Which Injectable Filler Is Best? Wrinkle Fillers - Risks and Benefits

 Injectable fillers help to combat the signs of old age in the face, by: 

• Adding more volume
• Tightening the skin 
• Reducing wrinkles 

But, depending on the type of skin you have, what you are trying to fix, how permanent you want the procedure to be, and whether you are looking for an invasive, or non-invasive procedure, there are different types of fillers that may be best for you. 

In this guide, I will help you to understand: 

• What are fillers? 
• How do they work? 
• What are the different types of injectable fillers?  
• Which one is best for you? 
• How to find a skilled injector near you 

Let's get started. 

I. What Are Injectable Fillers?

Injectable fillers are used to correct soft tissue defects in your face, more commonly referred to as facial wrinkles, or skin folds. These fillers are also used to augment the cheeks and the lips. With fillers, you can restore lost volume in such a way that you can add structure to certain parts of your face, contour your face, or refine your existing beauty.

As we age, our face naturally loses volume. This volume loss creates a visible hollowing of the face, most commonly seen in the form of: 

• Sunken cheeks
• Visible folds around the face
• Or lines around the mouth

With injectable fillers you can restore that lost volume and bring back the younger more vibrant you. Before understanding which one is best for you, it is important to first understand how they work. 

II. How Do Injectable Fillers Work?

Injectable fillers restore lost volume by stimulating the natural collagen production in your skin. Almost all FDA-approved fillers are considered temporary, and they will achieve smoothing or filling effects, which last for approximately 6 months to 1 year or more depending on each person, what areas were treated, and which filler was used.

The reason these products are temporary is because your body will eventually absorb the filler, at which point it can no longer do its job. These fillers are typically administered through an in-office procedure that is fast, lasting an average of 30 minutes. There is almost no physical downtime in the majority of situations and the results can be seen immediately.

III. What Are the Different Types of Injectable Fillers?

There are four types of injectable fillers, each of which is comprised of different contents and serve slightly different purposes:

1. Hyaluronic Acid Fillers

Hyaluronic acid fillers, as the name suggests, are made from hyaluronic acid. This is a protective lubricating gel which is naturally produced by your body.

These fillers are the most popular filler on the market today because they are soft, they create a natural appearance, and they are incredibly safe, and versatile.

Moreover, Hyaluronic acid fillers are also reversible, so if anything were to go wrong, or you changed your mind after the fact, it isn't a problem. These fillers can be used in many areas of the face, including:

• Cheeks

• Jawline

• Nasolabial folds

• Marionette lines

• Nose

• Forehead

• Eyes

The most popular brand names include:

• Restylane

• Juvederm

• Belotero

Hyaluronic acid fillers come in light, medium, and heavy formulations. Each of these treatments are designed in order to treat a different severity of aging signs in the face: 

 Treatment  

Typical Use

Common Brands

Light

Treating fine wrinkles and superficial lines

Belotero Balance

Juvederm Volbella

Restylane Silk

Medium

All over the face, at times layered with light or heavy fillers

Juvederm Vollure

Juvederm Ultra

Juvederm Ultra Plus

Restylane

Restylane Refyne

Restylane Defyne

Heavy

Structural filling and lifting of areas like the nose, cheeks, chin, or temples

Juvederm Voluma

Restylane Lyft

Regardless of formulation, these fillers are temporary, with results lasting between 3 months and 2 years.

2. Non-Hyaluronic Acid, Non-Permanent Fillers

Non-hyaluronic acid fillers have become more popular in the last decade, as an alternative non-permanent facial filler. With this type of filler, there are a few variations:

1. The first is a collagen variety, which is made from highly purified human collagen or cow collagen.
2. The second is calcium hydroxylapatite, which is a mineral, and one of the major components in bone. It is found commonly in the Radiesse lines.
3. The final option is an injectable poly-L-lactic acid material which is a biodegradable, biocompatible, synthetic material commonly found in the Sculptra lines.

Each of these non-hyaluronic fillers are used on select parts of the face, particularly the cheeks, nasolabial folds, nose and chin. All of these fillers are popular because of their ability to restore lost volume, and how safe they are. Results are temporary and last between 1 and 3 years.

The key difference between these treatments and hyaluronic acid fillers is that these treatments are not reversible. 

3. Permanent Fillers

In spite of what the name suggests, permanent fillers are only semi permanent in nature, but they are one of the longest lasting options.

There are many types of permanent fillers, but some of the most common ones include: 

1. Those made from collagen with PMMA microspheres found commonly in the Bellafill lines
2. Liquid silicone with the Silikon 1000 line

Bellafill has received FDA approval for correcting nasolabial folds and treating moderate-to-severe atrophic acne scars. The results of these treatments typically last about five years.

Silikon has not yet received FDA approval for cosmetic use, but is used off-label by some professionals. It is essential that you ask your injector which type of filler they are using, and make an effort to learn about it prior to receiving treatment. 

The Controversy With Permanent Fillers 

Permanent fillers remain controversial because if they are not injected perfectly, with precision and skill, they can results in permanent disfigurement. Moreover, these fillers can activate in an unpredictable fashion which means some patients have red, tender lumps that form as a result. The only way they can be removed is to have them surgically removed.

Other problems with permanent fillers include the fact that they can't be adjusted as your face ages. The fillers themselves can migrate with time. As a result of these potential hazards, many doctors won't inject near or over these products because they don't want to activate them and caused those red, tender lumps to manifest.

You deserve to live a fulfilling life and feel confident in your exterior beauty, but in order to do that you should stay away from permanent fillers. At this point in time, they are simply too dangerous, and too new compared with the safer options on the market that can help you to achieve the same beauty goals.

4. Autologous Fat Fillers

The fourth type of injectable filler uses your body's own fat in a natural fashion. With this type of filler, your own body fat is harvested using a micro liposuction procedure. The fat is then purified, at which point it is injected into your face. 

One of the main drawbacks of a fat transfer is that it is expected that your body will absorb some of that fat once it is transferred, which means that in the end, only a portion of the injected fat is going to stay in your face as intended.

But, precisely how much gets absorbed and how much remains is uncertain. This makes the degree of correction not nearly as predictable as it is with synthetic fillers.

With this type of dermal filler, there is a small chance that most of the fat can be reabsorbed by the body, resulting in minimal improvement. There is also a very small chance that the transferred fat can develop nodules, granulomas, or fat necrosis. 

Overall, this is a more natural approach to increasing volume and fighting signs of facial aging, but can sometimes require multiple treatments in order to be completely effective. One of the pros of this type of filler treatment is that the results are permanent, barring any extreme weight loss or re-absorption. 

IV. Which Injectable Filler Treatment is Best?

The best injectable filler for you truly depends on:

• Your anatomy
• Your goals
• The experience of the injector 

You should choose a master injector who is skilled, and experienced with a wide range of fillers. This by far the most important part of choosing a treatment. A master injector can recommend exactly which type of filler is best for your situation, and will be able to administer treatment with very little risk of complications. 

Generally speaking, both Restylane and Juvederm fillers are effective, versatile, safe, and reversible. This makes them great starting points for patients who are interested in giving facial fillers a try, but aren't sure which one is right for you. 

V. Are Injectable Fillers Worth It?

Overall, depending on the type of treatment you get, and the doctor you choose, injectable fillers are absolutely worth it. With the average treatment priced around $1,500, and results for the most popular treatments lasting around 1 year, dermal fillers are a safe and affordable way to fight the signs of old age. 

On top of that, if you choose Hyaluronic Acid as the type of filler you use, your results can be reversed if you don't like the outcome. Additional treatments can also be administered in order to alter specific parts of the face to get the exact shape and volume you are looking for. 

The most important thing when it comes to choosing the right injectable filler treatment for you is choosing the right doctor. A master injector will be able to tell you exactly what you should, and shouldn't look for in a treatment. They can make expert suggestions, and have very high success rates with their treatments. 

Less experienced injectors can make simple mistakes which can compromise your results, or even worse - leave you with deformations and health problems as a result of activated fluids. While it may be more expensive to pay up to work with a professional, it is highly recommended. 

Note: Finding the right injector can seem difficult if you do not know what to look for and how to filter through them. That is why I wrote this comprehensive guide to help you assess your injector, and make the best decision. 

VI. Finding the Best Injector Near You

My name is Dr. Larry Fan, and I am a Board Certified Plastic Surgeon who has been voted one of America's Top Plastic Surgeons for 10 years running. In my career, I have helped over 5,000 men and women to look and feel their best through surgical and non-surgical cosmetic procedures. 

I am a master injector, with years of experience in dermal fillers such as Botox, Fat Transfers, and Juvederm. I am confident that I have the passion and experience to help you obtain the looks you have always dreamed of. 

If you are interested in learning which one of these treatments is best for you, take our quick self evaluation in order to learn more. Or, if you would like to speak with me personally in order to get answers to your questions, or set up an appointment, contact me directly here.