Fillers Techniques

There are a lot of different types of dermal fillers on the market today, and they are all slightly different in their effects. Some work better on large wrinkles, some on small, and some are more just for overall plumping and recontouring. Since one of the most important things you can do to ensure you have a good experience with dermal fillers is make sure you're getting the right one for the job, we've created this page to help you learn a little more about some of the most popular fillers currently available.

Restylane

Restylane is the world's leading dermal filler. Invented in Sweden and first used in the U.S. In 2004, it has been injected more than 10 million times worldwide. Its primary component, hyaluronic acid, is a natural sugar that helps skin retain its shape and volume.

What Does It Treat?

Restylane is very effective at decreasing the appearance of labial lines (those around the the nose and mouth). It is also used to diminish wrinkles around the eyes and to smooth and plumpen the under-eye hollows. In addition, it can be used to add volume to the lips, whether they have lost volume through the aging process or were naturally thin to begin with.

How Does It Work?

Hyaluronic acid, the main ingredient of Restylane, is hydrophilic, which means it attracts water. When this substance is injected into the skin, it soaks up some of the surrounding water and binds it in place, firming, smoothing, and plumping the skin.

What Are The Potential Side Effects?

Because Restylane doesn't contain in animal proteins, it doesn't trigger allergies like some fillers may. However, there will possibly be some other post-injection side effects, although they will typically be very mild. Most commonly Restylane causes redness, swelling, itching or bruising. These side effects usually disappear within a day or two.

How Long Does It Last?

Dermal filler procedures using Restylane generally only take one injection to perform, and the effects kick in quickly. Patients will see some of the result before they leave the clinic, and the full effects will become visible within days, as the hyaluronic acid attracts and binds more water fairly quickly until it reaches capacity. One Restylane treatment can last for six to nine months on the face and three to six months in the lips.

Perlane

Perlane is a manufactured by the same Swedish company that makes Restylane, and chemically they're quite similar. The hyaluronic acid molecules in Perlane are somewhat larger, though, which means they can attract more water. This makes Perlane more effective at filling larger, deeper wrinkles and creases. Some studies have also shown Perlane to be longer-lasting than Restylane.

What Does It Treat?

Because of its larger molecules, Perlane is especially effective for deep facial creases such as nasolabial folds, which run from the sides of the nose down to the corners of the mouth, and the permanent forehead creases that some people develop over time. Like Restylane, Perlane can also be used to increase the size of the lips, or restore lost volume to them.

How Does It Work?

Hyaluronic acid, the main ingredient of Perlane, is hydrophilic, which means it attracts water. When this substance is injected into the skin, it soaks up some of the surrounding water and binds it in place, firming, smoothing, and plumping the skin.

What Are The Potential Side Effects?

Because Perlane doesn't contain in animal proteins, it doesn't trigger allergies like some fillers may. However, there will possibly be some other post-injection side effects, although they will typically be very mild. Most commonly Perlane causes redness, swelling, itching or bruising. These side effects usually disappear within a day or two. Less commonly, patients may develop red bumps around the injection site.

Although generally considered safe, Perlane has been known to trigger herpes flare-ups, so be sure to tell your doctor if you are or think you may be infected with the disease. Pregnant or nursing mothers shouldn't have Perlane, and neither should those on blood thinners.

How Long Does It Last?

The number of injections a patient needs depends quite a bit on how deep the wrinkles are, and how many of them are present. Some patients only need one syringe, while others may need several to achieve their desired results. The longevity of Perlane results vary some from patient to patient, but in general, the treatment lasts for about six months.

Sculptra

Sculptra is a powder made from poly-L-lactic acid, a synthetic material that has a variety of medical applications, including surgical stitches. When mixed with water and injected deep within the skin, it can plumpen, smooth, and recontour the surface skin. Although man-made, poly-L-lactic acid has been proved safe for use in the human body by medical history that stretches back for decades.

What Does It Treat?

Sculptra is very good for treating folds and deep or large wrinkles, such as the ones that run from nose to lip (nasolabial lines), from the lip to the chin ("marionette" lines), and forehead lines or creases. It can also be used to fill in depressions left by scars and minimize their effect.

Sculptra is generally not used to enhance the lips, although it can lift the corners of a sagging mouth. It isn't recommended for use near the eyes, or for people who have active skin infections or problems, or who typically scar easily.

How Does It Work?

Sculptra injections cause your body to produce more collagen, a natural protein that is one of the major building blocks for skin. Your body then uses the collagen to repair and rebuild cells that have been damaged or lost due to age, sun exposure, and other factors. The end result is healthier skin with fewer wrinkles and a full, firm, and overall more youthful appearance.

What Are The Potential Side Effects?

With Sculptra, the most common side effects are redness, swelling, itching, and bruising at or near the injection site. Much like a flu shot, massaging the area can help these minimize these effects. Less commonly, some people develop small lumps or nodules under their skin after receiving Sculptra injections. Although these lumps are not harmful, they can look a little and unusual and take months to disappear, so patients are advised to contact their doctor if nodules develop. If another appointment is made, the doctor can inject a seconds chemical to help the lumps dissolve.

How Long Does It Last?

Patients considering Sculptra should be aware that because the point of the treatment is not to create an injectable implant but to encourage the body to repair itself, it does not produce the most immediate results. There will typically be some visible plumping immediately after the surgery, but it is only water retention and will quickly drain. It will take a few weeks for new collagen to grow. On the plus side, though, Sculptra is one of the longest-lasting dermal fillers available, with results that can last up to two years. Eventually, though, the new collagen will break down again, and touch-up treatments will be required to maintain the desired effects.

How many treatments are needed will depend on how much the patient's skin has deteriorated, and how much of the underlying fat has been lost. Some people get the results they want with just one Sculptra injection, but generally speaking most people need two or three treatments, spaced four to six weeks apart. In some rare cases, a person may require as many as six treatments to be satisfied with their results.

Radiesse

Radiesse is one of the longest-lasting dermal fillers. It is composed of tiny calcium-based particles—the same as those that make up bones and teeth—suspended in a carbon-cellulose gel. In addition to its own effects, the filler stimulates the body to produce new collagen, which helps the results last longer.

What Does It Treat?

Radiesse is good for filling deep wrinkles and creases such as nasolabial folds and frown lines on the forehead. It can also be used to fill in hypotrophic (depressed) scars. The calcium hydroxylapatatite in the formula also makes it the best choice for injection-based recontourings of facial features such as noses and chins. Radiesse can augment these features if the patient feels they are too small, and it can also smooth out bumps or breaks in the bone.

How Does It Work?

Radiesse works on two fronts. First, the CaHA particles act as an injectable implant, filling in deep folds and rounding and pushing out other features as the patient desires. Secondly, these particles encourage the production of new collagen within your own body, which is one of the key building blocks of new and healthy skin. These particles attach themselves to the calcium "scaffold" already in place and help regrow missing or damaged cells, resulting in smoother and younger-looking skin.

What Are The Potential Side Effects?

Radiesse is biocompatible, so it won't cause allergic reactions like some fillers can. Side effects are usually mild, and most commonly include bruising and swelling. As with any injection, there is a very slight risk of infection. Patients on blood thinners should tell their doctors about their medications before the procedure, as blood thinners can increase the risk of excessive bleeding. There have also been a few reported cases in which patients developed harmless nodules under the skin after injection.

How Long Does It Last?

Some results of Radiesse will show up immediately, but the full effect can take two weeks or more to become apparent, as the body continues to produce collagen. Radiesse is one of the longest-lasting dermal fillers, with results that can last a year or more.

Evolence

Evolence is a collagen-based structural dermal filler. The collagen in Evolence is derived from porcine sources and has been used for years in a wide variety of medical procedures, including heart valve replacements.

What Does It Treat?

This new generation collagen filler is intended for injection into the mid-to-deep dermis for the correction of moderate to deep facial wrinkles and folds, such as nasolabial folds

How Does It Work?

Unlike most other dermal fillers, Evolence does not include any hyaluronic acid, but instead creates collagen structures under the skin that mimic those naturally produced by the body. As one of nature's most fundamental and abundant building blocks, collagen comprises up to 80% of the dermis and it helps maintain skin strength, structure and support. Unfortunately, collagen naturally breaks down as a person ages, leading to the appearance of wrinkles, lines and folds. Evolence replaces some of the lost collagen with a framework of collagen derived from pigs, which are genetically very similar to humans.

What Are The Potential Side Effects?

The most common side effects of Evolence injections are usually injection-site related and include mild swelling, redness, and pain. Other rare side effects include the development of small areas of firmness under the skin at the treated sites. These are usually not noticeable unless the areas are pushed on. Evolence has undergone rigorous testing and has been demonstrated to be safe and effective through clinical studies.

How Long Does It Last?

The results of Evolence are immediate, with little to no downtime post-treatment. It has been proven to last at least six months, although some studies indicate it can commonly last up to 12 months in many people.

Dysport

Dysport, formally known as Reloxin, is an anti-wrinkle injection manufactured from the same botulism neurotoxin responsible for Botox. Like Botox, it is used to smooth out facial folds and wrinkles by relaxing the muscles that create them.

How Does It Work?

Dysport treatments are injected directly into the facial muscles that are responsible for causing wrinkles, where the neurotoxin temporarily paralyzes these muscles. This enforced relaxing of the muscles allow the skin to smooth out and removes muscle-based wrinkles, such as frown lines. Dysport differs from Botox in that it diffuses, or spreads, more widely under the skin, which means it requires fewer injections to treat any given area.

What Are The Potential Side Effects?

Like all neurotoxins, Dysport doesn't discriminate which muscles it shuts down. This makes the large spread a bit of a double-edged sword, because while it means that fewer injections are required, it also means there is a greater risk of the toxin spreading too far, leading to unintended consequences such as eyelid or brow drooping. Because of this risk, Dysport should only be injected by very skilled professionals, who can gauge exactly where the injections need to go. Some patients have also reported headaches after receiving Dysport injections, but these are generally minor and disappear quickly.

How Long Does It Last?

How long it takes for the results of Dysport to become noticeable varies a little from patient to patient, but usually some wrinkle-smoothing is visible within the first five days. Because Dysport contains less protein than Botox does, the body breaks it down more slowly. Some studies have shown that Dysport can occasionally last as long as 13 months; however, four to six months is probably a better guess for most typical patients.

Juvederm

Juvederm is a smooth injectable gel developed by the same company that manufactures Botox. Like Restylane, its primary component is hyaluronic acid, a natural sugar that helps skin retain its shape and volume.

What Does It Treat?

Juvederm comes in two types: Juvederm Ultra and Juvederm Ultra Plus. Ultra is more useful for smaller lines, such as those that accumulate around the corners of the eyes and mouth. It can also be used as a filler to augment the lips. Juvederm Ultra Plus has a denser formula and is used for very deep lines or folds that the Ultra formula cannot completely treat.

How Does It Work?

The main ingredient of Juvederm is a naturally occurring sugar called hyaluronic acid. This acid is hydrophilic, which means it attracts water. When it is injected into the skin, it soaks up some of the surrounding water and binds it in place, firming, smoothing, and plumping the skin. This helps combat the sagging and loss of fullness that many people experience either as a result of sun damage or of the aging process.

What Are The Potential Side Effects?

Juvederm has fairly typical side effects for a dermal filler: swelling around the injection site, redness, itching or other skin irritations, bumps, or bruising (especially if you are taking any medication containing blood thinners) are all possible, all though in most cases these symptoms are relatively mild and should pass within a week. If the symptoms seem to be getting worse or are overly troubling, patients are advised to call their doctors.

If patients have a history of severe allergies, they should not get Juvederm injections.

How Long Does It Last?

Juvederm produces nearly immediate results, with some effects visible right away, and the full effect present within just a few days. It generally lasts nine to twelve months.

Prevelle Silk

Prevelle Silk combines lidocaine, a local anesthetic frequently used in cosmetic surgery, with a low concentration of hyaluronic acid suitable for smoothing away fine lines almost painlessly, and with a low incidence of negative reactions.

What Does It Treat?

Because Prevelle Silk contains a fairly lower concentration of its active ingredient, this filler is more suitable for reducing fine lines than it is for deep lines or folds. It is especially good for lines near the eyes and mouth, and any other small wrinkles in delicate or sensitive areas.

In addition, Prevelle Silk is ideal for patients who find themselves in "last minute" sorts of situations, where they don't have time to wait for swelling to go down or effects to kick in. Many of the heavier duty dermal fillers take a week or more for the patient to get looking as good as possible, which means if a person wants to look good for a job interview tomorrow, they are better off not getting it at all. Prevelle Silk, however, requires very little time to reach peak performance, making it more of an option in those sorts cases.

How Does It Work?

Prevelle Silk uses hyaluronic acid, a common ingredient found in many dermal fillers, to attract water to the injected area and bind it there, reducing the appearance of lines and wrinkles and making the area appear firmer and younger.

What Are The Potential Side Effects?

Because of the low concentration of hyaluronic acid, Prevelle Silk has very few side effects, even when it is injected into very sensitive areas. It comes fully hydrated, so there is very little swelling associated with it, and what there is usually disappears within hours. In addition, the lidocaine mixed in to the formula makes the procedure nearly pain-free.

How Long Does It Last?

As discussed above, Prevelle Silk achieves peak performance within hours, making it ideal for last minute situations. Because of the low concentration of hyaluronic acid, though, Prevelle Silk doesn't last as long as most other dermal fillers. It generally fades away within two months.