Dermal fillers are commonly known as gel-like substances that are injected beneath the skin to restore volume, smooth lines and soften wrinkles, or even enhance facial contours. Due to dermal fillers’ ability to replicate aesthetic improvements while being less costly than surgery and have limited-to-no recovery time, have made their popularity grow exponentially in recent years. Although results from dermal fillers are temporary, the newest fillers on the market have been formulated to last as long as 2 years.
Since 1981, a variety of dermal fillers have been approved by the FDA, which vary based on their chemical makeup, duration, and degree of softness. For example, softer fillers are used in the lips, while sturdier fillers might be desired to enhance cheekbones. In general, dermal fillers are categorized based on the substance they are made from. Below are the various categories of dermal fillers along with examples of each.
What are the types of dermal fillers out there?
Hyaluronic acid dermal fillers are the most popular category of dermal fillers. Hyaluronic acid is a substance that is naturally produced by the body. The highest concentrations are found in the skin, inside joints, and within the eye sockets. The role of hyaluronic acid is to increase moisture, retain collagen, and provide elasticity and flexibility. It can also be described as a humectant, as it serves to attract and bind water molecules, thus keeping the skin hydrated as well as giving it volume.
FDA-approved hyaluronic acid dermal fillers include:
- Juvéderm products: Juvéderm XC, VOLUMA, VOLBELLA, VOLLURE
- Restylane products: Restylane, Restylane Silk, Restylane Lyft, Restylane Refyne, and Restylane Defyne
- Belotero Balance
Calcium hydroxylapatite is also a naturally occurring substance that is present in our bones. It is a mineral-like compound, making it thicker than hyaluronic acid fillers and also the heaviest of all dermal fillers.
The only FDA-approved calcium hydroxylapatite dermal filler is Radiesse. Radiesse produces results that last a year or more in many patients.
Poly-L-lactic acid is a synthetic substance that is biocompatible, which means it is safe to use in the body, as well as biodegradable. In fact, before it was used as a dermal filler it was used for many years in medical devices, such as dissolvable stitches.
The only FDA-approved Poly-L-lactic acid dermal filler is Sculptra® Aesthetic.
Polymethylmethacrylate (PMMA) is a synthetic, biocompatible substance that has been used for much of the last century in permanent surgical implants. When used as a dermal filler, PMMA takes the form of a “microsphere” or tiny ball, that remains beneath the skin to provide continued support. PMMA fillers also contain collagen to provide additional structure and firmness.
FDA approved PMMA fillers include Bellafill® (formerly known as Artefill).
Which areas can these fillers be used?
Hyaluronic Acid dermal fillers can restore a more youthful appearance by filling out wrinkles and replacing lost facial volume. Research has shown that repeated treatments can stimulate the production of collagen, resulting in added firmness and support. The duration of these fillers varies based on the product and can range anywhere from several months to over a year or two.
According to the American Board of Cosmetic Surgery, Calcium Hydroxylapatite has been reported to help stimulate natural collagen production, and it is typically used for deeper lines and wrinkles.
Poly-L-Lactic Acid (PLLA) dermal fillers are classified as collagen stimulators based on their mechanism of action: they smooth fine lines and wrinkles by helping skin rebuild natural collagen, with the filler gel itself dissolving a few days after treatment. These fillers are mainly used to treat deeper facial wrinkles and produce results that can last more than 2 years.
Polymethylmethacrylate (PMMA) fillers are most commonly used to treat medium-to-deep wrinkles, folds and furrows, particularly nasolabial folds. They can also be used to fill out pitted scars and to augment thin lips. A drawback of PMMA fillers is that multiple injections are needed to create volume and it can take up to three months to realize the full effects.