What is the purpose of a dermal filler?

As you age, changes in hormones and the breakdown of collagen and elastin fibers cause your skin to thin and lose volume. Think of these changes as going from a piece of cardboard to tissue paper — the thinner, more delicate your skin is, the easier it is to wrinkle. Fillers work to re-inflate areas of thinning skin to make your skin appear smoother and more even in tone. While there are several options on the market, fillers are intended to make areas of skin appear more voluminous and therefore more youthful.

How does the procedure work?

Fillers require a physician’s consultation to determine your desired results. Because there are lots of filler varieties and options out there, your physician needs to know how much volume you are hoping to achieve and the locations you would like to see the most improvement. Your doctor will discuss with you how much and what type of filler he would recommend and likely provide you with a cost estimate. Once you’ve agreed upon everything, it’s time to start the procedure.

Your physician will start by marking areas of your face where the filler is to be injected. After swiping on an antibacterial agent, your physician may utilize a numbing injection. However, some fillers have painkilling medications already pre-mixed in them to minimize pain. Once the pain-killing medication has taken effect, your physician will inject small amounts of the filler to the marks. The entire process typically takes less than 30 minutes. Your physician may then recommend applying ice packs to minimize swelling. You may not notice results right away, but you should begin to notice smoother, less wrinkled skin in a few days, depending on the filler type used.

What are the different dermal filler types?

While there’s just one Botox treatment, there are several fillers. They vary in materials, consistency, cost and how long each lasts. The physician consultation can really be the starting point for determining the best filler choice for your face. Dermal filler options include:

• Collagen. 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. 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.

• Hyaluronic Acid. 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.

• Polymethylmethacrylate. Also known as PMMA, this filler type is considered semi-permanent because it can last for many years. 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.

How much do fillers cost?

The answer really depends on your physician and how much of the product you need. The average cost for a filler procedure in the United States is $800 per filler session, according to Forbes.com.

Do I have to be a certain age to get fillers?

Different physicians may have their own standards for the age they will treat patients with dermal fillers. These fillers have applications that go beyond wrinkles — they also can treat issues such as acne scarring or other scarring forms that leave a shallow scar.

“Patients can go throughout their twenties without seeing significant changes, and then almost overnight start to notice wrinkles,” says John T. Alexander II, MD, JD, FACS, a board-certified plastic surgeon at Alexander Cosmetic Surgery in San Diego, Calif. “If you start having minor procedures such as dermal fillers in your thirties and forties, you can keep your skin in good condition that can extend the time before you may need an invasive procedure.”