Injected fillers are primarily used to improve the appearance of the skin’s texture. It can help fill out deep facial wrinkles, creases and furrows, skin depressions, and some types of scars. It can also be used to give a fuller, more luxurious look to the lips. Fillers are not usually sufficient for severe surface wrinkles on the face, such as multiple vertical “lipstick lines” that sometimes form around the mouth.

The most commonly used fillers are made of hyaluronic acid, which is naturally found in the skin. Thanks to its ability to store moisture, hyaluronic acid is responsible for giving skin a plump and hydrated look. Hyaluronic acid fillers are a gel-like substance that creates volume in the skin. Once injected, they begin to integrate into the substance of the skin, attracting water molecules and hydrating the surrounding tissue.

Fillers were first used to treat facial lines and creases to stave off the signs of aging. More recently, fillers are being used to augment and enhance facial features such as creating sharper cheekbones, more defined jawlines, and straighter noses. Fillers can also be used on other parts of the body such as the décolletage, neck, and hands to rejuvenate crépey skin.

The market is abuzz with facial fillers, some of them will require several treatments over weeks or months for optimal benefits, followed by occasional touch-ups. Commonly used fillers include:

HYALURONIC ACID (HA)

This gel-like substance is found naturally in the body. It’s used to “plump up” skin, adding volume to places like the cheeks and smoothing out wrinkles, especially around the eyes, lips, and forehead.Brand names include Juvéderm and Restylane. Because the body reabsorbs the hyaluronic acid gradually over time, results generally only last 6 to 12 months, reports the American Board of Cosmetic Surgery (ABCS). There have been some advances in the development of these dermal fillers, and these will typically last 12 months or longer.

CALCIUM HYDROXYLAPATITE (CAHA)

This filler uses calcium (in the form of microscopic particles) and adds it to a gel that is injected. The gel is of a thicker consistency than HA, which makes it better suited for deep wrinkles, says the ABCS. The results of CaHA (brand name Radiesse) tend to last about a year.

POLY-L-LACTIC ACID

This biodegradable acid helps stimulate the skin’s collagen production, instead of “filling” wrinkles. That gives firmness to the skin and reduces the appearance of wrinkles. Marketed under the brand name Sculptra Aesthetic, this filler is used to treat deep wrinkles and increase the volume where fat has been lost. It works gradually but can provide results for at least two years, making it a semi-permanent filler.

POLYMETHYLMETHACRYLATE (PMMA)

This filler consists of tiny balls (called microspheres) and collagen that plump up the skin. This type of filler (marketed under the name Bellafill) is considered permanent, with results lasting five years, it’s usually not the first choice of doctors. According to research, long-acting dermal fillers have higher rates of complications, such as infection and nodules.

Polymethylmethacrylate (PMMA)

This filler consists of tiny balls (called microspheres) and collagen that plump up the skin. This type of filler (marketed under the name Bellafill) is considered permanent, with results lasting five years, it’s usually not the first choice of doctors. According to research, long-acting dermal fillers have higher rates of complications, such as infection and nodules.

The fillers are injected using a fine needle inserted at several points along the edge of the site. Overfilling is necessary to allow for absorption in the weeks following treatment. You may feel a slight stinging or burning as the site is injected. However, most people report the injections to be of only minor discomfort.

Most patients resume normal activities following treatment in spite of some temporary puffiness over the area. Generally, within a few days, this will resolve, and the material is no longer visibly distinguishable from the surrounding skin. The results of your fillers injection will vary for each individual as will the length of time it will last. Some patients have reported their treatment lasting a year or longer, while others say only 3-6 months. Therefore, repeated injections may be necessary. We will discuss with you how to maintain your results with repeated treatments.