What Are Dermal Fillers?

Dermal fillers are injectable gel-like substances used to treat a wide range of cosmetic issues in the face and hands, including diminished volume, fine lines, wrinkles, and scars. Several different companies make fillers, and each has its own unique formulations, which are useful for treating distinct problems in separate areas of the face.

By placing fillers in certain areas of the face, we can contour and create the visage you’ve always dreamed of. Over time, dermal fillers are slowly absorbed by the body and most last anywhere from 9 to 24 months before needing a touch-up.



Fillers vs. Botox

Dermal fillers and botox are both minimally invasive, injectable cosmetic treatments. Both are performed as outpatient procedures in the comfort of your doctor’s office and require minimal downtime. While both can improve the overall appearance of the face, they achieve this in different ways.

Botox is primarily used to treat fine lines and wrinkles. It is a purified form of the botulinum toxin, and is a safe, FDA-approved treatment that has been used for several decades now.
Botox works by blocking nerve signals to the muscles that contract and cause fine lines around the eyes, forehead, and mouth, also known as expression lines. By blocking the nerve signals, muscles in the injection site become temporarily paralyzed, thus softening or eliminating wrinkles from the area. These results can last between three and five months, and the treatment takes about five minutes to complete.

Dermal fillers, on the other hand, are primarily used to rejuvenate the appearance by restoring structure and balance to various areas of the face. Fillers can be made with varying ingredients, including:

  • Hyaluronic acid, such as JUVÉDERM®, Restylane®, and Belotero®
  • Calcium hydroxylapatite, such as RADIESSE®
  • Poly-L-lactic acid, such as Sculptra®
  • Polymethyl-methacrylate microspheres (PMMA), such as Bellafill®

Each of these fillers is designed to treat certain kinds of aging or other cosmetic issues. Depending on which one is used, they can last anywhere from 9 to 24 months. On average, treatment takes approximately 45-60 minutes.

What Can Fillers Do?

Dermal fillers can be used for a wide range of cosmetic procedures in the face and hands to improve your overall look. As we age, we begin losing collagen and elasticity, which ultimately leads to fine lines, wrinkles, and thinning of the face. While many already know fillers are used to reduce the appearance of wrinkles, they are also useful for creating contours on the face such as higher, defined cheeks; structured chins and jawlines; and fuller, hydrated lips.

The primary uses for dermal fillers include:

  • Plumping lips
  • Enhancing or filling in shadowed areas of the face such as the cheeks and temples
  • Improving overall symmetry and definition of facial features
  • Diminishing or removing under-eye shadows or wrinkles caused by the lower eyelid
  • Filling in recessed scars
  • Softening static lines around the mouth and nose due to loss of collagen and elasticity

Are Filler Injections Painful?

Usually, no. The only discomfort you should feel during the procedure is the initial pinch from the injection, but topical numbing cream before the procedure will minimize this sensation. Additionally, most fillers contain a local anesthetic, which reduces discomfort, and you may notice some numbness in the treated area for a few hours.

Some swelling, bruising, and/or tenderness can occur after the procedure. This is typically minor and goes away within a few hours or days. Many patients can treat this discomfort with over-the-counter pain medications such as acetaminophen (Tylenol®). We recommend you avoid NSAIDs such as ibuprofen (Motrin®) and aspirin because they have a blood-thinning effect and can lead to more bruising. Talk to your treating physician about whether you should use ice on the treated areas..




How Long Do Fillers Last?

How long a filler lasts depends on which filler is used and where is is placed in the face. Some fillers, such as Restylane® and JUVÉDERM® Ultra, last for approximately 12 months before a touch up is needed. RADIESSE® typically lasts about 15 months, and JUVÉDERM VOLUMA™ can last for up to two years.

Are Fillers Reversible?

Yes, most dermal fillers can be reversed. Those made of hyaluronic acid (HA), such as JUVÉDERM® and Restylane® can be dissolved with an injection of Hylenex®, which is kept in the office. For those who are unhappy with the look of their new fillers, Hylenex® is a simple way to remedy this. Please let your doctor know if you have any allergies or are taking any medications, as Hylenex® is contraindicated in some instances due to medication interactions.

JUVÉDERM® Family

JUVÉDERM® makes several products, all formulated with hyaluronic acid (HA), a naturally occurring sugar in our bodies that adds suppleness, hydration, and elasticity to the skin. These products include:

  • JUVÉDERM® XC
    Treats moderate to severe facial lines and wrinkles around the nose and mouth
    Creates an overall smoother appearance
    Lasts up to 12 months
  • JUVÉDERM® Ultra XC
    Plumps lips and smooths moderate to severe parentheses lines (also known as “smile lines”) around the nose and mouth
    Lasts up to 12 months
  • JUVÉDERM VOLBELLA® XC
    Plumps lips and treats perioral lines (also known as “lipstick lines”)
    Lasts up to 12 months
  • JUVÉDERM VOLLURE™ XC
    Treats moderate to severe facial lines and wrinkles around the nose and mouth
    Creates an overall smoother appearance
    Lasts up to 18 months
  • JUVÉDERM VOLUMA® XC
    Treats the cheeks due to natural, age-related midface volume loss
    Lifts and contours the cheek area creating a fuller look
    Lasts up to 24 months

Restylane® Family

Restylane® makes several products, all formulated with hyaluronic acid (HA), a naturally occurring sugar in our bodies that adds suppleness, hydration, and elasticity to the skin. These products include:

  • Restylane®
    Lasts up to 6 months, or as long as 18 months if touch-up treatments are performed at 4 ½ and 9 months
  • Restylane® Silk
    First FDA-approved product to treat both the fullness of lips as well as the smoothing of wrinkles and vertical lines around the mouth
    Lasts up to 6 months
  • Restylane® Lyft (formerly known as Perlane-L®)
    First and only FDA-approved dermal filler to treat both the face and hands
    Treats volume loss deeper in the cheeks, midface, and back of the hands
    Lasts up to 6 months when used for the treatment of wrinkles and folds or between 2 and 12 months when used to increase the fullness of the cheeks
  • Restylane Refyne™
    Designed with XpresHAn Technology™ which supports natural-looking results through the use of a unique cross-linking gel carrier
    Subtle formulation for softening mild to moderate laugh lines (nasolabial folds and marionette lines)
    Lasts up to 12 months
  • Restylane Defyne™
    Designed with XpresHAn Technology™ which supports natural-looking results through the use of a unique cross-linking gel carrier
    Thicker formulation to smooth deep laugh lines (nasolabial folds and marionette lines) and provide a natural-looking, youthful appearance
    Lasts up to 12 months

RADIESSE®

RADIESSE® is a dermal filler made of smooth calcium hydroxylapatite (CaHA) microspheres. This formulation stimulates the body’s natural collagen production, resulting in a smoother, more youthful overall appearance. It is primarily used for adding volume to the cheeks and chin but is also FDA-approved for the treatment of the back of the hands. Because it is not hyaluronic acid-based, it is not reversible with Hylenex®. RADIESSE® typically lasts up to 15 months when used for contouring the face.

For questions about dermal fillers or schedule an appointment with Jerome R. Potozkin, MD, please call us today at (925) 838-4900!