Dermal Fillers Menu
The menu of dermal fillers offers options to achieve our filler goals: the most natural looking outcomes. There are different fillers for different jobs: thin ones for fine lines and hydration, soft ones for lips, mobile ones for high movement areas, thick ones for heavy lifting and sculpting, bio-stimulating ones for general volumization and smoothing, semi-permanent ones for scars, structure and firmness. Choices are as necessary as skill for the best outcomes.
The main menu categories of the most commonly used dermal fillers:
Hyaluronic Acid (HA) Fillers – Juvederm, Restylane
Hyaluronic acid occurs naturally in our bodies. It is the key molecule involved in moisture retention for skin, connective tissue and eyes. It is what gives skin its bounce, keeping it plump, hydrated, soft and smooth.
As we age, our HA supply diminishes, much like a grape turns into a raisin. To better illustrate, children are loaded with HA – their skin glowing and juicy. When lightly pressing a child’s skin, it bounces right back. When lightly pressing an elder’s skin – not so much. No bounce. No luster. No suppleness.
HA fillers allow us to instantly replace volume and smooth fine lines and deep wrinkles, from lip lines and soft lip augmentation to sculpting a jawline and refilling deflated cheeks.
The longevity of HA fillers range from 6 – 24 months.
The most commonly used HA fillers:
Juvederm collection of fillers (Ultra, Ultra Plus, Volbella, Vollure, Voluma)
Restylane collection of fillers (Silk, Lyft, Refyne, Defyne)
Poly-L-Lactic Acid (PLLA) – Sculptra
Sculptra Aesthetic is the only FDA-approved PLLA injectable. It functions as a general volumizer, a collagen stimulator (aka. bio-stimulator), not as a site specific filler like the others.
Sculptra Aesthetic is made with biocompatible, biodegradable, synthetic material called poly-L-lactic acid, also used for dissolvable sutures. This material gradually breaks down and is replaced by your body’s own collagen, rebuilding skin’s underlying structure and increasing skin volume and lift. Another by-product of Sculptra is the “Sculptra Glow,” referring to the visible improvement in skin quality as collagen is stimulated.
Polymethylmethacrylate (PMMA) – Bellafill
Bellafill is a semi-permanent dermal filler and bio-stimulator. Bellafill uses PMMA micro-particles suspended in bovine collagen. The bovine collagen serves as a carrier for the PMMA micro-particles. The bovine collagen carrier is then reabsorbed by the body after a few months, leaving the PMMA micro-particles. Collagen bundles around the PMMA micro-particles, lifting and smoothing skin in the injected areas.
As collagen continues to bundle around the particles and fill the injected areas, results often look better in a year than after the initial injections. To avoid risk of over-correction, it is important to inject Bellafill over several sessions.
Bellafill is ideal for correction of distensible, rolling acne scars. With each session, new collagen fibers are formed. After several sessions, correction can be permanent for this scar type.
Bellafill is touted as the 5+ year filler, but sometimes, it lasts even longer.
Calcium Hydroxylapatite (CaHA) – Radiesse
Calcium Hydroxylapatite is a naturally occurring component of our bones.
Radiesse is generally used for deeper wrinkles and hands.
So, which filler goes where?
The different physical properties of dermal fillers, injection depth and goals are determining factors as to which fillers are used for particular areas. Following is a general guide:
Lips: Juvederm (Ultra, Ultra Plus, Vobella, Vollure), Restylane
Lip Lines: Juvederm (Volbella), Restylane
Smile Lines: Juvederm (Vollure), Bellafill
Chin: Juvederm (Voluma), Bellafill, Restylane, Radiesse
Marionettes: Juvederm (Voluma, Vollure), Bellafill, Sculptra, Restylane
Jawline: Juvederm (Volluma), Restylane, Radiesse
Nasolabial Folds: Juvederm (Voluma), Bellafill, Sculptra, Radiesse
Cheeks: Juvederm (Voluma, Vollure), Bellafill, Sculptra
Temples: Juvederm (Voluma), Bellafill, Sculptra, Restylane
Hands: Juvederm (Voluma), Bellafill, Radiesse
Neck Lines: Juvederm (Ultra, UltraPlus, Vollure), Bellafill, Restylane, Sculptra
Chest Wrinkles: Juvederm (Ultra, UltraPlus, Volbella), Sculptra
Acne Scars: Bellafill