Dermal fillers are an increasingly popular way to help reverse the visual signs of aging and restore a youthful appearance. As we age, our outer most layer of skin gradually loses three of its most important components: collagen, elastin and hyaluronic acid, leading to the appearance of lines and wrinkles. Dermal fillers help stop and even reverse this process by injecting collagen, hyaluronic acid or other important substances back into the skin. All dermal fillers do not work the same way, though, so no single filler is suited for use in every area of the face.
Dermal fillers offer immediate results. It’s important to note that the filler does not last that entire time and then immediately disappear. It slowly metabolizes over time, therefore, patients often return in half that time for maintenance treatments.
Juvederm Ultra XC
Juvederm contains a smooth gel made of hyaluronic acid, a naturally produced substance that absorbs water and adds volume to the skin. “Hyaluronic acid is a sugar that’s found naturally in your skin and makes your joint spaces feel slippery. Its function is to absorb water, deliver nutrients, and act as a cushioning agent. So when you inject it into your skin, it acts like a sponge and expands to fill in wrinkles and folds and support sunken areas,” explains Dr. Debra Wattenberg, who specializes in cosmetic dermatology in her New York City boutique clinic, SkincareRX, and is an associate clinical professor of dermatology at Mount Sinai Hospital. Juvederm Ultra XC is used to smooth mild to moderate wrinkles and is also a great filler for those wanting more volume in their lips but want to do so conservatively. Results are immediate and depending on the area, results last from 6 to 9 months, depending on the area treated.
Juvederm Ultra XC Plus® Juvederm is used to smooth moderate to severe wrinkles, especially those around the nasolabial folds and marionette lines, by temporarily adding volume to facial tissues. One treatment of Juvederm Ultra XC Plus lasts approximately one year, depending on the area treated, and the results are immediate. Juvederm Ultra XC Plus may also be used for lips, for those who want a bit more volume than Ultra XC can give.
Juvederm Voluma is the newest hyaluronic acid soft tissue filler to gain FDA approval. It has been available in Europe since 2005 and is used in 72 countries worldwide. Juvederm Voluma is unique in that the HA is cross-linked through a process called Vycross that helps provide an excellent lifting capacity in the cheek area. This special cross-linking also helps to avoid degradation, making Voluma long-lasting, approximately 18 months, depending on the area treated.
Versa is a hyaluronic acid filler and is similar in formula to Juvéderm and other HA fillers. This injectable, however, uses Thixofix cross-linking technology that ensures the filler can be injected easier, making it simpler to shape and gives it a more natural feel and appearance when compared to thicker gel fillers. Versa can be used to soften nasolabial folds, marionette lines, and give volume to the lips. Versa causes less swelling than other hyularonic fillers, which can make it more appealing than Juvederm for lip volume. Results are immediate and last approximately one year, depending on the area treated.
Radiesse® is another form of dermal filler used for soft tissue augmentation. It is composed of beads of Calcium Hydroxylapatite (CaHA) suspended in a water-based gel carrier. Radiesse works by stimulating the body into producing more collagen. It gives the skin an overall smooth appearance by adding volume to the face and is a great substance for getting rid of deep, etched-in lines around the cheek, nasolabial folds, and marionette lines. The result is immediate and tends to last 12 to 18 months, depending on the area treated. Radiesse is not recommended for volumizing lips because the pressure from the muscles in the lips can cause the filler to form lumps. Side effects may include some swelling or redness at the injection site. Radiesse® can be more cost-effective as you get 1.5ml of filler per syringe compared to only 1ml of filler in most other filler syringes.
Bellafill is a popular dermal filler comprised of tiny beads of polymethylmethacrylate, or PMMA. These are suspended in a gel of bovine collagen. Once injected into the skin, the Bellafill solution fills in fine lines and facial wrinkles. The microspheres of PMMA also stimulate the body’s own production of collagen, a key structural element within the skin. This is a popular method for filling in the deep lines running from the corners of the mouth to the nose, as well as volumizing cheeks. Bellafill is also used for filling in other types of facial lines or wrinkles as well as non-surgical nose jobs and lip augmentations. Bellafill is the longest lasting filler on the market, through 5 years. Bellafill does cost more than other fillers, however it is a great filler for those who get filler every year, as you are saving a lot of money in the long-run. If you are sensitive to dairy products, an allergy test must be performed before receiving this filler.
Belotero is one of the lightest dermal fillers available, made of hyaluronic acid. Sometimes called the “starter filler,” it is ideal for someone who wants to reduce fine lines around the lips (smoker’s lines), corners of the mouth, and minor marionette lines (the lines from the corners of your mouth down toward your jawline). When using to treat smoker’s lines around the mouth, a few units of Botox or Xeomin can really maximize the results, giving an even smoother appearance. It can also be used for the tear trough area, to soften the appearance of dark circles under the eyes. For those with very, very thin lips wanting a tad bit more volume, Belotero is a good option. Results are immediate, however, lines will improve over the course of the day as the filler pulls water into the surrounding tissues. One injection of Belotero tends to last 4 to 6 months, so 1 to 2 treatments per year will help maintain results.
DR. CARISSA ALINAT’S TOP CHOICES FOR FILLER BY AREA
Top Choices for Volumizing Cheeks: Radiesse, Voluma, or Bellafill
Top Choices for Smoothing Nasolabial Folds (lines from corners of nose to mouth): Radiesse or Bellafill
Top Choices for Smoothing Marionette Lines (lines from the corners of your mouth down toward your jawline): Radiesse or Bellafill
Top Choice for Very Mild Volumizing of Lips: Belotero
Top Choice for Mild Volumizing of Lips: Juvederm Ultra XC
Top Choices for Moderate Volumizing of Lips: Versa or Juvederm Ultra XC Plus
Top Choices for Maximum Volumizing of Lips: Additional syringe(s) of Versa or Juvederm Ultra XC Plus
Top Choice for Treating Smoker’s Lines (lines around the mouth): A combination of Belotero and a few units of Botox or Xeomin for temporary results, & 3-6 microneedling treatments for long-term results
Top Choice for Treating Tear Trough/Dark Circles under the Eyes: Belotero
Top Choice for Smoothing Fine Lines on the Surface of the Skin: Belotero and 3-6 sessions of Microneedling with PRP
Top Choice for Smoothing Acne Scars: Bellafill
Top Choice for Smoothing Chin Wrinkles: Belotero, Bellafill
Top Choice for Smoothing Hands: Radiesse
*Since every patient is unique, a different filler may be used based on your individual needs and may not be one of the top choices per area treated.