Skincare Beginner’s Guide: Facial Fillers

Facial Fillers 101: Everything You Need to Know Before You Get a Dermal Filler

So you’re considering taking the plunge, or more appropriately, the syringe…

Perhaps you’ve been following your favorite celebrity on Instagram, or the reflection in the mirror isn’t reflecting how you feel on the inside anymore. Or maybe some of your girlfriends have been getting facial fillers for a couple years now, and they seem to be aging in reverse, and group photos are no longer much fun.

Whatever your reason, you’re considering getting a facial filler, also known as a dermal filler injection, to address your fine lines and wrinkles around your face and you have some questions. We want to give you all of the information you need to make a smart decision, but first a few words of wisdom...

Before You Get a Facial Filler, Know This…

Don’t try this at home. Do not go to any home parties, do not buy anything from the internet, and do not inject anything into yourself. There is a reason why a license is required to inject fillers into your face, and your face is not something you want to take a chance with.

Not all injectors know what they are doing. Do your homework. Talk to your friends, read skincare expert reviews, and look at skin before and after’s. It is easier than ever to do your research these days, so there is no reason to walk in blindly. Look at their credentials and understand if they are permitted to inject in your state. It is your responsibility to know the rules, regulations, and laws.

How do I know who is licensed to inject in my state? Search online under the licensing board in your state; for example, if you live in California, this is the state’s Department of Consumer Affairs search tool to find licensed skincare individuals and practices.

Really consider your reason for wanting a facial filler. Why do you want to get a dermal filler and where do you want it? Perhaps more importantly, consider what are your expectations and your desired end result? Just because everybody else is doing it is not necessarily a good reason to have facial fillers done yourself.

Not all facial fillers are the same. Again, do your homework. It is your responsibility to be informed so you can ask the right questions when you are in front of the licensed skincare professional who will be performing your injections. For a breakdown and comparison of some of the more popular facial fillers, keep reading below.

Lastly, consider a consult first, before you commit. If this is your first time, consider a consult with a skincare expert and get more than one opinion from a trusted professional.

It is normal to be nervous and uncertain. The last thing you want to do is make a rash, or impulsive decision, on something so important and costly.

By doing a consult first, you can gather all of the information, take it home, and think about it. You can weigh all of your options to make a confident, informed decision which will allow you to achieve your best results and the most beautiful version of you!

Thousands of women (and men too!) make the commitment every day to get fillers for reasons that are right for them. The medical professionals trained to perform injections can provide you with a service and a product that is truly transformational.

If you need help finding a skincare expert near you, use the ALASTIN Skincare Expert Search Tool to get started.

4 Popular Types of Facial Fillers

1.) Hyaluronic Acid

Have you heard of the following fillers?

Restylane ® family fillers by Galderma
Juvederm ® family fillers by Allergan
Belotero® by Merz
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 (HA).

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.

Is hyaluronic acid filler right for you?

Depending on the specific formulation, hyaluronic acid 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.

Hyaluronic Acid Filler Cost

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

2.) 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 of Calcium Hydroxylapatite Fillers

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.

Calcium Hydroxylapatite Filler Cost

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.

3.) 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 of Poly-L-Lactic Acid Fillers

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.

PLLA Cost

According to the ASPS, the average cost for Sculptra ® by Galderma is $878.¹²

4.) Polymethylmethacrylate (PMMA) Fillers

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

PMMA Cost

According to the ASPS, the average cost for PMMA fillers is $855.¹⁴

What kind of skincare regimen should I use before my facial rejuvenating procedure?

The consult with your skincare expert will help you to determine the proper skincare regimen before and after your facial procedure, but one tip they will all tell you is to make sure you have a dermatologist-approved broad spectrum sunscreen to protect your skin year-round.

The ALASTIN Skincare Regenerating Skin Nectar with TriHex Technology® will help to support your skin's natural ability to produce new collagen and elastin, making it a great complimentary product to use before and after facial filler treatments. As always, consult with your doctor on any new skincare regimen.

If you have sensitive skin, you might also consider a Gentle Cleanser to help calm the skin before and after your treatment as well.

There are likely endless questions you have about facial fillers, but we hope we’ve answered a few of your initial questions. We encourage you to consult your skincare expert and continue to research how you can achieve your desired results, and get glowing skin!

Sources:

“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/
Ibid
“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.