The earliest history of dermal fillers is from the 1800’s.  In more modern times, bovine collagen use started around 1981.  Then in 2003, hyaluronic acid fillers were approved.  The advent of these fillers has made a significant impact on the industry.  Currently there are a variety of fillers available on the market.  Which one should you choose?  This is a question that is best answered by your skin care professional.  However it is good to understand some of the differences and what to expect from a dermal filler treatment.


Currently, the most common fillers are Juvederm and Restylane.   There are several versions of each of these fillers available.  This allows for treatment of varying degrees and depths of volume loss and wrinkles.  However, all of them are composed of hyaluronic acid and work by the same mechanism of action.  Hyaluronic acid is a natural substance found in your body.  It attracts water and acts like cushion to bring volume back to the tissues and soften lines.  This water also keeps the skin surface looking fresh and smooth.


Recently several new fillers in the hyaluronic class have become available.  Voluma and Vobella are two of the newest in this class.  These fillers have the advantage of lasting longer than other hylauronic acid fillers, with results expected to last 24 to 30 months.  Voluma is great for adding volume to the midface, which readily flattens  as we age.  Volbella softens fine lines in the lips and around the mouth without adding much volume.  It is great for those of us who want a very natural look without any obvious change in contour on the lower face.


Radiesse, another dermal filler, works a little differently than hyaluronic acid fillers but produces similar results.  It is composed of calcium hydroxyl appetite and does provide some immediate filling.  An added benefit of Radiesse is that it also stimulates the formation of new collagen and may last a few months longer that Juvederm or Restylane.  It is great for the adding volume to the cheeks and for softening smile lines.


Bellafill and Sculptra are each in a class of their own.  Bellafill is a semi-permanent filler with results lasting around 5 years.  The advantages of a long lasting filler have to be weighed against the fact the results are  not reversible and will remain present for several years.  Bellafill can be used to treat smile lines, also known as nasolabial folds, and acne scarring.  Sensitivity testing may be indicated prior to use.  Sculptra is indicated for increasing volume in the midface or cheek area but is not an option for lips or smile lines.  It requires a series of treatments every few weeks initially to obtain the desired result.  This filler stimulates collagen production over a period of 1 to 2 months.  Maintenance with additional injections will still be needed about every year although some improvement may be seen up to 2 years after treatment.


Bottom line: there are several fillers available, each having unique properties and effects.  You should discuss these options with your skin care professional to determine which treatment is best.  Sometimes a combination of fillers can be done to obtain optimal results.  Consultations regarding dermal fillers are complimentary at many offices, so be sure to set aside time to discuss the options prior to treatment.