Botox isn’t the only injectable on the market that’s meant to rejuvenate your face. Dermal fillers refer to a variety of products your physician can use to puff up areas of skin, such as those “parentheses” around your mouth that can affect your appearance. Here’s how dermal fillers can help turn back the clock.

Dermal Filler Significance

Dermal fillers are a blanket term for a number of different products intended to add bulk or volume to areas that appear wrinkled or hollow, such as around the cheekbones. Fillers are recommended for application in certain areas of your face where volume is beneficial. This includes your lips, nasolabial folds or smile lines and "marionette” lines or the lines near your lips that seem to turn down. Fillers range in types from temporary to semi-permanent and tend to be priced based on how long the filler lasts.

“Fillers and Botox have been the top procedures for many years,” says John T. Alexander II, MD, JD, FACS, a board-certified plastic surgeon at Alexander Cosmetic Surgery in San Diego, Calif. “The procedures have essentially no down time and are less invasive.”

What Dermal Fillers Treat

Fillers aren’t to be confused with Botox, another injectable material that treats certain wrinkle types.

“While they’re both injectables, Botox and fillers don’t have the same effect on your face,” says Dominic Brandy, MD, cosmetic surgeon and Founding Medical Director of The Skin Center Medical Spa in Pittsburgh, Penn. “Botox is going to relax a muscle that is contracted, while fillers will add volume to areas where you may have lost it, such as the cheek.”

Types of Dermal Fillers

Several different dermal filler types and brand names exist under the “filler” umbrella. Each one can vary in thickness, how long it lasts and what it’s made of. Some types of dermal fillers include:

  • Collagen. Collagen is one of two fibers in your body that keep your skin looking tight and wrinkle-free. As you age, your collagen fibers start to break down, which can cause you to appear older. Collagen can be taken from human skin or from cows and injected into your skin. Examples of brand-name collagen products include CosmoDerm, Cosmoplast, Zyderm and Zyplast.
  • Calcium Hydroxylapatite. This dermal filler is considered the heaviest or most substantial, which is why your physician may use this substance only for deep folds or creases, such as frown lines, sunken cheeks and nasolabial folds. The compounds are made from microspheres made with calcium and suspended in water. Examples of brand-name calcium hydroxylapatite fillers include Radiesse and Radiance.
  • Human Fat. Your physician can harvest fat from your body and inject it into areas where you may have lost facial volume, especially under your cheekbones. Because you are using fat from your own body, the risk for an adverse reaction is minimized.
  • Hyaluronic Acid. Don’t let the name “acid” fool you — this acid is found naturally in your body, which can minimize the effect for allergic reactions. This is a naturally occurring acid type in your body and can give you a softened, natural appearance when injected. Examples of hyaluronic acid injections include Captique, Esthélis, Elevess, Hylaform, Juvéderm, Perlane, Prevelle, Puragen and Restlyane.
  • Polylactic Acid. This filler doesn’t create immediate results, but don’t write it off just yet. Polylactic acid encourages your body’s own collagen production when injected, which means your results will gradually appear over time. This is typically injected into the lower portions of your face, such as thin lips or nasolabial folds.
  • Polymethylmethacrylate. Also known as PMMA, this filler type is considered semi-permanent because it can last for many years. The dermal filler is a suspension that is 20 percent PMMA microspheres combined with 80 percent collagen gel. This dermal filler type can be used for wrinkles, nasolabial folds, pitted acne scars and thin lips. Examples of brand names include Articol, Artefill and Metacrill.

“The first thing I do when determining the best filler is to sit with a patient and have them look in the mirror, and I ask them what they’re trying to accomplish,” says Fernando Colon, MD, board-certified plastic surgeon and Medical Director of The Skin Center Medical Spa located in Gahana, Ohio. “It comes down to the patient and physician to determine what’s best and why a doctor would recommend a certain filler over another, especially the first time you are having this procedure type performed.”