Dermal Fillers

Fillers are organized into different groups according to the material they are made of.

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Hyaluronic Acid:

Hyaluronic acid, a substance naturally present in the skin, aids in maintaining skin hydration and fullness. HA fillers, usually soft and gel-like, offer temporary results lasting 6 to 12 months or more as the body naturally absorbs the particles. Many HA fillers contain lidocaine to reduce discomfort during and after the procedure. FDA approved HA fillers include:

• Juvéderm products: Juvéderm XC, VOLUMA, VOLBELLA, VOLLURE

• Restylane products: Restylane, Restylane Silk, Restylane Lyft, Restylane Refyne, Restylane Defyne, Restylane Kysse, Restylane Contour

• Belotero Balance

• Revanesse

• The RHA collection: RHA 2, RHA 3, and RHA 4

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Calcium Hydroxylapatite:

Calcium hydroxylapatite, a substance found naturally in our bones, can also be used as a filler. The calcium particles in the filler are very small and are suspended in a gel-like substance. Compared to hyaluronic acid fillers, CaHA fillers are thicker and have a longer duration, usually lasting around 12 months. Additionally, CaHA is known to stimulate collagen production and is commonly used for treating deeper lines and wrinkles. Radiesse® is an FDA-approved CaHA filler.

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Poly-L-Lactic Acid:

Poly-L-lactic acid is a synthetic substance that is both biocompatible and biodegradable, making it safe for use in the body. It has a long history of use in medical devices, such as dissolvable stitches. Unlike other fillers, Poly-L-lactic acid acts as a collagen stimulator, helping the skin naturally rebuild collagen to smooth fine lines. The filler gel itself dissipates within a few days after treatment. This type of filler is commonly used to address deeper facial wrinkles and can provide results that last for more than 2 years. Sculptra® Aesthetic is an FDA-approved brand of Poly-L-lactic acid filler.

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PMMA:

PMMA, also known as Polymethylmethacrylate, has been widely utilized in the medical field for several decades due to its synthetic and biocompatible nature. Within dermal fillers, PMMA is present as microspheres, small balls that remain beneath the skin for an extended period, ensuring ongoing support. These fillers also incorporate collagen, a naturally existing substance in the skin responsible for its structure and firmness. One FDA-approved PMMA filler is Bellafill® (previously referred to as Artefill).

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Autologous fat injections (facial fat grafting):

Autologous fat injections involve a surgical procedure and are the sole injectable filler treatment that necessitates surgery, offering long-lasting results. The patient's own fat is extracted from a different body area through liposuction, purified, and then injected into specific facial regions like the cheeks, temples, or lower eyelids to replenish volume. Specialized training is essential to safely administer fat injections and ensure optimal outcomes, making it crucial for the procedure to be carried out exclusively by a skilled, board certified cosmetic surgeon.