Hyaluronic Filler Comparisons
Hyaluronic acid (HA) is a naturally-occurring sugar molecule found primarily in the dermis, connective tissues, and the eyes. Injectable HA fillers are utilized to restore the volume and elasticity of a youthful appearance and lessen the appearance of wrinkles as we age. Since HA is naturally occurring, it is typically broken down and reabsorbed by the body in 4-12 months, though there are multiple reports of HA fillers lasting longer. HA fillers have become increasingly popular since their initial FDA approval in 2003. There are currently seventeen fillers approved for use in the United States from five different companies:
Allergan: Juvederm Ultra, Juvederm Ultra Plus, Voluma, Volbella, Vollure
Galderma: Restylane Silk, Restylane-L, Restylane Lyft, Restylane Contour, Restylane Refyne, Restylane Defyne, and Restylane Kysse
Merz Aesthetics: Boletero Balance
Prollenium Medical Technologies: Revanesse Versa
Teoxane: RHA 2, RHA 3 and RHA 4
Each of the seventeen HA fillers have their own viscosity and strength attributes to address specific aging deficiencies. For example, due to its soft volume and flexibility, Restylane Kysse trials focused on lip augmentation, ultimately receiving FDA approval for that treatment area. Whereas Restylane Lyft is much firmer and often used to support the cheek and help restore the frame of the face. Based upon information from the Medical Cosmetic Board, these are the HA fillers most suitable for each facial-injectable area:
Under eye/tear trough: Juvederm or Restylane-L
Lips: Restylane Kysse, Juvederm Ultra, Volbella, Restylane Silk, or Restylane Refyne
Cheeks: Voluma, Restylane Contour Restylane Lyft
Nasolabial Folds: Juvederm, Restylane, or Vollure
Chin: Restylane Defyne or Juvederm
As HA fillers near their 20-year anniversary, we are fortunate to have an array of options to suit each patient’s unique needs, ultimately achieving a balanced and natural result more likely.
References:
Gold MH. Use of hyaluronic acid fillers for the treatment of the aging face. Clin Interv Aging. 2007;2(3):369-76. doi: 10.2147/cia.s1244. PMID: 18044187; PMCID: PMC2685277.
Kontis TC, Rivkin A. The history of injectable facial fillers. Facial Plast Surg. 2009 May;25(2):67-72. doi: 10.1055/s-0029-1220645. Epub 2009 May 4. PMID: 19415573.
Daoud, Alexander, and Robert Weiss. ‘Hyaluronic Acid Fillers: Where We Have Been and Where We Are Going’. Biochemistry, IntechOpen, Oct. 2021. Crossref, doi:10.5772/intechopen.97264.
Jenny Laminack, MPA, PA-C resides in Alpharetta, GA where she practices medical and cosmetic dermatology at Atlanta Center for Dermatologic Diseases.