Dermal fillers are a cornerstone of non-surgical facial rejuvenation, offering targeted solutions for volume loss, contouring, and wrinkle correction. Understanding the differences between filler types is essential for safe, effective, and natural-looking results.
Types of Dermal Fillers: Scientific Overview
Dermal fillers are categorized by their primary active ingredient and mechanism of action. The most widely used types include hyaluronic acid (HA), calcium hydroxylapatite (CaHA), poly-L-lactic acid (PLLA), polymethyl methacrylate (PMMA), and autologous biostimulatory fillers. Each offers unique benefits, longevity, and safety profiles (Reference 1, Reference 2).
Hyaluronic Acid (HA) Fillers
HA fillers account for approximately 70-87% of all filler procedures due to their biocompatibility, reversibility, and versatility (Reference 1, Reference 5). They are suitable for lips, cheeks, nasolabial folds, tear troughs, jawline, and fine lines. HA fillers can be dissolved with hyaluronidase in the event of overcorrection or vascular compromise (Reference 2).
Popular HA Fillers at Cosmetic Injectables Center Medspa:
- Juvederm Fillers: Includes Juvederm Ultra XC, Ultra Plus XC, Volbella XC, Vollure XC, Voluma XC, and Volux.
- Restylane Fillers: Includes Restylane-L, Lyft, Silk, Contour, Defyne, Refyne, Eyelight, and Kysse.
- Teoxane Fillers
- Belotero Balance
- Revanesse Versa & Versa Lips
- RHA Collection: RHA Redensity, RHA 2, RHA 3, RHA 4
- SKINVIVE™ by JUVEDERM®: FDA-approved for skin hydration and smoothness.
Reversal Agents:
- Hylenex and Vitrase: Used to dissolve HA fillers in case of overcorrection or complications.
Calcium Hydroxylapatite (CaHA) Fillers
CaHA fillers provide immediate volume and stimulate collagen production, making them suitable for deeper folds and jawline enhancement. They last approximately 12-18 months and are not reversible (Reference 1, Reference 2). CaHA can interfere with certain imaging studies.
- Radiesse: Used for facial contouring and hand rejuvenation.
Poly-L-Lactic Acid (PLLA) Fillers
PLLA fillers stimulate the body’s own collagen over time, offering gradual and long-lasting volume restoration (up to 2 years). They are ideal for deep tissue enhancement and facial lipoatrophy. PLLA is not reversible and requires a series of treatments for optimal results (Reference 1, Reference 2).
- Sculptra: FDA-approved for facial volume loss and collagen stimulation.
Autologous and Biostimulatory Fillers
These fillers use the patient’s own biological material or advanced biostimulatory compounds to enhance skin quality and volume.
- EZ Gel: Uses autologous growth factors for natural rejuvenation.
Filler Rheology and Selection
Filler selection is based on rheological properties such as viscoelasticity and cohesiveness. Biphasic HA fillers (e.g., Juvederm Voluma, Restylane Lyft) provide high lifting capacity for cheeks and jawline, while monophasic fillers (e.g., Belotero Balance) are better for superficial lines and dynamic areas (Reference 3).
Filler Comparison Table
| Filler Type | Example Brands/Links | Duration (avg) | Reversible | Main Indications | Key Safety Notes |
|---|---|---|---|---|---|
| Hyaluronic Acid | Juvederm, Restylane, Belotero, Teoxane, RHA, Versa, SKINVIVE | 6-24 months | Yes | Lips, cheeks, lines, hydration | Bruising, swelling, rare vascular occlusion; reversible |
| CaHA | Radiesse | 12-18 months | No | Jawline, deep folds, hands | Nodules, imaging interference; not reversible |
| PLLA | Sculptra | Up to 24 months | No | Deep volume, collagen loss | Gradual results, nodules possible; not reversible |
| Autologous/Biostim. | EZ Gel | Varies | N/A | Skin quality, fine lines | Minimal risk, uses patient’s own material |
Safety, Efficacy, and Complications
Scientific reviews confirm high patient satisfaction (83.4%) and low complication rates (1:100 to 1-4:10,000) across all filler types (Reference 1, Reference 4). Most adverse events are mild and self-limited (e.g., swelling, bruising, tenderness). Severe complications, such as vascular occlusion, are rare but require immediate intervention—especially with HA fillers, which can be dissolved with hyaluronidase (Hylenex and Vitrase).
Non-HA fillers (CaHA, PLLA) offer longer-lasting results but are not reversible, and complications may require pharmacological or surgical management (Reference 4). Proper patient selection, anatomical knowledge, and advanced injection technique are critical for minimizing risks (Reference 5).
How to Choose the Right Filler
Selection depends on treatment goals, anatomical area, desired longevity, and individual risk factors. For dynamic areas (lips, perioral lines), softer HA fillers like Restylane Silk or Juvederm Volbella are preferred. For structural support (cheeks, jawline), firmer options like Juvederm Voluma, Restylane Lyft, or Radiesse are ideal. For gradual collagen stimulation, Sculptra is indicated.
A consultation with a certified expert injector is essential to assess medical history, anatomy, and expectations. At Cosmetic Injectables Center Medspa, all treatments are performed by certified injectors under the direct supervision of Dr. Sherly Soleiman, MD, a board-certified physician and national trainer for Allergan.
Why Choose Cosmetic Injectables Center Medspa?
- Physician-led, on-site care by Dr. Sherly Soleiman, MD (NPI Registry), a board-certified Family Medicine physician with over 25 years of experience and a national reputation for safety and artistry in medical aesthetic procedures.
- Top 1% Allergan practice in the USA, recognized for advanced injection techniques and patient safety.
- Comprehensive range of FDA-approved fillers, including all major HA, CaHA, PLLA, and autologous options.
- Complimentary consultations with Master Nurse Injectors; physician consultations available.
- Serving Sherman Oaks, Encino, Beverly Hills, and the greater Los Angeles area.
Frequently Asked Questions
What is the difference between hyaluronic acid and non-HA fillers?
Hyaluronic acid (HA) fillers are reversible and versatile, suitable for most facial areas. Non-HA fillers like calcium hydroxylapatite (CaHA) and poly-L-lactic acid (PLLA) offer longer-lasting results and collagen stimulation but are not reversible. Individual results and risks vary by product and patient.
How long do dermal fillers last?
Duration depends on the filler type and treatment area. HA fillers typically last 6-24 months, CaHA up to 18 months, and PLLA up to 2 years. Longevity varies by metabolism, injection site, and product formulation.
Can fillers be dissolved if I am unhappy with the results?
Only HA fillers can be dissolved using hyaluronidase (Hylenex and Vitrase). Non-HA fillers cannot be reversed and may require other interventions if complications occur.
Are dermal fillers safe?
When administered by certified expert injectors, dermal fillers have a high safety profile. Most side effects are mild and temporary. Severe complications are rare but require immediate medical attention. Proper technique and anatomical knowledge are essential for safety.
Which filler is best for lips?
Soft, flexible HA fillers such as Juvederm Volbella, Restylane Kysse, and Revanesse Versa Lips are commonly used for lip augmentation due to their natural feel and reversibility.
What is the risk of vascular occlusion with fillers?
Vascular occlusion is a rare but serious complication, most commonly associated with HA fillers. Immediate recognition and treatment with hyaluronidase are critical. Choosing an experienced provider significantly reduces this risk (FDA Summary).
Can fillers be used for under-eye hollows?
Yes, specialized HA fillers such as Restylane Eyelight are designed for tear trough correction. Proper technique and product selection are essential to minimize swelling and irregularities.
What is SKINVIVE™ by JUVEDERM®?
SKINVIVE™ by JUVEDERM® is an FDA-approved HA-based injectable for improving skin hydration and smoothness, distinct from traditional volumizing fillers.
How do I know which filler is right for me?
A personalized consultation with a certified injector is necessary to assess your goals, anatomy, and medical history. The team at Cosmetic Injectables Center Medspa provides individualized recommendations for optimal safety and results.
Are there fillers for hand rejuvenation?
Yes, Radiesse is FDA-approved for hand volume restoration, improving the appearance of tendons and veins.
For a full list of available fillers and to learn more about each option, visit our Filler By Type page or schedule a consultation with our certified team. Individual results may vary. All procedures are performed under the direct supervision of Dr. Sherly Soleiman, MD, a board-certified physician and national expert in medical aesthetic procedures.
References:
- A Comprehensive Evaluation of Dermal Fillers in Aesthetic Medicine: Safety, Efficacy, and Long-Term Outcomes
- FDA Executive Summary General Issues Panel Meeting on Dermal Fillers
- Conditions to Consider When Choosing Fillers
- Safety and Potential Complications of Facial Wrinkle Correction with Dermal Fillers: A Systematic Literature Review
- The Demographics of Patients With Dermal Filler Complications
- Dr. Sherly Soleiman, MD – NPI Registry
- Cosmetic Injectables Center Medspa – About