How to Choose a Facial Filler

A Handy Guide to the Most Popular Types of Dermal Fillers

Facial fillers, also known as dermal fillers, can work all sorts of magic: plump thinning lips, give eyebrows a lift, enhance cheekbones, erase under-eye circles, smooth smile lines, and leave you looking more rested and rejuvenated—and yes, even, a few years younger. 

Dermal fillers can be injected in less than an hour and require little to no downtime afterward. Side effects are minor. Once in a while, a person may have an allergic reaction to a dermal filler, but for most people, the worst that will happen is mild bruising, swelling, or redness where the filler was injected—all temporary side effects. 

Temporary is the key word when talking about the only other potential downside of facial fillers: They don't last forever. Sometimes the effect wears away after 6 months months, depending on the filler and how it's used. That said, some procedures yield results that are good for as long as a year and a half.  

How to Choose Before You Use

There are many dermal filler products on the market. Finding the right one for you will depend on your budget, your doctor’s experience and preference, and your individual skin nuances—how much sun damage you have, for instance, or how elastic or inelastic your skin is. Keep in mind that what works for your friend may not be the best option for you. If you're thinking of going under the needle, here are some key things to know about some of the most-used dermal fillers.

Note: Don't confuse dermal fillers with other injectables like BotoxDysport, or Xeomin, which are wrinkle relaxers. Although, like fillers, these products are “injectables,” they work their magic very differently—by temporarily paralyzing muscles that cause crow's feet, forehead furrows, and the "eleven" lines between the eyebrows. They don't fill, plump, or enhance an area. They can, however, be used along with fillers.

Juvéderm

man receiving facial injection
Adam Gault/Science Photo Library/Getty Images

What it can do: Juvéderm is a collection of fillers and different forms are designed to be used in different areas of the face. For instance, Juvéderm Voluma XC is used to add back youthful contours to the cheeks, which naturally flatten over time. It also smoothes moderate-to-deep "parentheses" lines around your nose and mouth (aka the nasolabial folds) and the lines that run from the corners of your mouth toward the chin (the marionette lines). Juvéderm Ultra XC plumps up the lips, as does Juvéderm Volbella XC, which also is used to soften vertical lip lines. Wondering about the pain factor? Though not totally painless, most HA fillers are infused with the anesthetic lidocaine to minimize discomfort during and after treatment. 

How it works: The main ingredient in Juvéderm is hyaluronic acid (HA), a naturally occurring sugar found in the body that gives the skin moisture, volume, and elasticity. As HA gets depleted with age, skin loses volume and wrinkles are more likely to appear. When injected, HA acts like a sponge to attract water into the skin. As a result, it plumps up the area in which it was injected. In addition to producing instant smoothing results, research from 2007 shows that HA injections boost the skin's own production of collagen. That means fewer touch-ups may be needed, and that when it's time for a touch-up, less of the material will be necessary (so repeat treatments should be cheaper). One advantage of HA-based fillers over earlier options is that because HA is found naturally in the body there's no risk of allergic reaction.

How long it lasts: Depending on the material (some are thinner and more "flowy," others thicker, so they can potentially last longer), the effects of Juvéderm can last from 6 months to 18 months before the body gradually absorbs the material. If you're wondering what happens if you don't love your result, fear not: Fillers that contain HA can be partially or completely removed with hyaluronidase, an enzyme that breaks down HA. 

Price: According to 2017 stats from the American Society of Plastic Surgeons (ASPS), the average cost of a syringe of an HA-based filler is $682. 

Restylane

What it can do: Like Juvéderm, there's a family of Restylane products designed to treat various, sometimes overlapping, problem areas. The original Restylane smoothes away wrinkles and folds and can be used to add volume to thin lips. Restylane Lyft (formerly Perlane-L), a much thicker gel, is used to correct severe wrinkles and folds like the nasolabial folds, as well as volume loss in the cheeks. It's also FDA approved to add fullness to the backs of the hands. Restylane Silk is designed especially to enhance the lips, as it is made with smaller particles than the other products. 

How it works: This is another line of products that rely on the immediate smoothing ability of hyaluronic acid. Injections may also stimulate natural collagen production, so fewer touch-ups may be needed and less material necessary when they are. 

How long it lasts: Clinical studies found that with "full treatment," which includes one repeat injection, results with Restylane can last up to 18 months. Results in the cheeks last up to a year and up to 6 months in wrinkles and folds with Restylane Lyft. Results in the lips last up to 6 months with Restylane Silk. 

Price: According to 2017 stats from ASPS, the average cost of a syringe of an HA-based filler is $682. 

Sculptra Aesthetic

What it can do: Sculptra initially was used in patients with human immunodeficiency virus (HIV) who had loss of facial fat. Now it's approved for cosmetic use in people who aren't infected with HIV to build up cheeks, fill in hollows or sunken areas of the face, and increase skin thickness to diminish the appearance of folds and lines. It is not injected into the lips or used around the eyes.

How it works: The active ingredient in Sculptra is poly-L-lactic acid (PLLA), a synthetic compound that encourages the formation of new collagen. For this reason, it takes several treatments, about four to six weeks apart, for results to become obvious. The number of treatments a person needs will depend on the extent of facial aging.

How long it lasts: In a clinical study published in 2011, the effects of Sculptra lasted up to two years after the first treatment session was completed (an average of three injections). 

Price: According to 2017 stats from the ASPS, the average cost of a syringe of Sculptra is $903. 

Radiesse

What it can do: Radiesse is used to treat moderate-to-severe facial creases, such as the nasolabial folds. It also can be used to plump up cheeks and other facial contours. It's not used on the lips. 

How it works: Radiesse contains microspheres of calcium hydroxylapatite, a type of mineral that's found in human teeth and bones. When used in a filler, the calcium particles are tiny and suspended in a thick gel-like solution. While Radiesse immediately replenishes lost volume, over time the gel is absorbed and the body metabolizes the calcium, leaving behind your own collagen. 

How long it lasts: Results with Radiesse last a year or more. However, because calcium hydroxylapatite stimulates natural collagen production, fewer touch-ups (and less material) may be necessary to maintain the result. 

Price: According to 2017 stats from the ASPS, the average cost of a syringe of Radiesse is $662. 

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