Filler

When deciding if fillers are right for your skin, there's a few options. Let's dive into the most common fillers on the market! 

What are Fillers?

Neuromodulators, like Botox, are a favorite treatment in dermatology. When injected into the skin, Botox temporarily weakens the targeted muscles, leading the overlying skin to become smoother and more youthful-looking. Though Botox is the most popular and well-known, other brands of neuromodulators include Xeomin, Dysport, Jeaveau, and Daxxify. 

Fillers + Anatomy

Our skin has three layers with muscle and bone underneath. Filler can be injected into different layers (depending on the location, the quality of the filler, and condition being addressed): 

Common Injection Sites

Neurotoxin is frequently injected into specific areas to reduce the appearance of wrinkles and fine lines. The most common sites for Botox injections include:

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  • Forehead - smooth horizontal lines and frown lines

  • Between the eyebrows (glabellar region) -  reduce furrows or "11s"

  • Around the eyes (crow's feet) - soften wrinkles

Filler Overview

What is the difference between these fillers? They all have the same purpose (to fill) but do so in different ways. The most popular fillers are composed of: 

Hyaluronic Acid​

Juvederm, Restylane, Belotero

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  • Naturally occurring in the skin

  • Attracts water to add volume

  • Promotes smoother, plumper skin

  • Lasts ~ 6 - 12 months

  • CAN ERASE

Calcium Hydroxylapatite

Radiesse​

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  • Targets moderate to severe wrinkles

  • Stimulates collagen production: calcium as a scaffold for collagen to build upon

  • Longer-lasting results

  • Lasts ~1 year

Poly-L-lactic Acid​ (PLLA)

Sculptra​

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  • Targets deep lines and volume loss

  • Stimulates collagen production: PLLA acts as foreign body to induce inflammation, promoting collagen production

  • Lasts ~2 years

In addition to the type of material, fillers also differ based on thickness/consistency. Let's use food as a way to compare the consistency of different fillers: 

WARNING: OPINIONS INCOMING

Want to know what dermatologists *really* think about fillers? Asked and answered! Introducing "Noted Dermatologist Opinions," where only verified Board-Certified Dermatologists say what they *really* think about these devices with the strict condition of anonymity. All have verified credentials. Remember, these are OPINIONS only. Let's go! 

Under Eye Fillers

  • Belotero

  • Juvederm

  • Restylane

  • Radiesse

Lip Fillers

Juvederm Ultra

Manufactured by Allergan

Noted Facts:​​

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  • FDA approved 2015 (one of the first for lips)

  • Classic, gold standard of lip filler

  • Build lots of lip volume in one sitting: plumping + attract more water + blends well into the patient’s own lip tissue

  • Juvéderm Ultra: slightly softer, more natural to touch

  • Who is it best for?:

  • patients who want to grow their lips several sizes larger + plump lips

  • KYLIE JENNER

  • Duration: 6-10 months.

 

Noted Dermatologist Opinions:​

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  • Great for "tech neck."

  • My favorite for under eye. 

  • I use Belotero for smoker's lines. 

  • Acne scars. 

  • My favorite for neck lines: Botox + Belotero. 

tl;dr:​

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  • A tried and true neuromodulator, but our sampling indicated that they prefer Dysport over Botox. 

The fillers in this category are often made of lighter, less dense substances to ensure a natural look and feel. 

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  • Restylane® and Juvederm® Volbella = subtle

  • Juvederm® Ultra and Juvederm® Ultra Plus = dramatic and pouty lips

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  • Juvederm Ultra

    • FDA approved 2015 (one of the first for lips)

    • Classic, gold standard of lip filler

    • Build lots of lip volume in one sitting: plumping + attract more water + blends well into the patient’s own lip tissue

    • Juvéderm Ultra: slightly softer, more natural to touch

    • Who is it best for?:

    • patients who want to grow their lips several sizes larger + plump lips

    • KYLIE JENNER

    • Duration: 6-10 months.

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  • Volbella

    • FDA approved 2016

    • Natural and subtle: soften and hydrate: almost undetectable and adopts the shape of the patient’s lips; fuller, more hydrated

    • gentle filling capacity, is the softest and most liquid, takes up the least amount of space beneath the skin.

    • No swelling --> lips more red due to the fact it is placed superficially. It does not attract water, a phenomenon which can give the lips a whitish hue.

    • Best for:

    • Aged lips

    • thin-lipped patients who desire undetectable filler

    • "I want lip filler, but I don't want to look like a Kardashian!"

    • least duration: Vollure is the slightly stronger version of Volbella and is essentially the same product but lasts slightly longer.

    • Duration: 6 - 12 months​​

 

  • Restylane kysse

    • FDA-approved in 2020

    • Softest filler on the market

    • subtle, natural looking: integrate the gel into lip tissue and save the natural look.

    • This product tends not to migrate due to its inherent stickiness.

    • Decent duration: up to 1 year

    • Best for: Best introductory filler on the market, meaning a first time patient who is seeking lip enhancement will more than likely be happy with Kysse.

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Belotero

Manufactured by Allergan

Noted Facts:​​

  • Facts

 

Noted Dermatologist Opinions:​

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  • Great for "tech neck."

  • My favorite for under eye. 

  • I use Belotero for smoker's lines. 

  • Acne scars. 

  • My favorite for neck lines: Botox + Belotero. 

tl;dr:​

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  • A tried and true neuromodulator, but our sampling indicated that they prefer Dysport over Botox. 

Belotero

Manufactured by Allergan

Noted Facts:​​

  • Facts

 

Noted Dermatologist Opinions:​

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  • Great for "tech neck."

  • My favorite for under eye. 

  • I use Belotero for smoker's lines. 

  • Acne scars. 

  • My favorite for neck lines: Botox + Belotero. 

Nasolabial Folds + Marionette Lines

Best for deeper wrinkles (such as nasolabial folds/"marionette lines")

  • Juvederm ULtra and Ultra+

    • Juvederm Ultra Plus is made especially for these deep lines, creases, and the lines extending down the mouth to the marionette lines’ oral commissures.

    • Both are primarily indicated for the treatment of nasolabial folds and marionette lines.

    • Juvederm Ultra is designed for mild-to-moderate lines and wrinkles

    • Ultra Plus is for deeper wrinkles and folds.

    • Use for NLFs: Ideal for moderate nasolabial folds.

    • Properties: It has a softer consistency, making it suitable for more superficial placement and providing a smooth result.

    • Juvederm Ultra Plus

      • Use for NLFs: Better for more pronounced nasolabial folds.

      • Properties: It's thicker than Juvederm Ultra, offering more volume and support for deeper lines

 

Refyne + Defyne:

  • Newer

    1. more flexibility

    2. both stationary and animated lines around the mouth.

 

  • Restylane Refyne

    • Use for NLFs: Designed for mild to moderate nasolabial folds.

    • Properties: Features XpresHAn Technology™ for flexibility and natural movement, ideal for areas of expression.

 

  • Restylane Defyne:

    • Use for NLFs: Targeted for moderate to severe nasolabial folds.

    • Properties: Similar to Refyne but with a thicker gel, it offers additional support for deeper lines while maintaining natural facial expressions.

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  • Vollure

    • Use for NLFs: Suitable for moderate to severe nasolabial folds.

    • Properties: Known for its balance between softness and firmness, providing a natural look and long-lasting results.

    • Vollure was developed to respond to the need for a long-term dermal filler in the smile lines. Juvederm Vollure lasts approximately 18 months when treating these “parentheses lines” and is an extremely natural-looking injection.

    • For more superficial marionette lines, Juvederm Vollure can help. This thin filler allows us to smooth very shallow lines without over-plumping the area, which can make patients look unnatural.

    • thin filler it does not overpump the region, very natural

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  • Belotero

    • FDA-approved dermal filler specifically designed to smooth nasolabial folds

    • Lasts six months to one year

 

  • Radiesse

    • ​

 

Restylane

  • Use for NLFs: Effective for mild to moderate nasolabial folds.

  • Properties: It has a somewhat granular texture, which can provide a good lift and support.

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  • Sculptra

    • When injected in nasolabial folds, it provides more gradual results as it rebuilds collagen. Results last longer than hyaluronic acid fillers; however, Sculptra is often just the first step. After Sculptra has gotten to work rebuilding collagen, many patients also receive a hyaluronic acid filler to plump up the area for the finishing touch.

Cheeks + Chin Filler

Best for deeper wrinkles (such as nasolabial folds/"marionette lines")

Cheeks:

  • Juvederm Voluma

  • Juvederm Ultra +

  • Restylane Lyft

  • Restylane Contour

  • Radiesse

  • Sculptra

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Chin: 

  • Belotero

  • Juvederm Voluma

  • Juvederm Ultra +

  • Restylane Defyne

  • Radiesse

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Neck Filler

Best for cheek volume and jaw contouring

The fillers used here are usually the densest and provide significant lift and volume to the treated areas.

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  • Sculptra: A poly-L-lactic acid-based filler, known for stimulating collagen and providing long-lasting volume.

  • Radiesse: Made of Calcium hydroxylapatite, it's used for deep volume restoration and stimulates natural collagen production.

  • Juvéderm Voluma: Specifically designed for deep injection to restore volume to cheeks and chin.

Manufactured by Merz

Hand Filler

Best for cheek volume and jaw contouring

The fillers used here are usually the densest and provide significant lift and volume to the treated areas.

  • Radiesse: Also used at the periosteal level for facial contouring and bone structure enhancement.

  • Ellansé: A longer-lasting filler that stimulates collagen production and is used for deep structural facial rejuvenation.

  • Bellafill: Known for its long-lasting effects, it's used for deep wrinkles and acne scars; it's also used for nose and chin augmentation.