What are Injectable Dermal Fillers?

Dermal fillers are gel-like, volumizing substances that are injected beneath the skin to restore lost volume, smooth fine lines and deep creases, or enhance facial contours. Over the last few years, more than 1 million men and women annually have chosen this popular facial rejuvenation treatment, which can be a cost-effective way to look younger without surgery or downtime.

How Can Dermal Fillers Enhance My Appearance?

While dermal fillers are casually known as “wrinkle fillers,” they can do much more than just smooth out wrinkles, although they are excellent at this too! Here are a few of the common issues dermal fillers can help address:

  • Smooth out lines around nose and mouth. (a.k.a. marionette lines, smile lines, and parentheses)
  • Enhance & restore volume to sunken cheeks.
  • Diminish vertical lip lines
  • Plump & enhance the lips
  • Smooth out a chin crease

What are Fillers Made With?

There are a variety of FDA approved filler products that cosmetic surgeons use to achieve an individual patient’s goals. Each is uniquely formulated to have a certain texture, density, and injection depth, which means that certain fillers work better for certain areas of concern. In general, fillers are categorized by the substance they are made from. A note for your safety: always make sure that you are receiving FDA approved, brand name fillers, which are only available through a licensed physician, such as a board certified cosmetic surgeon.

Hyaluronic Acid (HA)

Hyaluronic acid is a naturally occurring substance that is already found in your skin. It helps keep skin plump and hydrated. HA fillers are typically soft and gel-like. The results are temporary, lasting 6 to 12 months or longer before the body gradually and naturally absorbs the particles. Certain HA fillers are infused with lidocaine to help minimize discomfort during and after treatment. FDA approved HA fillers include: Juvederm, Belotero, Restylane, Perlane, and VOLUMA

Calcium Hydroxylapatite (CaHA)

Calcium hydroxylapatite is also a naturally occurring substance, found primarily in our bones. When used in a filler, the calcium particles are very tiny, almost microscopic, and suspended in a smooth gel. The consistency of a calcium hydroxylapatite filler is typically thicker than that of a hyaluronic acid filler, and the results will typically last longer as well, about 12 months for most patients. Calcium hydroxylapatite is also reported to help stimulate natural collagen production, and it is typically used for deeper lines and wrinkles. FDA approved calcium hydroxylapatite fillers include Radiesse.

Poly-L-lactic Acid

Poly-L-lactic acid is a biocompatible (meaning it is safe to use in the body), biodegradable synthetic substance. It has been used for many years in a number of medical devices, such as dissolvable stitches. Poly-L-lactic acid fillers are considered a “semi-permanent,” as the results typically last more than 2 years, and can help stimulate collagen production. As a thicker filler material, Poly-L-lactic acid is typically used to treat deeper facial wrinkles. FDA approved Poly-L-lactic acid fillers include Sculptra Aesthetic.

Polymethylmethacrylate (PMMA)

Polymethylmethacrylate (PMMA) is a synthetic, biocompatible substance that has been used in medicine for much of the last century. When used in dermal fillers, PMMA takes the form of a “microsphere” or tiny ball, that remains beneath the skin indefinitely to provide continued support. PMMA fillers will also contain collagen, a naturally occurring substance in the skin that provides structure and firmness. FDA approved PMMA fillers include Artefill.

Choosing a Provider for Filler Treatments

When selecting a provider for injectable treatments, give your decision the same level of care and scrutiny that you would for a surgical procedure. Even though it is non-surgical, filler treatment is still a medical procedure that requires specific training, knowledge and skill to ensure safe treatment and natural-looking results. You’ll want to choose a provider with an extensive knowledge of facial anatomy, a well-developed aesthetic eye, and a surgeon’s skill and precision.

Whomever you choose, make sure your provider has a proven background in cosmetic medicine as well as training and substantial experience performing filler injections. Ask to see before & after photos of each potential provider’s patients. If an R.N. or physician’s assistant will be performing your injections, that person should be working closely under the supervision of a qualified physician, preferably a board certified cosmetic surgeon.

What to Expect During Treatment

Botulinum toxin injections are non-surgical and typically completed during an office visit. Your initial treatment will begin with a consultation, during which you will meet with your cosmetic surgeon to discuss your concerns and goals.

Pre-treatment consultation

During your consultation, your cosmetic surgeon will evaluate your area of concern and review your medical history. While the risks associated with dermal fillers, you need to fully disclose your medical history prior to treatment, as certain allergies, skin and neurological conditions, or medications can jeopardize your safety or results. For instance, you need to tell your cosmetic surgeon if you have been taking NSAIDs (e.g., aspirin, ibuprofen, naproxen) or blood thinners, as these increase the likelihood of bruising.

Your injectable filler treatment

Just before the actual treatment, the area will be cleaned, and you may be given a topical anesthetic to numb the area prior to injection. Many filler products also contain lidocaine, a mild anesthetic, which is intended to help minimize discomfort during and after your treatment. Your provider will then inject a precise amount of filler strategically beneath the skin.

Depending on the product and the areas treated, you should be able to notice results immediately after receiving filler injections. Some patients experience mild bruising and swelling, but these are temporary and should subside over the days following treatment. You will be able to go back to your normal activities right after treatment, but your cosmetic surgeon may ask you to take the day off from exercise or other strenuous activity.

How Long Do the Results Last?

How long the effects of dermal filler treatments will last varies widely, depending on the product used, the area of treatment, and the patient. Generally speaking, the denser the product is and the more deeply it is injected, the longer it will last, although this is not a hard and fast rule. To maintain your results, your cosmetic surgeon will simply repeat treatment, adjusting the amount and techniques as necessary to ensure optimal results.

Hyaluronic acid fillers tend to be the most temporary option, and therefore are often recommended for first-time filler patients. These will typically last from 6 to 12 months, depending on treatment. For example, injections to the lips will wear out a little faster than those to the nasolabial folds. Certain HA fillers, such as VOLUMA, are formulated to last longer, but are usually limited to certain areas, such as the cheeks.

Synthetic fillers tend to be longer lasting, as they are not absorbed by the body. They can be a great option for the right patient, but you’ll want to be ready to commit to results that will be there for several years—and take care to choose an experienced, qualified provider whose aesthetic style you like.

With the help of an experienced, qualified provider, injectable fillers can provide natural-looking enhancements to help you feel more confident in your appearance.  If you’re ready to learn more about your options, the next step is to meet with a board certified cosmetic surgeon for a consultation. You can use our ABCS Find-a-Surgeon tool to locate a cosmetic surgeon near you.