What Are Dermal Fillers?

It is soft tissue filler that is approved as medical devices by the FDA. These devices are injected into the skin to help fill in facial wrinkles, restoring a smoother appearance. Treatment entails a series of tiny injections under the skin’s surface – at the subdermal-dermal levels. The amount administered depends on the depth and size of the skin defect or wrinkle. Most fillers are approved for injection in the nasolabial folds, a.k.a. smile lines. Injection in other areas is allowed, but considered off-label. Fillers can also be used as “volumizers,” plumping and lifting cheeks, filling out thin lips, and plumping sagging hands.

How Do They Work?

Unlike Botox injections that relax the muscle under a wrinkle, injectable wrinkle fillers, fill the line or crease with one of several different substances. As a result, the line or crease seems to have nearly disappeared. Some people may need more than one injection to achieve the wrinkle-smoothing effect. Dermal fillers, as their name suggests, fill in the area under the skin. They all work to improve the appearance of aging skin in the following ways:

  • filling in wrinkles, fine lines and deep creases
  • improving other imperfections like scars
  • filling out thin or wrinkled lips
  • plumping up cheeks
  • contouring the jaw line and other areas of the face

How About FDA Regulations?

FDA has approved injectable dermal fillers for treatment of moderate to severe wrinkles and localized fat loss (lipoatrophy), as well as lip and cheek augmentation in the face. The FDA has approved two absorbable injectable dermal fillers for lip augmentation, and one for cheek augmentation, in patients over the age of 21. FDA has NOT approved injectable wrinkle fillers to:

  • Increase breast size (breast augmentation)
  • Increase size of the buttocks
  • Rejuvenate the hands or feet
  • Implant into bone, tendon, ligament, or muscle

FDA has NOT approved liquid silicone or silicone gel for injection to fill wrinkles or augment tissues anywhere in the body.

Reference:  http://www.fda.gov/medicaldevices/productsandmedicalprocedures/cosmeticdevices/wrinklefillers/default.htm

How Long Do They Last?

In general, most of these wrinkle fillers are temporary because they are eventually absorbed by the body. The effect lasts for about six months or longer. This depends on the type of facial fillers or filler injections used. For optimal results, additional treatment sessions are encouraged. Successful results depend on health of the skin, skill of the doctor and type of filler used. Some research shows that repeated injections may help stimulate the body’s own natural production of collagen. There is also some evidence that less filler is needed over time to achieve the same look. However still, this needs to be validated scientifically.

What Are The Different Types And Which One Shall I Choose?

Various types of facial fillers are available; each is designed with one or several purposes.  Some fillers are natural and some are synthetic. To help you discuss your options with your doctor, click on the link below. It illustrates a breakdown of the wrinkle fillers currently available. It includes their basic ingredients, how they work, their risks and benefits, and the best areas for treatment. Your doctor can help you choose the right one for you. Reference: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/CosmeticDevices/WrinkleFillers/ucm227749.htm

What Is The Downside?

Side effects observed included mild to moderate tenderness, swelling, firmness, lumps and bumps, bruising, pain, redness, discoloration, and itching that lasted for seven days or less. In some cases, those bumps may be permanent and may warrant open surgery to remove them. A bluish skin discoloration known as the Tyndall effect is also possible. The color change can last for several months.

Is Juverderm Voluma An Alternative To Radiesse?

Juvéderm Voluma® is an excellent alternative to Radiesse®. However, personally I like both fillers.  There are advantages and disadvantages to each. Voluma® is an HA product which is good for first time patients since it is reversible. Its effect can be easily reversed by injection of hyaluronidase in the rare event of a problem. In the recent FDA studies, Voluma® was shown to last up to 2 years or longer.  Radiesse® is not an HA and can’t be reversed.   Radiesse®  is also long lasting and typically lasts longer than other HA products except Voluma®.  In terms of results, I have found Voluma® to be slightly smoother since these fillers are used for deeper injections and is probably less painful during the injection process.

Further Reading:


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Dermal Fillers

Before and After Photos

Dermal Fillers before and after pictures.