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Choosing the Right Facial Filler: Understanding Different Types and Their Uses

There’s no denying it, facial fillers are hot right now. The American Society of Plastic Surgeons (ASPS) reports that over 5 million people in the U.S. got a facial (dermal) filler in 2022, which is a 70% increase from 2019! They are an amazing, minimally-invasive treatment to minimize the appearance of wrinkles and fine lines on the face, plump up areas of lost volume, and enhance facial contouring in a natural-looking way. Some facial fillers even go the extra mile and stimulate collagen production and restructuring for weeks or months after the injection treatment. In this post, we’re doing a deep dive of the different types of facial fillers, their best uses, and how you can try these revolutionary, minimally-invasive treatments in Portland, Maine.

Types of Facial Fillers

Hyaluronic Acid (HA)

Hyaluronic acid (HA) fillers are by far the most popular, accounting for over 4.8 million of the dermal fillers administered in that 2022 report. Since HA is a naturally occurring sugar already produced by the human body, HA fillers are typically very well-tolerated and have a very low chance of rejection. HA fillers use water to swell up the skin cells, giving a smooth, full appearance. HA fillers dissolve over time as they are absorbed by the body, so injections will need to be repeated every 6-12 months, depending on the client’s metabolism and appearance goals. The Food & Drug Administration (FDA) has approved many HA fillers under different brand names, including JUVÉDERM®, Revanesse®, Belotero, RHA® Collection, and more. While the approvals for each brand may differ slightly, HA fillers are typically FDA-approved to treat moderate to severe facial wrinkles and folds, including both static and dynamic facial lines. Some HA fillers are approved for hand augmentation as well. The thickness of the HA filler, measured as its G prime rating, determines the best use and placement of the filler. A higher G prime rating indicates a stiffer, thicker filler. Because HA fillers are available in a range of G prime ratings, HA fillers are probably the most versatile fillers on the market.

Derma PRP filler

Platelet rich plasma (PRP) is fast becoming one of the most useful natural treatments for rejuvenation throughout the body.  Most recently, PRP’s benefits in aesthetic medicine have been discovered and the long list of its benefits continues to grow.

Cosmetic fillers are a popular way to rejuvenate the face, lessen the appearance of fine lines and wrinkles and improve scars.  While there are several great filler products on the market, PRP offers a truly organic alternative with faster results.  Since the patient’s own blood is used to rejuvenate their appearance, using PRP also alleviates the risk of allergic reaction or skin sensitivity.

The procedure helps restore or enhance areas which require volume. PRP can be used for the following:

  • Diminishing the glabellar lines, also known as the number 11 sign between the brow
  • Diminishing forehead lines
  • Improving the appearance of periorbital lines, also known as crow’s feet
  • Diminishing nasolabial folds
  • Reducing smile lines
  • Treating acne scars
  • Improving the vertical lip lines, also known as lipstick lines
  • Improving the marionette lines (the ones from the corners of the  mouth to the chin)

PRP contains growth factors which stimulate the body to repair and restore tissues using the body’s own natural processes. With this technique, you can rejuvenate the skin by isolating elements from the blood which can then be injected below wrinkles, folds and even acne scars.

The benefits of PRP as a cosmetic filler is the ability to help your skin heal faster, no allergic reaction and faster skin rejuvenation for a longer period of time.

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Calcium Hydroxylapatite (CaHA)

Calcium Hydroxylapatite (CaHA) fillers are made of calcium minerals suspended in a gel-like substrate, which is then injected into facial wrinkles. CaHA fillers take longer to break down than HA fillers, so repeat injections are only needed every 18 months or so. Since CaHA is also a naturally occurring substance found in the human body, rejection risk is also very low. The only FDA-approved CaHA filler currently on the market is Radiesse®. In addition to filling facial wrinkles, CaHA fillers are also approved for hand augmentation.

Poly-L-lactic Acid (PLLA)

Poly-L-lactic acid (PLLA) is a synthetic, biodegradable polymer substance used in many medical applications, including dermal fillers. PLLA fillers are injected as a series, with desired results building up over several months. Once the series of injections is finished, the results can last for up to two years. The only FDA-approved PLLA fillers are made by Sculptra®, which are approved for “correction of shallow to deep nasolabial fold contour deficiencies and other facial wrinkles” (FDA). Sculptra® fillers are sometimes used off-label for other areas of the body as well.

Polymethylmethacrylate (PMMA)

Polymethylmethacrylate (PMMA) fillers are different from HA, CaHA, or PLLA fillers because they are NOT biodegradable and are NOT absorbed by the body over time, making them a more permanent filler solution. PMMA filler is made of tiny, round, smooth “beads” suspended in a gel-like substance which is injected into the treatment area. Once the client’s desired look is achieved, there is no need to repeat the PMMA filler treatment. The only FDA-approved brand of PMMA filler is Bellafill®, which is approved to correct “nasolabial folds and moderate to severe, atrophic, distensible facial acne scars on the cheek in patients over the age of 21 years” (FDA).

Autologous Fat Grafting

Autologous fat grafting is the oddball in the facial filler world. This procedure involves harvesting available fat from another area of the patient’s body (a bit of liposuction, if you will), processing that harvested fat using special techniques, then reinjecting the processed fat into the areas of the face where the client wants to see improvement. This gives the client a semi-permanent solution to wrinkles and volume loss, as only about 40% of the injected fat will be absorbed by the body over time. To reduce this reabsorption, autologous fat grafting is often combined with a neuromuscular blocker and/or platelet-rich plasma (PRP) treatments for optimal results. Since autologous fat grafting is more invasive than the other facial filler methods, it requires more aftercare and recovery time. The process is FDA-approved for facial use.

Which Facial Filler is Right for You?

With so many different facial filler options available and approved by the FDA, there’s a filler out there for almost everyone! Consult with a trained and experienced injector to find the facial filler, or combination of fillers, that is best for your skin’s needs and your desired results.

Find the full list of FDA-approved dermal fillers for the face by searching for “LMH” at https://www.accessdata.fda.gov/scripts/cdrh/devicesatfda/index.cfm

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esthetic medspa Portland offers a variety of non-surgical cosmetic treatments for the face and body. Our commitment to timeless, natural beauty and focus on thoughtful, personalized client care sets us apart as Portland, Maine’s premier luxury medspa.