Injectable dermal fillers are gel-like substances that are injected underneath your skin to change its appearance. They’re a popular and minimally invasive treatment for wrinkles.
According to the American Board of Cosmetic Surgery, over 1 million people get injectable dermal fillers every year.
As you age, skin that sags or wrinkles can be caused by loss of fat and proteins in the skin layer. Injectables can’t permanently replace lost fat and proteins, but they can mimic your skin’s original structure.
Unlike Botox treatments, which relax your muscles to minimize the appearance of wrinkles, dermal fillers are known for plumping up, adding volume or fullness, and smoothing your skin.
There are several categories of wrinkle fillers, and each works in a slightly different way.
Hyaluronic acid
Hyaluronic acid is already naturally produced by your skin. You may recognize the ingredient from cosmetics that claim to plump and hydrate your skin.
Hyaluronic acid fillers are gel-like, and results can last 6 to 12 months. These fillers tend to be a bit more expensive than collagen.
Brand names:
Calcium hydroxylapatite
This type of calcium is found in your bones. It’s a mineral-like compound that’s soft like a gel, and it doesn’t require any animal products to be created, making it vegan-friendly. This is one of the longer-lasting types of injectables, with a life span of 9 to 15 months.
Brand name: Radiesse
Collagen stimulator
Polylactic acid is a type of filler that dissolves after just a day or two. Instead of staying put underneath your skin, Poly-L-lactic acid is meant to stimulate natural collagen production in your body.
Poly-L-lactic acid is the same ingredient that encourages healing in dissolvable stitches used after surgery. Although this ingredient is biodegradable, it’s still a synthetic ingredient.
Brand name: Sculptra
Polymethyl-methacrylate (PMMA) microspheres
These microspheres are tiny, synthetic balls that are injected to give structure underneath deep wrinkles or to fill out thin lips.
PMMA microspheres are considered a longer-term solution than hyaluronic acid and polylactic acid. Because of how long this treatment lasts, doctors often require several appointments to slowly fill in the area with multiple, smaller injections.
Brand name: Bellafill
Autologous fat injections
This type of filler material comes from your own body. Autologous fat injections use fat deposits from donor areas of your body, like your tummy area or buttocks.
The fat is extracted via a liposuction procedure before being injected into another area of your body where volume has been lost. Unlike most other types of injectables, these natural fillers last forever.
Different types of fillers are recommended depending on the area of your body that you’re looking to target.
Deep wrinkles
While most of the fillers can be used for this area, there are a few that might be preferred by some people. These might include PMMA, polylactic acid, and certain hyaluronic acids.
Under-eye area
Fat injections, hyaluronic acid, and polylactic acid can be used around the eye area. Certain hyaluronic acids might be better than others for this area. Some tend to not provide the optimal correction, and can leave the area looking lumpy or bumpy.
You should be advised that no filler has been approved by the Food and Drug Administration (FDA) for use in the under-eye area.
Nasolabial or smile lines
Most of the hyaluronic acids and PMMA microspheres have been approved by the FDA for use in this area. They can be used for the smile lines and folds around your nose.
Forehead and crow’s feet
If you’re opposed to Botox injections, filler solutions for your forehead furrows and crow’s feet include polylactic acid, calcium hydroxylapatite, and PMMA.
Fillers in this area are also not approved by the FDA, and many providers won’t use injectables in this area due to complications.
Cheeks
Cheeks can be plumped and structured with polylactic acid and many of the hyaluronic acids.
Lips
Most of the hyaluronic acids can be used as lip fillers, and they’ve been approved by the FDA to do so. Most of the other filler options shouldn’t be used on the lips.
Chin
Calcium hydroxylapatite, hyaluronic acid, or essentially any of the above dermal fillers can be used to contour and add volume to the chin.
Hands
Hyaluronic acid and calcium hydroxylapatite can be used to fill in loose skin on your hands, as well as decrease the appearance of veins.
Chest or décolletage
Not to be confused with breast augmentation, wrinkles around your chest area and lower neck can be treated with hyaluronic acid.
Fillers do have measurable cosmetic benefits for your appearance. People who swear by fillers report younger-looking skin, fewer fine lines and wrinkles, and a more visible bone structure.
For those who are self-conscious about the visible signs of aging, fillers are fairly straightforward and work for their intended purpose.
Hyaluronic acid, in particular,
Side effects of fillers are typically minimal and easy to manage. Frequently reported symptoms include:
- swelling at the injection site
- bruising
- itching
- pain in the days after treatment
In less common instances, you may experience rarer side effects. These side effects may be
- visible clumping of the filler material
- filler material in an area of your face where it wasn’t injected, also called filler migration
- headache
- blurred vision and, in severe cases, blindness
- allergic reaction
- infection
- discoloration or a change in skin pigment
Fillers may have a similar result to neurotoxin injections, more commonly known as the brand name Botox, by giving you a more youthful appearance, but they work much differently.
Botox works by paralyzing the muscle underneath your skin. It’s hard to know how each person’s body will react to Botox, and how stiff the facial expressions might be afterward.
Botox also takes days or weeks to settle, so the results aren’t immediately apparent. Results last 3 to 4 months.
With fillers, the material is injected underneath your skin. Depending on the type, this material might serve several purposes, but all fillers have the same aim: restoring lost volume to make skin look smoother, plumper, and more structured.
You can usually tell how fillers are working in the hours after treatment. Their results tend to last longer than Botox — anywhere from 6 months to forever, depending on the type of filler material.
There are steps you can take to minimize the risk of side effects from fillers. These steps start with finding a licensed provider and doing your homework by reading reviews and attending an initial consultation.
Remember to never purchase dermal filler material online, and don’t attempt to inject dermal fillers yourself.
Also, be aware that the FDA hasn’t approved silicone injections for body contouring. Butt fillers and fillers for spaces between your muscles aren’t safe or approved filler treatments.
After getting a dermal filler treatment, follow your doctor’s instructions carefully before and after the procedure. Avoid drinking alcohol the day before the procedure and 2 days after.
If swelling occurs, apply aloe vera gel or arnica gel to the affected area. Avoid itching and touching the area so that you don’t introduce bacteria to the injection site.
If your side effects seem more severe than you expected, call your doctor right away.
If you’re considering dermal fillers, schedule a consultation with a licensed cosmetic surgeon in your area. This consultation should include an honest discussion about the areas that you’re seeking to modify, as well as what sorts of results you can expect.
Your doctor should be frank in their assessment of how effective fillers are and how long they’ll last.
During this consultation, make sure to discuss how much these treatments will cost you out of pocket. Insurance doesn’t cover dermal fillers, though there are extremely rare exceptions.
Dermal fillers are relatively low-risk treatments to slow down or reverse the signs of aging. There are several different kinds of fillers to choose from, and a doctor can help you pick the best based on price and the areas you’re seeking to target.
For the most part, the results of fillers last longer than Botox, and fillers are certainly less costly and invasive than a surgical facelift.
Speak to your doctor about cosmetic fillers if wrinkles and sagging skin are noticeably affecting your life.