Last Updated on July 17, 2021 by Dr Sanusi Umar MD

A dermal filler is a medical grade substance that is used to treat depressions and wrinkles in the skin. Fillers are injected below the crease or problem area to produce a lifting effect. With all the various  product brand names that we hear about, many people in Los Angeles are interested in learning about the different types of dermal fillers, what they do and which injectable is best for their needs. In this Q&A video below, Dr.U gives an overview of the three main categories of dermal fillers, the specific types and how they are used.

 

In this Q&A video, Dr.U shares information and insights on various dermal fillers, their basic properties and how they are used.

Names of Fillers for the Face

Magazines and beauty sites mention often discuss various dermal filler brands, such as Juvederm, Restylane, Perlane, Belotero and more. Sometimes, these articles may not provide background information on the properties of each filler and their general applications. It will be important to learn these basics and then consider how well the characteristics of a particular product can solve a particular issue.

What are the Best Dermal Fillers

Dr.U recommends acquiring a basic understanding what each dermal filler is made of, and how the ingredient behaves under the skin to produce a particular outcome.

This level of knowledge will help provide more clarity on goals and priorities when you speak to an actual doctor. For example, are you aiming for very subtle results, or a more aggressive and noticeable form of improvement? Is the longevity of the dermal filler product an important priority to you, over other criteria?

The Three Main Types of Dermal Fillers Los Angeles Patients Should Know

The names of different filler products can seem numerous with a vast amount of information to learn. However, by understanding a basic categorization system, it will be much easier to gain a grasp on the different options available and know which dermal filler is best for your area(s) of concern.

In the Q&A video, Dr.U mentions that there are three main types of dermal fillers, which are based on the substance they are made of.

Hyaluronic Acid Dermal Fillers

Hylauronic acid is a sugar molecule naturally found in our bodies which holds large amounts of water. It not only adds volume to the treated areas, but also provides hydration which contributes to rather natural and subtle looking outcomes.

It is possible for hyaluronic acid fillers for laugh lines to soften and improve facial expressions.

Many types of dermal fillers are made of hyaluronic acid which can produce a soft, subtle looking outcome for applications like mild laugh lines.*

Before and after photos of a lip augmentation for the cupid's bow

Choosing the right dermal filler for the lips often depends on the type of results the patient wants to achieve*

 

The actual hyaluronic acid used to formulate injectable fillers is actually derived from bacteria for a more sterile end result.  It undergoes a series of extensive purification and refinement processes to reduce the risk of allergic reactions in patients.

Our bodies are able to recognize the basic molecular  structure of HA allowing us to assimilate dermal fillers made from this substance without incurring severely unwanted complications.

One of the benefits of using hyaluronic acid dermal fillers is that it can easily be dissolved using an enzyme known as hyaluronidase. Thus mistakes  and unwanted outcomes can easily be corrected right away. With other types of fillers, patients have to wait until the product is completely metabolized by the body, which can take months.

Dermal fillers made of hyaluronic acid include:

  • Juvederm
  • Restylane
  • Perlane
  • Belotero

Hyaluronic acid dermal fillers are generally used for filling in cheek depressions as well as nasolabial grooves which develop around the nose and mouth.

They can be used to treat various forms of wrinkles. However, in these cases, it is recommended that the injections are placed deeper in the skin. Hyaluronic acid is a clear colored substance, making it prone to a light bending phenomenon called the Tyndall effect. When light shines on the treated area, the rays will bend as they pass through the clear colloid gel and produce a bluish coloration which can resemble a bruise.

A relatively newer form of hyaluronic acid dermal filler is Belotero which undergoes a more advanced form of processing in the making of the final product. This form of hyaluronic acid has a very different set of characteristics as a continuous substance, rather than a clear suspension.

Because of Belotero’s properties, it can be injected more closely to the skin’s surface without the risk of incuring the Tyndall effect. This hyaluronic acid dermal filler is quite ideal for lifting very fine superficial lines and wrinkles.

Determining which dermal filler is best often depends on the challenge that needs to be addressed. For this Los Angeles patient, Belotero was the best option to fill her fine line on the cheek

Determining which dermal filler is best often depends on the challenge that needs to be addressed. For this Los Angeles patient, Belotero was the best option to fill her fine line on the cheek.*

 

Before Belotero became available, it was very difficult for older generations of hyaluronic acid dermal fillers to correct fine lines on the skin without clumping or producing discolorations. Now patients are able to solve issues like static crows feet lines, etched frown and forehead lines, slight vertical cheek lines and even wrinkles around the lips.

Calcium Hydroxylapatite Dermal Filler

Calcium hydroxlapatite is a compound that helps comprise our bone tissue. This molecule (in the form of tiny microspheres)  is used as the active ingredient of a dermal filler known as Radiesse.

The main advantage of calcium hydroxlapatite is that it offers a versatile and adaptable firmness to the area of application. The microspheres within Radiesse will cluster together tightly or more diffusely to mimic the nature and density of the surrounding tissue environment.

This property allows the  dermal filler to provide more structural support when it is needed for specific treatment applications.

In terms of cost, Radiesse is less expensive than hyaluronic acid dermal fillers. However, it cannot be used for lip augmentation since it will create lumps and granules.

Radiesse can be used for filling large volume areas, such as the cheeks. It is commonly used to for other areas of applications in non-surgical facial contouring, including the nose, chin, nasolabial folds and jowls.

 Different types of dermal fillers can be used to fill in laugh lines, also known as nasolabial folds. Radiesse was used for this patient

Different types of dermal fillers can be used to fill in laugh lines, also known as nasolabial folds. Radiesse was used for this patient *

 

Brand names of fillers for the face may not always be as important as other considerations such as longevity, naturalness of the results and their ability to provide structural support when needed *

Brand names of fillers for the face may not always be as important as other considerations such as longevity, naturalness of the results and their ability to provide structural support when needed *

At the Dr.U Skin Clinic in Los Angeles, Dr.Umar often uses Radiesse as his dermal filler of choice for the under eye area to solve issues like dark circles and puffiness. Since Radiesse is an opaque, whitish substance and not a clear colloid gel, it will not produce the Tyndall effect. Since the skin the tear trough area is very thin, this property of calcium hydroxlapatite makes it an ideal choice.  

Dermal Filler Made of Poly-L-Lactic Acid (PLLA)

Poly-L-Lactic acid is a compound used to make dissolvable sutures which can also stimulate the production of the skin’s collagen.  It is also the ingredient used in the dermal filler known as Sculptra.

Sculptra is often used for large volume filling applications that result from aging or illness.  For example, this dermal filler is commonly used to treat the manifestation of sunken cheeks which occurs in HIV patients.

Sculptra is also used to lift deep creases, lines and folds, such as those which form around the mouth..

One of the main advantages  of Sculptra is that outcomes can last up to two years.

Since Poly-L-Lactic acid readily absorbs water, the final outcome of Sculptra procedures usually take time to become fully apparent.  Therefore, the enhanced volume achieved at the time of the treatment only reflects a fraction of the actual end results.

 

Which Dermal Filler Is Best?

 

A qualified doctor can certainly evaluate different types of dermal fillers and recommend the optimal one for your treatment areas. But it is best to do your own research to understand how different products work to solve specific issues.

 

The quality of your dermal filler results will depend on the skill and experience level of your provider. Due to the popularity of dermal fillers, they are now being offered by aestheticians and even as products that regular consumers can buy online for DIY treatments. But these practices are not advised.

 

Instead it is recommended to choose a medical specialist who is board certified in plastic surgery or dermatology, like Dr.U.  Dermal fillers are not to be considered in the same category as ordinary beauty services, like getting a facial or a manicure. The Australian Society of Plastic Surgeons insightfully comments, “with the increase in use has been associated downgrading of the risks that come with hyaluronic acid fillers.”

 

Injections must be administered by experts who understand intricate anatomical details such as the location of specific blood vessels, nerves and muscles. Accidental injections into the wrong area can lead to serious consequences.

 

Cosmetic fillers have been known to cause blindness, and at worst, facial deformities. While no one wants to consider the chances of permanent damage, when they are looking to improve their appearance, these risks do happen. However, as noted, they can be prevented by choosing a service provider with the right credentials, who has extensive experience performing successful procedures on actual patients.

 

If you are in the greater Los Angeles area and would like to speak to Dr.U about choosing from different types of dermal fillers for a particular concenr, sign up for a complimentary consultation through our online form.

 

Further Reading

Learn how Dr.U’s Radiesse procedure for the laugh lines helped this female patient look younger by 15 years

 

Discover how it is possible to apply Juvederm to avoid duck lips while producing extremely natural looking lip enhancement results.