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The Difference Between Different Types of Facial Fillers

Which Filler Is Best For You?

By

Updated October 02, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

With all the dermal fillers on the market, it can be quite confusing as to which one should be used when. In the United States, the list of available fillers is long. They include:

  • Juvéderm Ultra
  • Juvéderm Ultra Plus
  • Perlane
  • Radiesse
  • Restylane
  • Sculptra

Before delving into a discussion about dermal fillers, it is important to make one point. Dermal fillers, such as those listed above, are often confused with wrinkle relaxers, such as Botox and Dysport. While dermal fillers and wrinkle relaxers are both considered “injectables,” they are in two entirely different categories. Botox and Dysport are used to paralyze muscles and stop the motion of muscles that cause wrinkles. They are not used to fill, plump, or enhance an area. They can however be used in conjunction with fillers.

Dermal fillers can be used to plump thinning lips, give the eyebrows a bit of a lift, enhance cheek bones, decrease hollowing under the eye to help reduce dark circles, decrease the appearance of smile lines and overall just give you a well-rested and rejuvenated appearance. They can be done in less than an hour and have little to no downtime. In some people, dermal fillers may cause some mild bruising, temporary swelling, or temporary redness at the injection site. Rarely, a person might experience an allergic reaction. The major disadvantage of dermal fillers is the effects are indeed temporary. There is one exception to that, though, which will be addressed. For the most part, however, the effects can last from a few months up to a year and a half.

This article will be a concise, yet comprehensive overview of the abovementioned fillers. The overview will include the ingredients, applications, duration of effect, pricing, antidotes/reversal agents, and special notes about each filler.

1. Juvéderm Ultra / Juvéderm Ultra XC

  • Main Ingredient: Hyaluronic Acid

  • Uses: Juvederm Ultra is good for fine lines and not so deep wrinkles of the face. It’s also good for adding volume to facial tissue. More so than its heavier/thicker counterpart, Juverderm Ultra Plus, Juvederm Ultra can be used closer to the surface of the skin. Additionally, since Juvederm Ultra is the lighter of the Juvederm versions, it is good for areas with thinner skin, such as the area under the eye. Injections in the eye area are considered “off-label.” This means the use of Juvederm Ultra in this area specifically is not FDA approved.

  • How It Works: When injected, the hyaluronic acid acts like a sponge. It absorbs water and as a result plumps up the area in which it was injected.

  • Duration: Juvederm Ultra is reported to last from six to nine months. Less material is usually needed for touch ups.

  • Price: One syringe of Juvederm Ultra will run you about $450-$600.

  • Antidote/Reversal Agent: The volumetric effects of Juvederm Ultra can be reversed with hyaluronidase.
  • Special Notes: The XC version of Juvederm includes the addition of lidocaine. Lidocaine is an anesthetic that helps reduce pain with injection.

2. Juvéderm Ultra Plus / Juvéderm Ultra Plus XC

  • Main Ingredient: Hyaluronic Acid

  • Uses: Good for medium or deeper lines and wrinkles of the faces, such as the nasolabial folds. It It is also useful for plumping up lips, earlobes, and cheekbones, filling acne scars. This version of Juvederm is heavier than its counterpart Juvéderm Ultra. Hence, it is generally reserved for deeper wrinkles and lines and plumping up flattened areas.

  • How It Works: The hyalruronic acid absorbs water and augments the injected area.

  • Duration: The effects of Juvéderm Ultra Plus last about one year.

  • Price: One syringe of Juvéderm Ultra Plus is priced around $500-$600.

  • Antidote/Reversal Agent: Hyaluronidase can be used to reverse the effects of Juvéderm Ultra.

  • Special Notes: The XC version of Juvéderm Ultra Plus includes the addition of lidocaine. Lidocaine, an anesthetic, reduces the pain associated with injection.

3. Perlane / Perlane-L

  • Main Ingredient: Hyaluronic Acid

  • Uses: Perlane is used to add volume to flattened areas, to plump up lips, and to help reduce the appearance of fine lines and deep folds. It is manufactured by the same company that makes Restylane. Perlane is thicker than Restylane, thus it is better for deeper or more prominent folds.

  • How It Works: Water is absorbed by the injected hyaluronic acid. This has the effect of building up the area of injection.

  • Duration: Some people find Perlane to be longer lasting than Restylane. However, the FDA commentary is that it lasts up to six months.

  • Price: One syringe of Perlane runs about $400-$600.

  • Antidote/Reversal Agent: Hyaluronidase is the antidote to Perlane.

4. Radiesse

  • Main Ingredient: Radiesse is made up of calcium hydroxylapatite in the form of microspheres.

  • Uses: Radiesse is used for the treatment of maoderate to severe facial wrinkles and folds, such as the nasolabial folds. It can also be used to plump up cheek bones. It is not used in the lips.

  • How It Works: Radiesse stimulates the body to form new collagen. This is supposed to make the produce last longer, thus reducing the need for a touch up. Additionally the gel and calcium-based microspheres add volume to the injected area.

  • Duration: Results are clinically proven to last a year or more.

  • Price: Radiesse normally costs approximately $1,000 per syringe.

  • Antidote/Reversal Agent: There is no antidote for Radiesse.

5. Restylane / Restylane-L

  • Main Ingredient: Hyaluronic Acid

  • Uses: Restylane is used to improve moderate to severe facial folds and wrinkles. It can also be used to enhance the lips.

  • How It Works: The area of injection is enhanced due to absorption of water by the hyaluronic acid.
  • Duration: Restylane’s manufacturer claims results can last to up to 18 months. That is however, with repeat injections at 4.5 months or 9 months. Without repeat injections, Restylane may last up to 6 months.

  • Price: Restylane is priced similarly to the Juvederm products.

  • Antidote/Reversal Agent: Hyaluronidase is the antidote to Restylane.

  • Special Notes: Restylane and Perlane are made by the same manufacturer. Perlane is the thicker/more viscous of the two products and is used for more heavy duty rejuvenation.

6. Sculptra

  • Main Ingredient: Poly-L-Lactic Acid
  • Uses: Sculptra was initially limited to use in patients with HIV who had loss of facial fat caused by antiviral medications. Now it is approved for cosmetic use in non-HIV infected individuals for building up the cheeks, filling in hollows or sunken areas of the face, and increasing skin thickness which decreases the appearance of folds and lines. It is not used to enhance the lips.

  • How It Works: Unlike the hyaluronic acid based fillers, Sculptra’s mechanism of action encourages the formation of new collagen in the injected area and the effects are not immediate. Multiple treatments are required, approximately 4 weeks apart. The number of treatments needed depends on the severity of the facial aging. The skin thickness increases gradually.

  • Duration: In a clinical study, the effects of Sculptra lasted up to 2 years after the first treatment session. A full treatment consists of an average of three injections approximately 4-6 weeks aparts.
  • Price: Sculptra comes in a vial as opposed to a syringe. One vial will cost anywhere from $750-$1000.

  • Antidote/Reversal Agent: There is no reversal agent for Sculptra.

  • Special Notes: The results from Sculptra are not immediate and are more subtle. It can take months to notice improvement, but it is long lasting.

7. Summary

In summary, Juvéderm, Perlane, Restylane, and Radiesse offer immediate results. Juvéderm, Perlane and Restylane have an antidote in case you don’t like the effects, whereas Radiesse and Sculptra do not. However, Radiesse and Sculptra are longer lasting than Juvéderm, Restylane, and Perlane. Radiesse and Sculptra also have the advantage of encouraging the formation of collagen, the scaffolding that gives skin a youthful appearance. Juvéderm, Perlane, and Resytlane are less expensive than Radiesse and Sculptra treatments.

Finding the right dermal filler for you will depend on your budget, your doctor’s experience and preference, and your individual skin nuances (e.g. amount of sun damage, skin elasticity) and facial features. What works for your friend may not be the best option for you. It is best to select dermal filler type on a case-by-case basis.

Sources:

About The Restylane Family of Products. Accessed September 29, 2012.

What Is Juvederm XC?. Accessed September 29, 2012.

Radiesse: Volumizing Filler. Accessed September 29, 2012.

Sculptra Aesthetic: Anti-Age For the Modern Age. Accessed September 29, 2012.

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