Filler Frenzy: Understanding Your Choices of Hyaluronic Acid-based Soft Tissue Fillers

Medically Reviewed by: Hema Sundaram, MD

  • Filler Frenzy

    Injectables are hot, and today there are a growing number of them available to help reverse signs of facial aging. Hyaluronic acid (HA) fillers represent one of the bigger and more popular categories of injectables. Hyaluronic acid occurs naturally in our bodies' connective tissues, the supply of which diminishes as we age. One of its roles is to keep skin plump and smooth.

    One-size-fits-all fillers are being replaced by designer or "site-specific" HA fillers because the latter offer more customization. The factors that distinguish injectables include cohesivity (how well the material sticks together), elasticity or G prime (its ability to withstand forces such as gravity and facial movements like frowning or smiling), and viscosity (spreadability). These factors are compared with an individual's unique facial structure and desired cosmetic result to determine the best choice of filler with the longest-lasting results.

    To better illustrate how these HA fillers behave when injected, our latest slideshow compares filler consistency to common foods. This method was developed by Hema Sundaram, MD.

  • Juvederm Ultra and Ultra Plus XC

    Filler Frenzy - Juvederm Ultra and Ultra Plus XC

    Approved for: Moderate-to-severe nasolabial folds, the creases running from the bottom of your nose to the corners of your mouth (also known as parentheses or smile lines).

    Consistency: Oatmeal

    Results: Up to one year

    Cost: $300 to $800

    Juvederm Ultra Plus XC contains lidocaine to ease the sting.

  • Juvederm Voluma XC

    Filler Frenzy - Juvederm Voluma XC

    Approved for: Midface rejuvenation (think cheeks)

    Consistency: Chocolate pudding

    Results: Up to two years

    Cost: Approximately $1,425

    Juvederm Voluma XC contains lidocaine to ease the sting.

  • Restylane, Restylane-L

    Filler Frenzy - Restylane, Restylane-L

    By Stilfehler, via Wikimedia Commons

    Approved for: Parentheses or smile lines, marionette lines that start at the corners of your mouth and run down to your chin, downturned lines at the corners of your mouth.

    Consistency: Cream of wheat grains in gelatin

    Results: Up to one year

    Cost: Approximately $725

    Restylane-L contains lidocaine to ease the sting.

  • Restylane Lyft

    Filler Frenzy - Restylane Lyft

    Approved for: Smoothing smile lines and mid-face rejuvenation.

    Consistency: Couscous in gelatin

    Results last: 10-18 months

    Cost: $875

    Restylane Lyft contains lidocaine to ease the sting.

  • Restylane Silk

    Filler Frenzy - Restylane Silk

    Approved for: Plumping the lips and filling fine lines around the mouth.

    Consistency: Jam

    Results last: Up to six months

    Cost: $400 to $700 dollars per syringe

    Restylane Silk contains lidocaine to ease the sting.

  • Belotero Balance

    Filler Frenzy - Belotero Balance

    Approved for: Moderate-to-severe facial wrinkles, and folds such as nasolabial folds (think etched-in lines and wrinkles around the mouth).

    Consistency: Honey

    Results last: About 6 months or more

    Cost: $400 to $700 per syringe

About the reviewer:

Hema Sundaram, MD, is a board-certified dermatologist and a Visiting Professor for the American Society for Dermatologic Surgery, with offices in Rockville, MD, and Fairfax, Virginia. She is an international advisor, a physician trainer and a regular author of scientific articles and book chapters on cosmetic dermatology and plastic surgery. Dr. Sundaram is also the author of Face Value: The Truth about Beauty — and a Guilt-Free Guide to Finding It.

  • Ormsby 50x50

    Marcia V. Ormsby, MD

    Annapolis Aesthetic Surgery, Inc.
    116 Defense Hwy.,
    Annapolis, MD 21401
    (866) 899-0158

  • P

    Ronald H. Schuster, MD

    10807 Falls Road, #100
    Baltimore, MD 21093
    (800) 572-1096

  • P

    Brian R Buinewicz MD

    Buinewicz Plastic Surgery & Medspa
    3655 Route 202
    Suites 225 and 230
    Doylestown, PA 18902
    (800) 769-0037