Injectable dermal fillers are a cosmetic procedure that can enhance your appearance, reducing wrinkle lines and adding volume. These injections are placed just under the skin to create a smoother and fuller look in the skin of the lips, cheeks, or hands.
This is a cosmetic procedure regulated by the FDA as medical device implants. They are approved to enhance appearance issues that are often caused by the loss of fat that happens as part of the aging process.
Injectable dermal fillers often involve dissolvable materials that make them temporary, but there are some synthetic materials that can have a more long-term effect. Dermal fillers are injected by cosmetic surgeons as a noninvasive procedure that can be done in under an hour with a relatively fast recovery time.
What Are Dermal Fillers?
Dermal fillers, also known as injectable implants, wrinkle fillers, soft tissue fillers, and facial and lip fillers, use a gel-like substance that is injected just under the skin for a fuller and smoother appearance.
Part of the aging process involves losing subcutaneous fat on your face. This makes the facial muscles work closer to the skin, increasing the appearance of smile lines and crow’s feet. The loss of volume can also cause the facial skin to stretch. Dermal fillers can recreate this volume and smooth out the lines of the face. Dermal fillers are injected in a doctor’s office by a trained professional cosmetic surgeon to enhance appearance and minimize some of the signs of aging.
Uses
Dermal fillers are FDA-approved for the following uses:
- Correction of acne scars on the cheek
- Smoothing out moderate to severe skin folds and facial wrinkles
- Adding volume to lips, under-eye hollows, cheeks, chin, jawline, and back of the hand
- Restoring fat loss in the face due to HIV (human immunodeficiency virus)
Dermal fillers can plump up thin lips, smooth out facial wrinkles and creases, enhance facial contours that are too shallow, reconstruct possible contour deformities in the face, and reduce the shadow of the lower eyelids. Dermal fillers can help to reduce some of the early signs of aging by restoring volume and smoothing out the lines on the face and backs of the hands.
Types
There are a variety of dermal filler products on the market today. Many of them are made from materials that the body produces naturally. Therefore, they are temporary as the body will eventually break them down as well. Often, dermal fillers need to be repeated regularly to maintain the effects.
These are common types of dermal fillers:
Hyaluronic acid (HA)
Brand names include Juvéderm, Hylaform, Prevelle, Captique, Perlane, Restylane, Esthelis, Puragen, Elevess, Belotero, and Voluma.
HA is made from a natural sugar that is found in your body. Over time, hyaluronic acid will be absorbed back into the body (between 6 and 24 months, depending on placement). Therefore, this type of injectable dermal filler is considered temporary.
HA can be used to smooth out facial folds, reduce the appearance of wrinkles and fine lines, and add structure and volume to the face, lips, and backs of the hands.
Calcium Hydroxylapatite
The brand name is Radiesse.
This is a mineral-like compound naturally found in human bones. It is produced biosynthetically, which can lower the risk for allergic reactions. It produces natural-looking results and does not migrate from the injection site.
Calcium hydroxylapatite is a temporary dermal filler that generally lasts at least 12 months, and it is well tolerated. It can improve moderate to severe creases in the face, including frown lines, marionette lines, and nasolabial folds. It can enhance facial volume and plump up the fullness of the cheeks.
Poly-L-lactic acid (PLLA)
The brand name is Sculptra.
This is a biodegradable synthetic dermal filler that works to stimulate your body’s production of collagen as a stimulator. Poly-L-lactic acid takes some time to work, and it does not produce immediate results. It can take around three monthly treatments to achieve the desired results, but it is semi-permanent, only occasionally requiring touch-ups.
It works best in the lower region of your face to smooth laugh lines, treat deep nasolabial folds, and add volume to thin lips.
Polyalkylimide
The brand name is Aquamid.
This is a semi-permanent biocompatible form of dermal filler that is not absorbed back by the body. It can be used to treat deep wrinkles, acne scars, facial wasting in people with HIV, thin lips, and lost facial volume.
Another form of dermal filler involves fat injections as dermal fillers. This is a more invasive procedure that requires harvesting fat from your body, generally from the abdomen or buttock, and then injecting it into your face to add volume. This is a minor surgical procedure that can require several fat grafts for the desired effects.
Who Is a Candidate?
Dermal fillers work best on people who are in good overall health, nonsmokers, and do not have any underlying health conditions that can impact the healing process.
You need to be committed to taking care of your skin. You will also need to be tested for allergies before receiving many types of dermal fillers to minimize the risk for an allergic reaction. The type of filler or procedure that will work best for you can depend on the type of issue you are trying to correct. Schedule a consultation with a trained professional cosmetic surgeon to determine if dermal fillers are a good option for you and which type will offer you optimal and desired results.
Costs
Dermal filler costs can vary based on where you live, who performs the procedure, the type of filler you choose, and how much solution is needed for your treatment.
On average, dermal fillers typically cost between $600 and $1,000 per syringe. Depending on the extent of your treatment, you can require multiple injections in one session or multiple sessions over time.
Risks
Dermal filler risks depend on the type and extent of the filler procedure. These are potential side effects:
- Bruising
- Swelling
- Redness
- Tenderness or pain
- Itching
- Rash
These are generally temporary side effects that will often dissipate with time as the injection site heals. Some forms of dermal fillers can cause lumps that are visible under the skin. More serious side effects can include migration of the filler, allergic reaction to one of the filler materials, or accidental injection into a blood vessel, which can cause skin death (necrosis), blindness, or stroke.
Overall, dermal filler injections are considered to be a safe and noninvasive procedure when performed by a trained and experienced professional.
The Procedure: What to Expect
Before receiving dermal filler injections, you will first meet with your provider for a detailed consultation and evaluation. You may need to undergo some facial testing and allergy testing depending on the type of dermal filler that is chosen. The provider will map your face, take photographs, and often mark the sites to be injected.
The injection site will then be cleaned with an antibacterial agent. When requested or desired, an anesthetic ointment or local anesthesia can be applied to numb the area. The dermal filler is then injected. The area will often be massaged and then evaluated.
Your doctor will likely start out with less filler and then determine if more is needed. The injection process typically takes 15 to 60 minutes.
Recovery
Immediately after the procedure, ice packs are often administered to help reduce swelling and bruising. You will typically not need medications, and most side effects clear up within a day or two.
You can return to most activities right away, but you should wait to engage in vigorous physical activity for 24 to 48 hours. Injectable dermal fillers are considered a minimally invasive procedure with a relatively fast recovery time.
Talk to your treatment provider about how to take care of your face after receiving dermal filler injections and follow all provided instructions.
You will often need to have a second or third treatment depending on the type of dermal filler you are receiving. This is typically done monthly, allowing time in between for the injection site to recover.
Results
Dermal fillers can help reverse some of the signs of aging, smoothing out wrinkles and facial lines and adding volume where it has been lost. Depending on the type of dermal filler you use, the results can be immediate.
Some of the longer-lasting injectable dermal fillers will require a few treatments and some time to show the desired results. However, they can also last longer and require fewer touch-ups over time.
It is important to be realistic with your expectations. Dermal fillers can enhance volume and smooth lines. However, results can vary and depend on your specific needs and circumstances. Be open and honest with your provider about what you are looking for to ensure the best results.
Botox vs. Dermal Fillers
Another method for smoothing out wrinkles and facial lines involves the use of botulinum toxin, or Botox. This is another form of injection that is placed just below the skin to temporarily relax, or paralyze, the muscles of the face and block nerve responses. This can smooth out wrinkles.
They are both considered minimally invasive procedures, and both are generally temporary. Dermal fillers, depending on the type, can last longer than Botox and often cost more as well.
Botox relaxes facial muscles to smooth wrinkles, while dermal fillers add volume and fill in lost fat tissues. Botox is FDA-approved to treat moderate to severe frown lines between the eyebrows (glabellar lines) or around the sides of the eyes (crow’s feet).
Botox is often used off-label for additional areas, including Botox lip flips that allow the lip to flip up for a subtle change in appearance as opposed to adding volume with fillers. Dermal fillers are approved to treat a broader range of cosmetic issues.
Where to Get Dermal Fillers
Dermal fillers need to be injected by an experienced and trained cosmetic surgeon certified by the American Board of Cosmetic Surgery or a licensed health care provider in the dermatology field. Injectable dermal fillers can be placed in a clinic or doctor’s office as a same-day procedure.
FAQs
How long do dermal fillers last?
The length of time dermal fillers will last depend on the type of filler used. Temporary dermal fillers absorb back into the body. They last between 6 and 12 months, while semi-permanent ones can last 2 to 5 years or even indefinitely.
How much does a dermal filler cost?
Dermal fillers range in cost based on the type of dermal filler you choose, your location, and where and who performs the procedure. Dermal fillers typically range from $600 to $1,000 for one injection. Often, more than one injection is required for best results.
Do fillers ruin your face?
Dermal fillers are considered a safe and effective cosmetic procedure that is minimally invasive and not likely to have serious side effects. There are potential complications that can occur leading to skin death and scarring; however, these are rare. When the procedure is done by a trained and experienced provider, they are very unlikely to occur.
The effects of dermal fillers are also generally temporary. If you do not like the outcome, the filler will break down in time and reabsorb into the body.
What type of filler should I choose?
The type of dermal filler that will be best for you is often based on the location and type of cosmetic effect you are looking for. Your treatment provider can best guide you on the most suited dermal filler for you.
Can dermal fillers be removed?
In short, yes. If you are unhappy with the results or experiencing side effects from dermal fillers, most forms can be removed. The temporary dermal fillers will absorb back into the body and therefore do not need to be removed, while the semi-permanent ones usually can be.
References
Dermal Filler Do’s and Don’ts for Wrinkles, Lips, and More. (December 2021). U.S. Food and Drug Administration (FDA).
Injectable Hyaluronic Acid. (2022). American Society for Dermatologic Surgery (ASDS).
Calcium Hydroxylapatite. (January 2015). The Journal of Clinical and Aesthetic Dermatology.
Superiority of Poly(L-Lactic Acid) Microspheres as Dermal Fillers. (January 2021). Chinese Chemical Letters.
PMMA Microspheres as Dermal Fillers. (2021). EPRUI Biotech.
How Can Fat Injections Be Used as Dermal Fillers? (2022). American Society of Plastic Surgeons.
Dermal Fillers: The Good, the Bad, and the Dangerous. (January 2020). Harvard Health.
Choosing a Cosmetic Surgeon. American Board of Cosmetic Surgery.
