Dermal Fillers - The Definitive Guide

dermal fillers - juvederm injection
With so many products on the market, it can be difficult to navigate and understand what is right for you. In this guide we'll go over the types of fillers, the different brands and how long the dermal fillers last. We will also give you recommendations for various procedures involving dermal fillers.

What are dermal fillers?

Dermal Fillers are injectables used for cosmetic purposes to shape and rejuvenate your face and body.

Not all dermal fillers are the same. They are made up of different components for various treatments. Fillers like Botox are meant to reduce muscle tension by numbing the nerves that control certain facial muscles whereas Juvederm fills parts of the face that have lost fullness. Because there are so many dermal fillers on the market, we'll go over what they do and their main ingredients:

Botox

Botox, named for its active ingredient "botulinum toxin type A", is a dermal filler that focuses on relaxing facial muscles that cause wrinkles mainly around the eyes. Although its main use is cosmetic, there are many other functions for Botox including:

  • Muscle Spasms
  • Migraines
  • Lazy Eyes
  • Eye Twitching
  • Bladder Dysfunction
  • Excessive Sweating

There are many similar products on the market that have comparable active ingredients but in different dosages and can't be used interchangeably.

Dysport, Xeomin and Myobloc are alternatives to Botox. Your healthcare practitioner may recommend one over the other for your particular needs.

Injection Lifespan - 3 to 4 months

Hyaluronic Acid

Hyaluronic Acid is the main molecule in your skin responsible for moisture. Youthful skin is pliable and resilient due to its high water content. Hyaluronic Acid is responsible for that water content. Injecting Hyaluronic Acid into your skin helps to add back that water content that youthful skin has and regain pliability and resilience. Many dermal fillers like Juvederm contain Hyaluronic Acid for this reason.

Juvederm

Juvederm is a dermal filler that uses Hyaluronic Acid as its active ingredient. It is used to fill in fine lines, wrinkles and sunken cheeks. Juvederm XC products include lidocaine, a numbing agent, to make the injection more comfortable. The full line of Juvederm products offer various consistencies for multiple treatment areas:

  • Juvederm Volbella - subtle lip fulness and line elimination
  • Juvederm Ultra - lip volume and surrounding areas Juvederm
  • Voluma - cheek lifting and contouring
  • Juvederm - moderate/severe folds and wrinkles like the ones from the nose to the mouth Juvederm
  • Vollure - moderate/sever folds and wrinkles (longer lasting)

Injection Lifespan - 9 months to 1 year

Belotero

Belotero is another dermal filler that is made of Hyaluronic Acid. It is used to fill in moderate to severe etched in lines and wrinkles and integrates with the skin to fill naturally give more volume.  Belotero is great for fine lines around the mouth or eyes, loss of volume under the eyes and around the cheeks (bags under the eyes), forehead wrinkles and some acne scars.

Injection Lifespan - 6 to 18 months depending on which product is used

Calcium hydroxylapatite

Calcium hydroxylapatite is the main ingredient in other types of dermal fillers which focus on regeneration of collagen in the skin. By generating collagen, your skin repairs itself and regains structure and a more youthful appearance. It has been used for over 10 years in aesthetic procedures and has many studies and trials backing it. Radiesse uses Calcium hydroxylapatite as its active ingredient.

Radiesse

Radiesse is a dermal filler which helps your skin regenerate collagen to build back up the structures that have been lost. Because it helps your skin rebuild, the results may last longer than other injectables. Keep in mind that these structures still break down and are not permanent and will require subsequent procedures.

Radiesse is good for moderate to severe skin folds and wrinkles. It will take on the appearance and nature of the cell structures around it giving you a natural appearance.

Injection Lifespan - 12 to 18 months

Applications for Facial Fillers

Before recommending specific fillers, make sure you meet with your provider and ensure you tell them your health history as well as any allergies (seasonal or otherwise). Some fillers can have adverse reactions depending on your genetic makeup and personal health history.

Dermal fillers are primarily used for restoring volume in the face. Aging is mainly attributed to a loss of volume. This causes hollowing in the cheeks and fine lines in areas of the face where there is no longer as much moisture and tissue. These fine lines typically start to appear around the nose and mouth as well as the cheeks and eyes. 

Dermal fillers can replace this lost volume and smooth out the wrinkles and fine lines. They can also make the lips more plump and diminish creases. Fillers are also used to improve the symmetry of your facial features.  

Crow's Feet & Frown Lines around the eyes

  • Xeomin or other neurotoxins are best for expression lines

Nasolabial Folds (parentheses or smile lines) around the nose and mouth

  • Juvederm
  • Belotero
  • Radiesse

Under Eyes or eye bags

  • Juvederm

Cheeks - lift and fill

  • Juvederm

Lips - fuller lips

  • Juvederm Ultra

Vertical Lip Lines

  • Belotero

Chin Wrinkles

  • Belotero
  • Radiesse
  • Juvederm

Acne Scars - fill and eliminate

  • Juvederm
  • Radiesse

Hand Rejuvenation

  • Radiesse

Dermal Filler Recommendations

Starting off with a product like Juvederm will give you an immediate result that is also temporary. Your injection will wear off in about 6-18 months depending on the area and amount. This will give you a good idea of how your look will change. If you like the results, you can opt for a synthetic product which lasts 1-3 years or a fat injection which lasts indefinitely. 

Something to consider with fat and synthetic injections are that the results will not wear off for a long time. Initially the fat injections will look fuller and then reduce to normal because some of the fat doesn't survive the translocation. 

Your provider will typically use an anesthetic like Lidocaine to make the injection more comfortable and numb the area locally. Make sure your provider knows if you are taking any medications. Some medications that thin the blood, like Aspirin, might cause bruising. 

When you go in for your consultation your provider will ask you about what you want and will make recommendations for you based on your experience and expectations.

If you'd like more information, schedule a consultation.