Facial fillers are injectable products that are designed to either smooth wrinkles or improve facial contours. Depending on the particular product, it can be injected at various levels, from the mid-dermis (within the skin) to just above facial bones. Their ability to smooth skin or improve facial contours and the longevity of their results depends on each product and its formulation.
There are a number of products that are FDA approved fillers for the face. This list includes:
- Hyaluronic acid gels
- Hydroxyapatite crystals
- Lactic acid crystals
- Methylmethacrylate beads
Hyaluronic acid is a naturally occurring substance found in our own skin and tissues. In its natural state, it is made of very long chains of sugar molecules that attract water molecules and provide support to the cells in the body. In the purification and processing of this material, these long chains are chemically bonded, called cross-linking. This gives it even more stable physical characteristics, and slows the resorption of the product once it’s been injected into the skin and subcutaneous tissue. Products that are more cross linked are thicker and more viscous gels with stiffer physical characteristics, and are therefore better at filling large facial contours by virtue of their structural support. They are more durable and less apt to be broken down or resorbed. Less cross linked products are less viscous and can permeate the more shallow part of the dermis, making it better suited for shallow injections to treat fine lines.
Restylane Fine Lines and Juvederm Ultra are the most popular products available in the United States for treatment of fine lines that occur around the mouth, chin, jaw line, between the eyes, and forehead. They are approximately equivalent in concentration of hyaluronic acid and percentage of cross-linked HA, and they perform and last in a similar fashion. They can be easily molded after injection and are the best product for the tear trough grooves between the lower lid and the nose.