Injectable dermal fillers have exploded in popularity over the last several years even though they have been FDA approved for over 15 years. Here’s the lowdown on what they are, what they do, and what you need to know when considering filler treatments!
What is filler?
In terms of aesthetic treatments, dermal fillers are injectable gels that are used to treat age-related volume loss or to change the natural contours of the face. Various brands and versions of filler will have different thicknesses and are usually suitable for injecting in different areas. Generally, most fillers are made of hyaluronic acid, which is a sugar molecule that occurs naturally in the skin and draws water. Many topical skincare serums use hyaluronic acid as a focal ingredient for hydrating the skin. Radiesse is comprised of calcium hydroxylapatite and cellulose, NOT hyaluronic acid. Sculptra is another injectable made of PLLA that is also notably NOT hyaluronic-acid based.
What are fillers used for?
Dermal fillers are used for two purposes: age-related volume loss and to change the natural contours of the face. Dermal fillers were originally FDA-approved to correct hollowness from aging. Part of the natural aging process is loss of collagen and elastin in the skin, bone reabsorption, fat pad drooping, and sagging of the skin. Naturally, this leads to changes in facial structure with age – lips become thinner and more inverted, temples become hollow, jowls may become apparent, and wrinkles may begin to form. Dermal fillers can be injected to slow the appearance of aging in the face, neck, and hands. Fillers can also be used to change the contours of the face, regardless of age. For example, fillers can be injected into the lips for more fullness, into the chin for a more defined jawline or a sharper chin, and even into the nasal bridge to change the profile of the nose. Fillers can even be used to change the contours of the body, such as to the “hip dips” to round hips or to the backs of the hands to alleviate aging-related volume loss.
Why are there different thicknesses of fillers?
Understanding the difference between thicknesses of fillers requires some basic chemistry knowledge. Hydrogen bonds, weak attractions between molecules, create cross-linked hyaluronic acid molecules. Cross-linking between hyaluronic acid molecules creates larger chains of non-linear HA molecules with greater density and permanence as compared to non cross-linked, linear molecules. Generally, the more cross-linking in a filler the firmer the filler is. Softer fillers with less cross-linking can be used for delicate areas like the lips, lower eyelid/tear troughs, or superficial areas, while firmer fillers may be used for deeper injection in bonier areas that can support the filler, such as the jawline, nose, chin, and cheeks. More cross-linkage in a filler may also give it more longevity. Of course, depending on the condition of the skin and the outcome that is desired, different injectors may recommend different types or amounts of fillers.
How long does filler last?
Depending on area of injection, type of filler, amount of cross-linking, and patient metabolism, filler can last anywhere from several months up to one or two years on average. Areas of high motion or areas that require softer fillers will need to be treated more often. Radiesse and Sculptra may last longer due to their composition, but cannot be dissolved if you are dissatisfied with results. Hyaluronic acid-based fillers can be dissolved with Hyaluronidase, an enzyme that breaks up the links between hyaluronic acid molecules.
What is the difference between brands of fillers?
Various aesthetics companies have different brands of FDA-approved injectable fillers for cosmetic use in the USA. Allergan, the makers of Botox, are the makers of the Juvederm family of fillers. The Juvederm line includes: Juvederm Ultra XC, Juvederm Ultra Plus XC, Volbella XC, Vollure XC, Voluma XC, and Volux XC. Galderma Aesthetics has the Restylane family of fillers, and were the first to market in the USA. The Restylane line includes: Restylane Silk, Restylane L, Restylane Lyft, Restylane Kysse, Restylane Refyne, Restylane Defyne, and Restylane Contour. Galderma is also the maker of Sculptra. Merz Aesthetics is the maker of Belotero Balance and Radiesse. There are a few other FDA-approved fillers that DSC does not carry. Additionally, there are many other brands of dermal fillers available in international markets that do not have FDA approval for usage in the USA.
Related: What is Botox?
How soon will I see results?
Because filler volumizes, you can see results immediately post-treatment. However, along with any other type of injection, temporary swelling, redness, soreness, and even bruising may be immediately apparent post-treatment, so final results may take several days to weeks. For example, filler injected into the lips can cause a lot of swelling day 2 and 3 post-treatment. Aesthetic treatments with filler should only ever be to the correct amount at the time of treatment. Your provider should never over-treat to compensate for the swelling that will dissipate after treatment. Because of this, it may require more than one treatment in order to achieve the most optimal aesthetic results.
How much filler do I need?
Most fillers come in 1.0cc syringes, with the notable exceptions of Radiesse and Sculptra. Radiesse comes in 1.5cc syringes, while Sculptra comes in powder form and is reconstituted before injection. 1.0cc is equivalent to 1 mL, which is about the size of a blueberry for a scale reference. Number of areas treated and expectations for treatment will dictate the amount of filler necessary. Contour changes in one area may be able to be achieved with conservative amounts of filler, but large areas of volume-loss may require a significant amount of filler. For anti-aging purposes, filler can be combined with laser treatments, injectable neurotoxins, and other skin tightening and lifting treatments for more comprehensive results.
Related: Energy-Based Skin Treatments
DSC Laser & Skin Care Center
889 S. San Gabriel Blvd. San Gabriel, CA 91776