Dermal fillers are used by cosmetic facial surgeons to reduce the signs of aging, minimize skin depressions and scars, and address fine lines and deep wrinkles or folds in the skin of the face. Fillers can also be used on hollow areas below the eyes.

Types of Dermal Fillers

Safe, FDA-approved products include hyaluronic acid, polymethyl methacrylate, poly-L-lactic acid, calcium hydroxylapatite or the person’s own body fat. The doctor will work with each person and recommend the most appropriate one based on the person’s skin type, age and other factors, also considering the effect that the person wants to achieve.

Hyaluronic Acid

Hyaluronic acid is a natural component of the skin’s connective tissue. Its safety and effectiveness have made it the most common filler used in cosmetic facial procedures. Injections of hyaluronic acid can soften fine lines and creases and restore fullness to the skin.

The difference between hyaluronic acid products is the size of the particles, which are designed to address different wrinkle depths: smaller particles for fine lines and larger particles for deeper wrinkles and folds.

Calcium Hydroxylapatite

Calcium hydroxylapatite treats deeper wrinkles and skin folds. It can help the doctor contour the jaw line and restore volume in and around the cheeks. These injections may last up to three years when used to fill wrinkles and up to one year when used for contouring.

Polymethyl Methacrylate (PMMA)

This filler consists of microspheres suspended in a collagen-based gel. The gel provides immediate volume that lifts the skin to soften wrinkles and acne scars. The microspheres stay in place and provide structural support for smoother looking skin.

Poly-L-lactic Acid

Originally developed to treat severe facial wasting in HIV infection, this treatment is now FDA-approved to address facial aging. Injections last up to two years.

Human Fat

The doctor may harvest fat from the person’s own body and reinject it to enhance facial fullness, fill in deep creases and build up shallow contours. Using fat injections is more involved than other injectable fillers since it requires liposuction to extract the fat before injection. Fat injections are somewhat unpredictable in how long they last, and vary from patient to patient and location of injection.

Other Injectable Cosmetic Treatments

Deoxycholic Acid

Deoxycholic acid is a natural ingredient in stomach acid and was FDA-approved for use in 2015 as a nonsurgical way to dissolve excess fat under the chin, also known as double chin. In the past, the only options for treating this area were liposuction and surgery.

The treatment consists of injections of deoxycholic acid, performed in the doctor’s office. Sometimes more than one treatment is necessary. Clinical studies showed the most common side effects include redness, swelling, bruising, and numbness, all of which were temporary, lasting less than four weeks. Gradually, over the course of several weeks, the acid gently breaks down the fat cells and the body flushes them away.

Deoxycholic acid treatments are best for patients whose double chin is due to excess fat and who have mild to moderate amounts of excess skin. People with significant excess skin are not appropriate candidates for this procedure.

Botulinum Toxin

The cosmetic form of botulinum toxin is a purified protein injectable filler that is FDA-approved for the temporary treatment of frown lines. This simple, nonsurgical injection can temporarily reduce or eliminate forehead creases, crow’s feet near the eyes and thick bands in the neck.
The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles, while giving the skin a smoother, more refreshed appearance.