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Comparing Different Types of Dermal Fillers
While hydration, a healthy diet and a good skincare routine can help your skin look younger for longer, time eventually takes a toll. If you’re starting to notice fine lines, wrinkles, or the loss of facial volume, dermal fillers are one possible solution.
Here’s what you should know about the difference between Botox vs Fillers. While neurotoxins like Botox eliminate wrinkles by freezing the underlying muscles in place, dermal fillers are natural, synthetic, and stimulant substances that increase facial volume.
There are numerous types of dermal fillers out there, but which one is right for you? That depends on your target area, budget, and desired results.
In this short guide, we’ll go over popular types of facial fillers, their cost, and their intended effects.
What is a Dermal Filler?
As we’ve discussed, injectable dermal fillers can help to reduce signs of aging. How do they work?
- As we age, the fat deposits in facial skin that make our skin look plump and youthful—begin to break down and lose elasticity. Losing our fat deposits can lead to the appearance of a hollow face or sagging skin.1
- As skin loses elasticity and oil, every day facial expressions can begin to leave wrinkles and grooves in the skin.
- Filler injections plump areas that have lost facial volume—from hollow cheeks to carved-out facial wrinkles.
Different signs of aging may require different filler formulations. Likewise, injecting more or less filler can achieve different results. For example, the volume and type of filler that easily fills in the fine lines around your eyes may have little effect on thin temples.
Next, we’ll go over four of the most popular fillers and their specific effects.
Have you heard of the following fillers?
- Belotero® by Merz
- Juvederm ® family fillers by Allergan
- Restylane ® family fillers by Galderma
- Teoxane® by Revance
While each of these types of dermal fillers uses slightly different technology (and Juvederm ® and Restylane ® have several different formulas), all rely on one common ingredient as the basis of their product—hyaluronic acid.
Hyaluronic acid naturally occurs throughout our bodies, especially in the following areas:
- The fluid around our eyes
- Connective tissue
- Cartilage and joint tissues
So hyaluronic acid, or HA, is something our body makes to keep us in good working condition. Because our bodies already contain HA, it’s unlikely to cause an allergic reaction in most people2.
How does this liquid add volume?
HA is thirsty—that is, readily able to store moisture. However, if injected on its own, it would leave the bloodstream in two days. Instead, products like Juvederm® and Teoxane® use crosslinking agents to create HA gels with greater longevity in the body.3
Hyaluronic acid filler is currently approved by the Food and Drug Administration to fill moderate to medium-depth facial wrinkles and scars.
Where Hyaluronic Acid Can Help
Is HA filler right for you?
Depending on the specific formulation, HA may help to fill any of the following kinds of wrinkles:
- Fine lines around your eyes (crow’s feet)
- Smile lines (at the corners of your mouth, also known as nasolabial furrows)
- Vertical lines between the eyebrows (frown lines)
- Vertical lines above the lips (also known as smoker’s lines)
- Horizontal lines across the forehead
HA filler can also reduce the appearance of some facial scars (depending on their depth).
Because different fillers have different particle sizes, talk to your healthcare provider to determine which specific brand may be right for you.
Effect and Longevity
After an HA injection—and any filler injection—you can expect bruising and swelling at the site.
It may take some time for the filler to fully settle into your tissue. You may be even more satisfied with your results after one month than you were after one day.
How long your filler will last depends on the specific formula used. Here’s a quick cheat sheet to give you an overview:
- One study found that people who received Juvederm ® Plus by Allergen fillers still had visibly reduced nasolabial furrows after nine months.4
- The same study found that visible improvements from Juvederm ® Ultra Plus by Allergen persisted for twelve months.
- Other studies suggest that HA filler can actually stimulate collagen production, which could lead to further or maintained improvement over time.5
With proper skin care, you can expect HA fillers to last anywhere from six months to a year or even longer.
Beauty is priceless. But according to the American Society of Plastics Surgery, the average cost for HA filler is around $620.6
As with all fillers, the cost will vary depending on factors like the following:
- Average rates in your geographic area
- Your healthcare provider’s training, experience, and rates
- The volume of fillers required to achieve the desired effect
- The numbers of areas treated per session
Calcium Hydroxylapatite Fillers
Although the name looks more complicated, calcium hydroxylapatite is a lot like HA. This mineral compound naturally occurs in the human body. It can be found in human bones, and is well-tolerated by most people.7
Radiesse® by Merz and other popular fillers suspend this mineral in a gel carrier to create products that are FDA-approved for the treatment of moderate and more severe lines including the following:
- Nasiolabal folds, the deeper furrows between the mouth and the nose
- Smile lines at the mouth and frown lines on the forehead
Besides filling in lines, fillers can also increase tissue volume:
- Fillers can be injected to create plumper, fuller looking cheeks
- They can also enhance facial contours in the jawline and chin or augment thin temples
- Potential applications extend beyond the face, i.e., augmenting bony hands
If facial symmetry is a concern, applying calcium hydroxylapatite fillers to just one side of your face (or injecting them in different amounts) may help achieve your desired appearance.
Effect and Longevity
Calcium hydroxylapatite is considered a long-lasting filler, and can last for up to one year.
A 2006 study of over 600 people who received Radiesse® by Merz surveyed receipts' satisfaction with their injectable dermal fillers after six months. 89% of subjects said that they would be interested in undergoing the procedure again in the future.8
Unlike HA, this kind of filler is not known to stimulate collagen production. However, its efficacy at filling in deeper lines and creating volume can make it a solid choice. Getting another round of injections after the results wear off is commonplace.
The American Society of Plastic Surgeons states that the average price of treatment is just slightly more expensive than HA at $690.9
Again, your individual price may vary from this number.
Poly-L-Lactic Acid (PLLA) Fillers
Unlike the two fillers we’ve discussed so far, PLLA is a synthetic compound that does not naturally occur in human bodies. However, it is biodegradable.
Rather than filling lines in itself as do HA and calcium hydroxylapatite, PLLA stimulates your body to produce that golden protein—collagen.
Sculptra ® by Galderma and other similar PLLA formulas are appropriate for filling in mild-to-moderate lines, like laugh lines. They can also be used to plump lips.10
Longevity and Effects
Because PLLA is a “stimulant” filler (i.e., it stimulates natural collagen growth), it does not take effect immediately.
As your body begins to produce its own collagen, you can expect to see the fullest results in about six weeks.11
This synthetic compound is then gradually eliminated by the bloodstream, with a half life of about six months. However, you may continue to see effects for between one and two years.
According to the ASPS, the average cost for Sculptra ® by Galderma is $878.12
Looking for a more permanent filler for your mild-to-moderate facial lines? Then you might be interested in polymethylmethacrylate (PMMA).
This substance is a synthetic polymer, and unlike the other fillers on this list, it is not biodegradable. However, it has long been used in dentures and prosthetic devices without adverse or carcinogenic effects.13
Bellafill® filler was first FDA-approved in 2006 for the long-term correction of nasolabial folds. It was found that people who received a single injection had noticeable results for up to five years.
Some may find PMMA’s long-lived effects preferable to the prospect of yearly injections.
PMMA fillers can be used for the following applications:
- Mild to moderate facial lines
- Acne scars
According to the ASPS, the average cost for PMMA fillers is $855.14
Choosing a Filler and Planning for Aftercare
While we hope our survey of fillers is helpful and informative, you should always consult with your healthcare professional to decide which fillers can help you achieve your desired results. Be sure to choose a reliable, licensed provider who you feel comfortable with.
Some people might be concerned about potential issues that can happen at the injection site.
These can include:
It’s important to keep up a nourishing skincare routine to help accelerate the healing process. That way, you can enjoy your new look without self-consciousness.
Our INhance Post-Injection Serum contains our TriHex Technology® and is designed to work in with injectables pre- and post-procedure to achieve bright, firm, healthy-looking skin.
INhance is formulated specifically for:
- Reducing bruins and swelling at injection sites
- Supporting healthy collagen production
- Hydrating and plumping skin
To help make those beautifying filler effects last, maintain a good skincare routine with a cleanser, moisturizer, and sunscreen that are appropriate for your skin type and texture.
ALASTIN: Medical Grade Skincare For Healthy Skin
Whether or not you’re ready to take the plunge with dermal fillers, a healthy skin care regimen is key to maintaining healthy skin.
Our scientifically backed, patented formulas are specifically designed to promote collagen production, protect skin from harmful free radicals, and deliver moisture.
Are you ready to help reduce signs of aging and improve your skin’s texture and radiance? Invest in medical grade skincare and nourish the skin you’re in.
- “Why Your Faces Ages and What You Can Do.” Harvard Health Publishing. https://www.health.harvard.edu/staying-healthy/why-your-face-ages-and-what-you-can-do
- Monheit, Gary and Kyle Coleman. “Hyaluronic Acid Fillers.” Dermatologic Therapy 19 (2006). https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1529-8019.2006.00068.x?casa_token=w6Hg6ZOJFtQAAAAA:teKtQcgGaUFP9v4vyrOtzgDm0bVA4-GfeINJYJpTMXTIfCXYe3i17f1G7CtRC9-MLmkgm54ZHQ6Dlg
- Bogdan Allemann, Inja, and Leslie Baumann. “Hyaluronic acid gel (Juvéderm) preparations in the treatment of facial wrinkles and folds.” Clinical interventions in aging 3.4 (2008). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682392/
- Lupo, Mary et al. “Effectiveness of Juvéderm Ultra Plus dermal filler in the treatment of severe nasolabial folds.” Plastic Reconstructive Surgery 121.1 (2008). https://pubmed.ncbi.nlm.nih.gov/18176233/
- Wang, Frank et al. “In Vivo Stimulation of De Novo Collagen Production Caused by Cross-linked Hyaluronic Acid Dermal Filler Injections in Photodamaged Human Skin.” Archives of Dermatology (2007). https://jamanetwork.com/journals/jamadermatology/article-abstract/411242
- The American Society for Aesthetic Plastic Surgery Cosmetic Surgery National Data Bank Statistics. https://www.surgery.org/sites/default/files/ASAPS-Stats2016.pdf
- Pavicic, T. “Calcium hydroxylapatite filler: an overview of safety and tolerability.” Journal of Drugs in Dermatology 12.9 (2013). https://europepmc.org/article/med/24002146
- Jansen, David et al. “Evaluation of a Calcium Hydroxylapatite-Based Implant (Radiesse) for Facial Soft-Tissue Augmentation.” Plastic and Reconstructive Surgery 118.3S (2006). https://journals.lww.com/plasreconsurg/Abstract/2006/09011/Evaluation_of_a_Calcium_Hydroxylapatite_Based.6.aspx
“Dermal Fillers.” American Society of Plastic Surgeons. https://www.plasticsurgery.org/cosmetic-procedures/dermal-fillers/cost
Woerle, Brigit et al. “Poly-L-lactic acid: a temporary filler for soft tissue augmentation.” Journal of Drugs and Dermatology 3.4 (2004). https://pubmed.ncbi.nlm.nih.gov/15303782/
- “Dermal Fillers.” https://www.plasticsurgery.org/cosmetic-procedures/dermal-fillers/cost
- Gold, Michael and Neil Sadick. “Optimizing outcomes with polymethylmethacrylate fillers.” Journal of Cosmetic Dermatology 17.3 (2008). https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.12539?casa_token=zDEH6C0QqOcAAAAA%3A-D5NVuuayzA8QKJaSzr2W0om_DXb_4nrG81csUaBZz47zH4QTr68x8zhjmAFmFAurh8COj1rmrDfow
- “Dermal Fillers.” https://www.plasticsurgery.org/cosmetic-procedures/dermal-fillers/cost
Article Reviewed by Wendy Johnson
Vice President, Marketing
Wendy Johnson brings to Alastin Skincare over 22 years of pharmaceutical, biotechnology, and aesthetics industry experience in various sales, training, marketing and thought leader development roles.
After spending 10 years in gastroenterology at Tap Pharmaceuticals and Prometheus Laboratories, with sales and marketing oversight for in-line and pre-launch products, Mrs. Johnson transitioned to an aesthetic career at SkinMedica in 2004. While there, she was responsible for marketing one of the top 2 branded prescription hydroquinones, launching a leading branded low potency steroid, and oversight of the acne franchise line extensions.
In 2010, Wendy joined Merz North America where she developed and managed the Physician Relations department in support of injectable, topical and device business units under Medical Affairs, before transitioning into managing a Regional Aesthetics Marketing team.
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