The Difference Between Types of Dermal Fillers

Dermal fillers are cosmetic injectables that can help reduce the signs of aging and restore volume and fullness in the face. With so many brands and types of dermal fillers on the market, it can be difficult to distinguish the difference between them. Not only do dermal fillers vary in the results they can achieve, but also in their composition, longevity, and suitability to various treatment areas. This article gives an overview of some of the most popular types of dermal fillers and explains what they can do, how they work, and how long they last.

What types of injectable dermal fillers are available?

1. Hyaluronic acid (HA) fillers – products made with manufactured hyaluronic acid designed to act like the body’s own naturally produced hyaluronic acid
2. Synthetic fillers – products containing lab-made substances not found naturally in the skin
3. Collagen fillers – products made with purified collagen extracted from animal sources or made with synthetic collagen
4. Autologous fillers – fat from one’s own body that is surgically removed, treated, and injected into the desired treatment area

The most popular and commonly-used dermal fillers are those with HA. There are currently over 30 dermal fillers containing HA licensed and available for sale in Canada. At Silhouette Spa and Laser, we use Revanesse and Restylane, two of the best known and trusted HA dermal fillers.

What is hyaluronic acid (HA)? How do HA fillers work?

Hyaluronic acid (HA) is a naturally occurring sugar found in the body. It maintains moisture in the skin by binding with water molecules to add volume. HA is found in soft connective tissues, joint fluids, and skin tissue.

As skin ages over time, it renews itself more slowly. The loss of HA from the skin (as well as a loss of collagen and elastin) can result in dry, thin skin and the appearance of lines and folds. Fillers containing manufactured HA can be injected into the skin to temporarily reduce the signs of aging, improve the skin’s contour or add volume to facial features.

What is the difference between various types of dermal fillers?

There are many different brands and types of injectable dermal fillers. Highlighted below are some key facts about some of the most-used dermal fillers on the Canadian market.

Hyaluronic Acid (HA) fillers

1. Juvéderm

Who makes it: Juvéderm is made by Allergan, the world leader in medical aesthetics which is headquartered in Ireland. Allergan has over 60 years of experience in product manufacturing.

What can it do: Juvéderm is a full range of gel filler products designed to treat fine or deep lines, restore facial volume, enhance or define facial features, or reshape and define lips.

Juvéderm Voluma XC is used to add contours to the cheeks, smooth moderate-to-deep lines around the nose and mouth, and smooth the lines that run from the corners of the mouth toward the chin.

Juvéderm Ultra XC plumps the lips, while Juvéderm Volbella XC plumps the lips and softens vertical lip lines.

Most Juvéderm fillers contain anaesthetic lidocaine to minimize discomfort during and after treatment.

Juvéderm works particularly well for under-eye bags, lips, and lines around the mouth.

How it works: The main ingredient in Juvéderm is HA. The injectable filler plumps up the treatment area, producing immediate smoothing results. HA injections have been shown to boost the body’s own natural production of collagen, requiring fewer follow-up appointments to maintain results. As HA is naturally found in the body, there is no risk of allergic reaction to the treatment.

How long it lasts: The effects of Juvéderm may be seen immediately and can last up to 9-24 months depending on the type of filler used and the area treated. Juvéderm fillers are temporary and will be naturally absorbed into the body, causing the effects to gradually fade away.

2. Restylane

Who makes it: Restylane products are manufactured by Q-Med, a Swedish division of Galderma that specializes in dermatology.

What can it do: Restylane consists of a full line of soft and firm injectable gels. Restylane smooths wrinkles and folds in areas such as the cheeks, mouth, nose, lips, and around the eyes, and can add volume to lips.

Restylane Lyft (formerly Perlane-L) is a thicker gel used to smooth deep wrinkles and folds (such as nasolabial folds) and restore volume loss in the cheeks. Additionally, it can be used to add fullness around the eyes or to the backs of the hands.

Restylane Fine Lines is specifically designed to enhance lips; it is made with smaller particles than other Restylane products.

Many Restylane products contain an integrated anaesthetic, lidocaine, to minimize discomfort during and after treatment.

Restylane works particularly well for the lips as well as nasolabial folds.

How it works: Restylane plumps and smooths the treatment area with the injection of HA. Results may be seen right away, but the full effects may not be visible for up to a few days after treatment. Injections may also stimulate natural collagen production in the treated area, requiring fewer follow-up treatments and less injectable required.

How long it lasts: The effects of Restylane may be seen within a few days of treatment and can last between 6-18 months, depending on the type of filler used and the area treated. Results can last up to 6 months in lines and folds with Restylane Lyft. Results in the lips can last up to 6 months with Restylane Fine Lines.

3. Revanesse

Who makes it: Revanesse is manufactured by the Canadian company Prollenium Medical Technologies Inc.

What can it do: Revanesse consists of a full line of cross-linked HA fillers. Revanesse products can restore facial volume, soften fine lines and wrinkles, add lift to brows and cheekbones, and subtly shape and refine facial features.

How it works: Once injected, Revanesse instantly plumps and smooths the treatment area with the injection of HA. The spherical and uniform particle shape of Revanesse provides a balance between smoothness and volume and has been developed to be accepted by the body and break down slowly over time. Revanesse has been shown to have a lower rate of swelling compared to other HA fillers, allowing for a very fast recovery time.

How long it lasts: The effects of Revanesse can last between 6-12 months, depending on the type of filler used and the area treated.
Calcium hydroxylapatite

Calcium hydroxylapatite

4. Radiesse

Who makes it: Radiesse is manufactured by Merz Pharma Canada.

What can it do: Radiesse is a type of synthetic filler used to treat moderate to severe facial wrinkles and folds around the mouth and chin, such as the nasolabial folds. It also can be used to add volume to cheeks and other facial contours and restore volume loss in the back of the hands. Radiesse is not injected into the lips.

How it works: Radiesse is a water-based gel filler which contains microspheres of calcium hydroxylapatite (CaHA), a type of mineral found naturally in human bones. Once injected, Radiesse immediately plumps the skin and continues to stimulate the body’s own production of natural collagen. The gel is gradually absorbed over time and the body metabolizes the calcium microspheres, leaving behind only the body’s natural collagen for long-lasting results.

How long it lasts: The effects of Radiesse last 12 months or longer. As calcium hydroxylapatite stimulates the body’s own natural collagen production, fewer follow-up treatments are required to achieve the desired result.

Other Information: The calcium microspheres in Radiesse can be seen in X-rays and CT scans. As a result, it is important that patients inform their health care providers if they have received treatment with Radiesse.

Polylactic acid

5. Sculptra

Who makes it: Sculptra is made by Galderma.

What can it do: Sculptra is a type of synthetic filler used to build up cheeks, fill in hollows or sunken areas of the face, and increase skin thickness to reduce the appearance of lines and folds. Sculptra is not injected into the lips or used around the eyes.

How it works: The active ingredient in Sculptra is poly-L-lactic acid (PLLA), a synthetic compound that stimulates the production of collagen. Consequently, it takes several treatments (approximately four to six weeks apart) for results to become visible.

How long it lasts: The effects of Sculptra can last up to two years after the initial treatment.

Summary

The HA fillers Juvéderm, Restylane, and Revanesse have similar long-term results. Juvéderm and Revanesse may show effects slightly more quickly than Restylane, but Juvéderm may come at a higher cost. Revanesse is notable for its lower rate of swelling compared to other HA fillers and is the only line of cross-linked HA fillers manufactured in Canada. Unlike other types of fillers, HA fillers can be partially or completely removed if desired with hyaluronidase, an enzyme that dissolves HA particles.

Clinical studies have shown that patients treated with the calcium hydroxylapatite filler Radiesse have expressed greater satisfaction with their results than patients treated with HA fillers.

Sulptra is one of the longest-lasting dermal fillers available, but requires several treatments to achieve the desired result. Furthermore, Sculptra is better suited to restoring volume loss than to smoothing wrinkles and cannot be used in the lips or around the eyes. The cost of Sculptra is also higher than other types of fillers.

All the fillers mentioned above have been shown to stimulate the body’s own natural production of collagen, leading to a reduction of lines and wrinkles over time with repeated treatment.

Dermal fillers vary in their composition, longevity and degree of softness. Given the wide range of fillers available, it is important to talk to an experienced medical professional to determine the best type and volume of filler needed to achieve your desired result.

Are you considering a cosmetic dermal filler treatment? Please feel free to talk to our knowledgeable staff at Silhouette Spa and Laser or book a consultation with our medical aesthetics injector for more information. We would be happy to assist you.

References

American Society of Plastic Surgeons: Dermal Fillers
Government of Canada: Cosmetic Injections
Healthline: Comparing Juvéderm and Restylane: Is One Dermal Filler Better?
Juvéderm
Radiesse
Restylane
Revanesse
Sculptra
Verywell: How to Choose a Facial Filler
WebMD: What You Should Know About Wrinkle Fillers