Noninvasive injectable fillers soften lines and restore volume and fullness to your face. Injectable fillers can also plump your lips and improve the appearance of some scars.
Fillers are largely temporary, which means that they eventually get absorbed by the body and will need to be re-injected to maintain your new look. Those you are most likely to encounter include the following:
- Cosmoplast, Cosmoderm and Evolence are collagen-based fillers. Collagen is a natural protein that supports the skin. Most notably, Evolence is a recently approved (July 2008) product that offers all the benefits of collagen, but provides longer-lasting results (see table below). Zyderm and Zyplast are no longer used. Evolence collagen dermal filler products are used to correct facial wrinkles and folds. Evolence is made of highly purified porcine collagen that is crosslinked via Glymatrix technology to provide long lasting results.
- Restylane, Juvederm, Perlane and Hylaform are hyaluronic acid (HA) fillers. HA is a natural substance found in our bodies. Until the recent approval of Evolence (above), HA fillers were the only ones that offered the benefit of providing longer-lasting results than their collagen-based counterparts.
- Elevess and Prevelle Silk are HA fillers, too, but they also contain lidocaine, a numbing agent, which is intended to provide additional relief from injection-related pain. However, Prevelle Silk is considered to be a less-impressive product because it has a lower concentration of HA and therefore doesn’t last as long as other HA fillers.
- Radiesse is made of hydroxyapatite (a mineral-like compound found naturally in human bones), which is suspended in a gel-like material. Radiesse is considered a second-tier product because it can clump and migrate, which requires surgery to correct. It is not recommended around the lips because of its larger particle size.
- Human Fat— (procedure a.k.a. autologous fat transfer) from your own body Note: In a fat transfer procedure, your doctor may extract fat cells from a discreet area of your body, prepare the cells, and then transfer them through injections. Fat injection usually requires multiple procedures because some of the fat injected into the body is absorbed each time. The average person receives a 25% to 75% improvement from one fat transfer treatment and, therefore, you could need 2 or 3 treatments to achieve your desired results.
Two other products you may encounter as filler options are Sculptra and ArteFill. However, permanent or longer lasting fillers may have permanent or longer lasting complications. Any filler can cause complication in untrained hands, and patients should look to their surgeons for what works best in his or her hands.
- Sculptra is a synthetic poly-L-lactic acid that is FDA approved to restore or correct the signs of facial fat loss (lipoatrophy) in people with HIV. It is also sometimes used off-label for cosmetic treatment.
- ArteFill is made of synthetic acrylate beads suspended in bovine (cow)-based collagen and used to improve nasolabial folds (“smile” lines). Because it is a more permanent filler option, there are higher risks associated with this filler.
Length of procedure: The actual injections happen quickly. Within minutes you’ll be done.
Recovery: You may appear slightly swollen or bruised, might experience temporary numbness or redness, and could have an “overfilled” look in the injected areas.
Risks: Although complications are uncommon, risks vary depending on the type of filler used. To avoid possible allergic reactions, fillers made from non-human sources may require a pre-treatment allergy test (Zyderm, Zyplast). Other complications may include infection at the injection site; acne-like skin outbreaks; bleeding, bruising and swelling; rash, itching and swelling; redness; and skin sensitivity. Some fillers are associated with granuloma (Radiesse, Sculptra, Artefill). There is also the possibility that skin could slough in very rare instances. When it’s all said and done, it’s also possible that your wrinkles could be under- or over-corrected and certain facial elements could be uneven.
Results: You’ll see your results immediately. The table that follows provide approximate information on how long you can expect your results to last and approximately how much you can expect to spend per treatment.
| Filler type | Length of time results lasts | Approx. cost | |
|---|---|---|---|
| Collagen | 3 months* | $500 per syringe | |
| HAs | About 6 months or longer* * | $600 to $650 per syringe | |
| Radiesse | From 6 months to a year | $1,000 per syringe | |
| Fat injections | From a few months to years, depending on how vibrant the fat cells remain after injection | $2,000 to $4,000 per syringe per treatment | |
| Sculptra | About a year | $1,500 to $2,200 per syringe per treatment | |
| Artefill | Up to five years | $500 or more per syringe | |
| Evolence | Minimum of 6 months | $550 per syringe |
* Evolence lasts for about 6 months; cost is TBD.
* * Prevelle Silk has a shorter duration (about 2 to 3 months) compared with other HA fillers.
