Dermal fillers, sometimes called soft tissue fillers, are substances designed to be injected beneath the surface of the skin to add volume and fullness.
Substances used in dermal fillers include:
- Calcium hydroxylapatite, which is a mineral-like compound found in bones.
- Hyaluronic acid, which is found in some fluids and tissues in the body that add plumpness to the skin.
- Polyalkylimide, a transparent gel that is compatible with the body.
- Polylactic acid, which stimulates the skin to make more collagen.
- Polymethyl-methacrylate microspheres (PMMA), a semi-permanent filler
Each one of these is designed to treat different signs of aging or other cosmetic issues.
The time they take to work, as well as how long they last, also vary. Some fillers last 6 months, while others last up to 2 years or longer.
People should discuss their individual needs and expectations with their doctor to determine what filler would be the best choice for them.
What can dermal fillers correct?
Different types of dermal fillers are designed to treat varying signs of aging. Depending on the filler selected, they may:
- plump up thinning lips
- enhance or fill in shallow areas on the face
- decrease or remove the shadow or wrinkle under the eyes caused by the lower eyelid
- fill in or soften the look of recessed scars
- fill in or soften static wrinkles, especially on the lower face
Static wrinkles include those around the mouth and along the cheeks. These wrinkles are usually a result of a loss of collagen and elasticity in the skin.
Dermal filler risks and considerations
Dermal fillers are considered to be safe but side effects can occur. A licensed healthcare professional should perform all dermal filler procedures using only FDA-approved fillers injected with a syringe. The most common problems include:
- skin rash, itching, or pimple-like eruptions
- redness, bruising, bleeding, or swelling
- undesirable appearance, such as asymmetry, lumps, or overcorrection of wrinkles
- skin damage that causes a wound, infection, or scarring
- ability to feel the filler substance under the skin
- blindness or other vision problems
- death of skin cells due to loss of blood flow to the area
The cost of dermal filler treatments varies and depends on the provider performing it, the area being treated and the type of filler selected. The ASPS 2016 statistics list the following cost per syringe:
- calcium hydroxylapatite, such as Radiesse: $687
- hyaluronic acid, such as Juvederm, Restylane, or Belotero: $644
- polylactic acid, such as Sculptra: $773
- polymethyl-methacrylate microspheres, such as Bellafill: $859
These costs may be more or less, depending on how much filler is used. Using less than a full syringe of filler may be cheaper than using a full syringe or more than one.
The provider may also charge additional fees for their professional services, office visit, or other costs.
In summary, the differences between Botox and fillers are:
- Botox: This freezes muscles to stop creases and wrinkles caused by facial expressions. These are typically found in the upper face, such as the forehead and around the eyes.
- Dermal fillers: These use hyaluronic acid and similar substances to “fill in” or plump areas that have lost volume and smoothness. This includes wrinkles around the mouth, thin lips, and cheeks that have lost fullness. They may also be used on forehead wrinkles, scars, and other areas that need extra volume for a smoother look.
- Botox results last 3 to 4 months. Dermal filler results vary, depending on which filler is used.
Because Botox and fillers are different substances designed for different uses, they can sometimes be combined in one treatment. For instance, someone may use Botox to correct lines between the eyes and a filler to correct smile lines around the mouth.
Millions of Botox and filler procedures are performed each year, and they have a good track record of safety.
A studyTrusted Source in JAMA Dermatology found that Botox and filler procedures are very safe when performed by experienced board-certified dermatologists. Side effects occurred in less than 1 percent of recipients, and most of these were minor.
Though Botox and fillers are minimally invasive, they still carry some risks. An individual should be aware of all possible risks and benefits before having these treatments.
Botox and fillers are not recommended for women who are pregnant or breastfeeding. People who have certain health conditions or who take any medications should discuss whether Botox or fillers are safe for them.
People should also discuss what Botox and fillers can realistically do for their appearance. Though they can enhance a more youthful look, the results are typically not as powerful as having a surgical procedure, such as a facelift.
Using a qualified medical provider, such as a board-certified dermatologist, plastic surgeon, or cosmetic surgeon helps ensure the procedure is done safely and properly. People should discuss the provider’s experience and training in dermal fillers and Botox before making a decision.