juvéderm typically cost about $550-$850 per syringe. Radiesse is about $550-750 per syringe and Sculptra comes in at approximately $900 per vial (most patients require 2-3 vials per session), while Bellafill costs around $1,000 per syringe. While dermal fillers can vary in cost based on your provider and locale, note that pricing that is too far below average is a red flag: your safety or results could be compromised.

Choose a board-certified cosmetic surgeon for your filler treatment

To help ensure optimal results and safety during your dermal filler treatment, be sure to always choose a board-certified facial cosmetic surgeon or a trained medical injector working under their supervision. He or she will utilize the most advanced injection techniques, and exclusively use authentic FDA-approved, brand-name fillers. To locate a facial cosmetic surgeon near you and get a quote on dermal filler treatment, use our Find A Surgeon tool.

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