Part One: Introduction to Dermal Fillers
Dermal fillers are minimally invasive injectable treatments that aim to correct a wide array of cosmetic concerns like fine lines, wrinkles, skin sagging and volume loss. They are called “fillers” because they use formulated compounds to replace what the body has naturally lost. While they primarily target the face, they can also be used in the neck and body.
Since the year 2000, there has been a 174% increase in the number of minimally invasive cosmetic procedures performed.[1] Considering how ingrained dermal fillers have become in our culture, it should come as no surprise that they have consistently been one of the most popular nonsurgical options.
But it is easy to lose perspective on just how popular they are. Throughout 2019, 3,816,274 soft tissue fillers were administered. Despite the COVID-19 restrictions and the adverse effects of a worldwide pandemic, fillers only saw an 11% decrease in popularity throughout 2020.[1]
In fact, if you took every surgical procedure performed in 2020, you would still be more than a million procedures short of coming close to the number of dermal fillers performed.
Why Are Fillers So Popular?
So what is it about dermal fillers that consistently propels them to the top of the popularity list every year? There is more than one answer to that question, but the three most significant reasons are pretty simple: they are effective, easy and affordable.
They Provide Results
In 2020, a study was performed on 24 patients seeking dermal fillers in the tear troughs, a common area of concern. After the treatment, 100% of those patients noted an overall improvement in their appearance. 75% of the patients also said they were satisfied with the results, while the other 25% said they would be satisfied after additional filler was administered.[2]
Patient satisfaction regarding these treatments is well documented. A study in 2010 conducted a 10-year retrospective survey to assess patient satisfaction levels following dermal filler treatment. There were 102 surveys returned, of which 89% of participants said they would recommend dermal fillers to a friend, and 75% continued dermal filler treatment.[3]
They Are Easy
Dermal fillers work, and patients continue to love the results they provide. But the other big selling point to dermal fillers is that they are minimally invasive, which means you don’t need to worry about extensive preparations, recovery or downtime.
Virtually every dermal filler can be performed in a medical office in under an hour. Considering that 52% of Americans are usually trying to juggle at least two tasks at once, the small amount of time it takes to have a procedure performed is an important piece of the puzzle.[4]
You won’t need to take time off work, be on bed rest for any amount of time or even miss your workout sessions. Your life will continue as usual as soon as you walk out of the office.
They Are Affordable
The average cost of a standard dermal filler is between $600 and $900. When you compare that price to a surgical procedure like a facelift — around $7,467 — you can see why many patients choose to go the nonsurgical route, especially if their conditions are not severe.
Why Do We Need Fillers?
As we go through the aging process, we all know that our bodies experience many different kinds of changes. We can feel it in our bones and faces as we begin to move away from the carefree years of our youth. What is happening in our bodies that is causing these changes to happen seemingly overnight?
We Produce Less Collagen
Collagen is the most abundant protein in our bodies, comprising roughly 70% of our dry skin mass.[3] It is also the substance primarily responsible for keeping our skin taut and youthful. Unfortunately, after the age of 20, it is expected that an average person will lose about 1% of their total collagen production every year.[5] This loss of collagen contributes to the development of fine lines, wrinkles, volume loss and skin sagging.
We Are Hit By Environmental Factors
One of the most harmful substances to the health of our skin is UV light. This poses a big hurdle for us since UV light includes sunlight. Even if you are adamant about wearing sunscreen, it is impossible for you to completely avoid UV damage.
Unfortunately, this does mean that anyone who lives an outdoor and active lifestyle is likely going to have problems with their skin sooner than those who do not spend as much time under the sun.
But UV exposure isn’t the only factor.
You have probably heard the term free radical floating around online or in conversation from time to time, especially when it comes to skin health. Free radicals are essentially molecules in the air that damage the skin and contribute to aging factors like fine lines, wrinkles and hair loss.
There is no way to escape free radicals, but our bodies are naturally able to fight off their effects. We do a better job at fending them off when we are younger, but as our bodies age, we lose our edge in the fight and begin to experience their harmful effects.[6] Certain lifestyle factors like air pollution, fried foods, smoking and alcohol consumption can contribute to the effect of free radicals.
Part Two: Types of Dermal Fillers
Calcium Hydroxylapatite
Brands: Radiesse
This is a biosynthetically produced material, meaning no animal products are used to make it. This means the likelihood of having an allergic reaction goes down significantly. In addition, the results are considered to be highly natural by the greater medical community. The solution does not migrate and rarely causes patients any side effects.
Hyaluronic Acid
Brands: Juvederm, Perlane, Restylane
As one of the more popular forms of dermal filler, hyaluronic acid is exceptionally effective at restoring volume because it is one of the components that is found naturally in your body. Hyaluronic acid was used to treat arthritis pain for a long time before being repurposed as a dermal filler. It has a host of other applications and is sold in various forms, including topical treatments and ingestible supplements.
Polylactic Acid
Brands: Sculptra
Polylactic acid works a little differently than other dermal fillers. While most injections focus on replacing what your body has lost, polylactic acid encourages your body to produce its own proteins to restore your natural facial volume. This method can provide reliable results with the added benefit of lasting much longer than most standard fillers.
Autologous Fat Injections
One of the procedures that has gained popularity in recent years is the autologous fat injection, also known as fat transfer. This is the only injectable treatment that does require invasive surgery in the form of liposuction. Still, many patients choose to go through the extra trouble because of how powerful the results are. By taking fat away from one part of your body, it can be purified and injected into the desired areas, effectively tackling two aesthetic concerns at once.
Part Three: Areas of Treatment
Dermal fillers are incredibly versatile procedures. While they specialize in filling facial volume and erasing fine lines and wrinkles, they can also provide unique benefits like liquid rhinoplasties, lip augmentation and acne scar treatment.
Acne Scars
Roughly 80% of people between the ages of 11 and 30 have some form of acne.[7] Unfortunately, even minor cases can cause long-term scarring on the face from popping, scratching and digging at the skin. Even if you leave the acne alone, it is still possible for scars to form from the module. One of the unique benefits of dermal fillers is their ability to smooth out the textural differences on the skin caused by noticeable acne scarring.
Treatments: Belotero Balance, Juvederm Voluma, Perlane, Radiesse, Restylane REFYNE, Sculptra
Bunny Lines
Bunny lines are the wrinkles that form at the top of your nose when you scrunch your face inward. They earned this name because they resemble a rabbit’s nose when it is sniffing. While this condition is often treated by a neuromodulator like Botox or Dysport, some dermal fillers can be used in conjunction or exclusively to provide similar results.
Treatments: Juvederm XC, Juvederm Voluma XC, Perlane, Sculptra
Cheek Contouring
As our bodies go through that natural aging process, it is normal for our cheeks to lose volume. The entire face is actually losing volume, but since the cheeks are naturally such plump areas, it is a much more noticeable feature of getting older. Luckily, dermal fillers can fill spaces in the cheek to create a healthy, youthful appearance. These can even be used for people who do not have signs of aging but would still like to improve their faces’ natural shape.
Treatments: Belotero Volume, Juvederm Voluma XC, Perlane, Restylane Contour, Sculptra
Chin Augmentation
Many men and women are unhappy with the natural projection or shape of their chins. While options are available, they are costly, time-consuming and require an extensive recovery period. For many patients, injectable fillers may be a better option for improving on a weak or under-projected chin.
Treatments: Restylane DEFYNE, Restylane Contour, Sculptra
Crow’s Feet
Crow’s feet are one of the most iconic forms of facial wrinkling. They are the small wrinkles and lines that appear outside your eyes and are usually some of the first aging signs to develop since your eyes play such an impactful role in everyday emoting and gesturing. Botox is often the go-to procedure for crow’s feet, but dermal fillers can also improve some cases.
Treatments: Belotero Soft, Juvederm Ultra, Juvederm Voluma, Radiesse, Restylane, Sculptra
Forehead Lines
These are the horizontal lines that run across your forehead. There are two primary causes of this condition: breakdown of skin integrity and facial movement. In many cases where signs of aging are minimal, these lines can be addressed by stopping muscle movement with Botox. If the underlying cause is the natural breakdown of tissue, they are best treated with a dermal filler. Your medical professional will be able to help you determine which is more suitable.
Treatments: Belotero Soft, Radiesse, Sculptra
Frown Lines
These are the wrinkles and folds that develop between your eyebrows. They are the most noticeable when someone is furrowing their eyebrows or making an unhappy face, but many people with minor signs of aging still have apparent frown lines. This condition is another case where either Botox or dermal fillers can be appropriate depending on the cause of your condition.
Treatments: Belotero Balance, Juvederm XC, Juvederm Ultra, Juvederm Voluma, Radiesse, Sculptra
Jawline Enhancement
As facial sagging begins to develop, gravity naturally pulls all of the skin downward. This leads to a damaged jawline contour that looks less sharp and defined. There are surgeries designed to correct this issue when the condition is severe, but for most people with mild or moderate symptoms, surgery can be too drastic. For those people, dermal fillers are a great way to redefine a clean jawline.
Treatments: Belotero Volume, Juvederm Voluma, Perlane, Radiesse, Restylane LYFT, Sculptra
Lip Augmentation
Lip fillers exploded in popularity a few years ago as celebrities like Kylie Jenner began showing off perfect, pouty lips. The trend may not receive the same amount of buzz that it did in past years, but the desire to increase the size and shape of our lips is far from over. For patients who are concerned the trend might be fleeting, fillers offer a temporary way to enjoy fuller lips without investing in lip implants in the long term.
Treatments: Juvederm XC, Juvederm Volbella, Restylane, Restylane Silk, Restylane-L, Restylane Kysse
Lip Lines
These vertical lines located above and below the lips are commonly referred to as smoker’s lines since they form whenever you purse your mouth. They are usually extremely thin, which means they are easily addressed by a wide variety of dermal fillers on the market. Despite being very fine, they are very recognizable and can have a big impact on your appearance.
Treatments: Belotero Balance, Belotero Soft, Juvederm XC, Juvederm Ultra, Juvederm Volbella, Perlane, Radiesse, Restylane SILK, Restylane-L, Restylane Kysse, Sculptra
Liquid Rhinoplasty
Rhinoplasty is traditionally one of the most popular and effective plastic surgeries performed. In fact, instructions on how to perform the earliest rhinoplasty techniques go back as far as 600 B.C. to one of the earliest surgeons in recorded history, Sushruta.[8] But surgery, even one as old as this, is not something that should be taken lightly, which is why many people prefer the nonsurgical liquid rhinoplasty that is performed with dermal fillers. By adding additional volume into specific areas, an entirely new nasal appearance can be created.
Treatments: Juvederm Voluma, Perlane, Radiesse, Restylane LYFT
Marionette Lines
Named after the infamous talking dolls, these wrinkles form below the lips on either side of the chin. Because they form in an open area of the face, marionette lines are very prominent and can have a significant effect on how aged your appearance is. Luckily, many dermal fillers excel at smoothing this area of your face.
Treatments: Belotero Intense, Juvederm Ultra, Radiesse, Restylane, Restylane DEFYNE, Restylane REFYNE, Sculptra
Mental Crease
Right beneath the lips and above the chin, there is a slight crease that naturally occurs. If you prefer to have a smoother chin area to achieve a sleeker facial appearance, there are many different options available to you on the market.
Treatments: Belotero Balance, Belotero Volume, Juvederm XC, Radiesse, Sculptra
Nasolabial Folds
Nasolabial folds, also known as laugh or smile lines, are the creases above the mouth and near the sides of the nose. Most people have some degree of nasolabial folds, but they can become much more prominent and add years to our appearance as we age. As one of the most common areas of treatment for dermal fillers, this is perhaps the condition that has the most versatility in filler options.
Treatments: Belotero Balance, Belotero Intense, Juvederm XC, Juvederm Ultra, Juvederm Voluma, Juvederm Volbella, Juvederm Vollure, Radiesse, Restylane, Restylane DEFYNE, Restylane REFYNE
Neck Folds
Skin sagging and wrinkling don’t always stop at the jawline. For many people, the signs of aging extend past the face and into the neck as well. One of the most important parts of having cosmetic procedures performed is remembering that the key to success is maintaining harmony and balance. If you have many procedures performed on the face but do nothing to address a wrinkled neck, then the results may feel off or underwhelming because of the contrast.
Treatments: Belotero Balance, Juvederm Volbella, Restylane REFYNE, Restylane SILK
Sunken Hands
If our face is the most common area for volume loss to occur, our hands are a close second. You probably have a picture in your head of what elderly hands can look like. They are often thin and wrinkled with very little mass. If you are experiencing similar symptoms, you can have your hands look healthy and plump again with dermal fillers.
Treatments: Radiesse, Restylane LYFT
Sunken Temples
If the area on the side of your eyes appears hollow, it could cause you to look much older than you feel. By filling that area with a dermal filler, you can restore a youthful appearance and healthy contour.
Treatments: Belotero Volume, Sculptra
Tear Troughs
The skin beneath our eyes is thinner than usual, which means it is very susceptible to giving the way we feel away. Big bags are a telltale sign that you are tired, and permanent creases are an even more obvious sign of facial aging. But adding in a bit of volume to those areas can help you look alert and signal to the world that you are slowing down yet.
Treatments: Belotero Balance, Juvederm XC, Juvederm Ultra, Radiesse, Restylane, Sculptra
Part Four: Results
In the vast majority of cases, you will be able to notice dermal filler results immediately after the procedure. It may take some time for them to settle, but for the most part, you will have a clear idea of what kind of changes your appearance will have the second the procedure is finished. You may be given particular instructions to follow to preserve your results, but they are generally pretty minor and do not get in the way of your lifestyle or routines.
How Long Does Each Filler Last?
The biggest question patients have regarding dermal fillers is “how long do they last?” It is an understandable concern since fillers are not permanent, and you should know what kind of maintenance to expect if you want to keep your results optimal.
To help solve that worry, here is a list of how long you can expect each of these major dermal fillers to last:
| Belotero Balance | 6 months |
| Belotero Soft | 12 months |
| Belotero Intense | 12 months |
| Belotero Volume | 18 months |
| Juvederm XC | 12 months |
| Juvederm Ultra XC | 12 months |
| Juvederm Ultra 2, 3, and 4 | 12 – 18 months |
| Juvederm Voluma XC | 2 years |
| Juvederm Volbella XC | 12 months |
| Juvederm Vollure XC | 12 months |
| Perlane | 6 months |
| Radiesse | 15 months |
| Restylane | 12 months |
| Restylane DEFYNE | 12 months |
| Restylane REFYNE | 12 months |
| Restylane SILK | 6 – 10 months |
| Restylane LYFT | 12 months |
| Restylane-L | 5 – 7 months |
| Restylane Kysse | 11 months |
| Restylane Contour | Under review |
| Sculptra | 2 years |
Part Five: Cost
Because there are so many different fillers on the market performed by various practitioners at different experience levels, it would be impossible to give a perfectly accurate estimate. Based on general trends and nationwide average, we can give you an estimated price of between $600 to $900 per syringe.
Keep in mind that this is only an estimate, and there is a large spectrum of costs that must be factored into your total price, such as:
- Your conditions
- Level of correction needed
- Experience of your medical professional
- Physical location
- Which filler you are using
Dermacare Laser and Skin Clinics
Dermacare is a worldwide industry leader in laser and cosmetic skin treatment. We are located in the San Diego and Carlsbad areas and led by Dr. Birchall, one of the top providers of dermal fillers and neurotoxin injectables.
Our office achieved Black Diamond provider status for Botox Cosmetic and Juvederm injections and was recognized as one of the Top 100 out of more than 30,000 providers in the country. Our entire staff is committed to providing you with the best possible experience and results possible during your aesthetic journey.
If you are interested in saving a bit of money on a dermal filler (or any cosmetic treatment), you can subscribe to our newsletter, where you will find monthly discounts, specials, tips, events and even prizes. It is the best way to make sure you are on top of all the opportunities we offer at Dermacare.
If you aren’t a member of Allé, a rewards program and resource for cosmetic treatments, we highly recommend joining. We are partnered with the program to bring our clients even more savings as they look to have injectable fillers and other procedures performed.
Works Cited
- Plastic Surgery Statistics. American Society of Plastic Surgeons, www.plasticsurgery.org/news/plastic-surgery-statistics.
- Diwan, Zoya et al. “A Prospective Study on Safety, Complications and Satisfaction Analysis for Tear Trough Rejuvenation Using Hyaluronic Acid Dermal Fillers.” Plastic and reconstructive surgery. Global open vol. 8,4 e2753. 29 Apr. 2020, doi:10.1097/GOX.0000000000002753
- Bharti, Gaurav & David, Lisa. (2010). Patient satisfaction with dermal fillers and effect on utilization of invasive aesthetic treatment modalities at a university-based cosmetic center. European Journal of Plastic Surgery. 34. 155-160. 10.1007/s00238-010-0494-5.
- Horrigan, John B. “Americans Fall along a Spectrum When It Comes to Information Engagement.” Pew Research Center: Internet, Science & Tech, Pew Research Center, 31 Dec. 2019, www.pewresearch.org/internet/2017/09/11/americans-fall-along-a-spectrum-when-it-comes-to-information-engagement/.
- “Why Does Skin Wrinkle with Age? What Is the Best Way to Slow or Prevent This Process?” Scientific American, Scientific American, 26 Sept. 2005, www.scientificamerican.com/article/why-does-skin-wrinkle-wit/.
- Villines, Zawn. “Free Radicals: How Do They Affect the Body?” Medical News Today, MediLexicon International, 29 July 2017, www.medicalnewstoday.com/articles/318652#What-causes-free-radicals-to-develop.
- “Acne Scars: Causes, Diagnosis, Types & Treatment.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/21222-acne-scars#:~:text=Acne%20scars%20on%20the%20face,procedures%20performed%20by%20a%20dermatologist.
- Saraf, Sanjay. “Sushruta: Rhinoplasty in 600 B.C.” The Internet Journal of Plastic Surgery, Internet Scientific Publications, 31 Dec. 2006, ispub.com/IJPS/3/2/7839.