What's the Difference Between Facial Fillers

Deciding Between Sculptra, Restylane, Radiesse, and Juvederm Products

Dermal fillers can be used to plump thinning lips, give the eyebrows a bit of a lift, enhance cheekbones, decrease hollowing under the eye to help reduce dark circles, decrease the appearance of smile lines and overall just give you a well-rested and rejuvenated appearance.

They can be done in less than an hour and have little to no downtime. In some people, dermal fillers may cause some mild bruising, temporary swelling, or temporary redness at the injection site. Rarely, a person might experience an allergic reaction. The major disadvantage of dermal fillers is the effects are indeed temporary. For the most part, however, the effects can last from a few months up to a year and a half.

Don't confuse dermal fillers with Botox and Dysport, which are wrinkle relaxers. While dermal fillers and wrinkle relaxers are both considered “injectables,” they are in two entirely different categories. Botox and Dysport are used to paralyze muscles and stop the motion of muscles that cause wrinkles. They are not used to fill, plump, or enhance an area. However, they can be used along with fillers.

With all the dermal fillers on the market, it can be quite confusing to determine which should be used when. In the United States, the list of available fillers is long. Below you will find an overview of those available in the U.S.

Juvéderm XC / Juvéderm Ultra XC

man receiving facial injection
Adam Gault/Science Photo Library/Getty Images

Main Ingredient: Hyaluronic Acid

Uses: Juvéderm Ultra is good for fine lines and not so deep wrinkles of the face. It’s also good for adding volume to facial tissue, especially wrinkles and fine lines. Juvéderm Ultra can be used closer to the surface of the skin and areas with thinner skin, such as the parentheses around the mouth and nose. 

Juvéderm Ultra XC can be injected into the lips and used for lip augmentation.

How It Works: When injected, the hyaluronic acid acts like a sponge. It absorbs water and as a result plumps up the area in which it was injected.

How Long Will It Last: Reported to last from six months to a year. Less material is usually needed for touch ups. Juvéderm Ultra XC can last up to one year.

Price: One syringe of Juvéderm Ultra or Juvéderm Ultra XC will run you about $450 to $700.

Reversal Agent? Yes. The volumetric effects of Juvéderm Ultra can be reversed with hyaluronidase.

Special Notes: The XC version of Juvéderm adds lidocaine. Lidocaine is an anesthetic that helps reduce pain with injection.

Juvéderm Voluma XC

Main Ingredient: Hyaluronic Acid

Uses: Good for adding volume and contour to the cheeks. 

How It Works: The hyaluronic acid absorbs water and augments the injected area.

How Long Will It Last: The effects of Juvéderm Voluma XC lasts about two years.

Price: One syringe of Juvéderm Voluma XC is priced around $900 to $1,400.

Reversal Agent? Yes. Hyaluronidase can be used to reverse the effects of Juvéderm Ultra.

Special Notes: The XC version of Juvéderm Voluma includes the addition of lidocaine. Lidocaine, an anesthetic, reduces the pain associated with injection.

Perlane / Perlane-L

Main Ingredient: Hyaluronic Acid

Uses: Perlane is used to add volume to flattened areas, to plump up lips, and to help reduce the appearance of fine lines and deep folds. It is manufactured by the same company that makes Restylane. Perlane is thicker than Restylane, thus it is better for deeper or more prominent folds.

How It Works: Water is absorbed by the injected hyaluronic acid. This has the effect of building up the area of injection.

How Long Will It Last: Some people find Perlane to be longer lasting than Restylane. However, the FDA commentary is that it lasts up to six months.

Price: One syringe of Perlane runs between $500 and $900.

Reversal Agent? Yes. Hyaluronidase is the antidote to Perlane.

Radiesse

Main Ingredient: Calcium hydroxylapatite in the form of microspheres.

Uses: Radiesse is used to treat moderate to severe facial wrinkles and folds, such as the nasolabial folds. It can also be used to plump up cheek bones. It is not used in the lips.

How It Works: Radiesse stimulates the body to form new collagen. This is supposed to make the produce last longer, thus reducing the need for a touch-up. Additionally, the gel and calcium-based microspheres add volume to the injected area.

How Long Will It Last: Results are clinically proven to last a year or more.

Price: Radiesse normally costs approximately $600 to $800 per syringe.

Reversal Agent? No.

Restylane Silk / Restylane / Restylane-L

Main Ingredient: Hyaluronic Acid

Uses: Restylane is used to improve moderate to severe facial folds and wrinkles. Restylane Silk is designed especially to enhance the lips, as it is made with smaller particles than the other products.

How It Works: The area of injection is enhanced due to absorption of water by the hyaluronic acid.

How Long Will It Last: Restylane’s manufacturer claims results can last to up to 18 months. That is, however, with repeat injections at 4.5 months or 9 months. Without repeat injections, Restylane may last up to 6 months. Restylane Silk may last up to 6 months.

Price: Restylane products cost approximately $600 per syringe.

Reversal Agent? Yes. Hyaluronidase is the antidote to Restylane.

Special Notes: Restylane and Perlane are made by the same manufacturer. Perlane is the thicker/more viscous of the two products and is used for more heavy-duty rejuvenation.

Sculptra

Main Ingredient: Poly-L-Lactic Acid

Uses: Sculptra was initially limited to use in patients with HIV who had loss of facial fat caused by antiviral medications. Now it is approved for cosmetic use in non-HIV infected individuals for building up the cheeks, filling in hollows or sunken areas of the face, and increasing skin thickness which decreases the appearance of folds and lines. It is not used to enhance the lips.

How It Works: Unlike the hyaluronic acid based fillers, Sculptra’s mechanism of action encourages the forming of new collagen in the injected area and the effects are not immediate. Multiple treatments are required, approximately 4 weeks apart. The number of treatments needed depends on the severity of the facial aging. The skin thickness increases gradually.

How Long Will It Last: In a clinical study, the effects of Sculptra lasted up to 2 years after the first treatment session. A full treatment consists of an average of three injections approximately 4-6 weeks apart.

Price: Sculptra comes in a vial as opposed to a syringe. One vial will cost anywhere from $750 to $1,000.

Reversal Agent? No.

Special Notes: The results from Sculptra are not immediate and are more subtle. It can take months to notice improvement, but it is long-lasting.

Choosing a Filler

Finding the right dermal filler for you will depend on your budget, your doctor’s experience and preference, and your individual skin nuances (e.g. amount of sun damage, skin elasticity) and facial features. What works for your friend may not be the best option for you. It is best to select dermal filler type on a case-by-case basis.

Sources:

About The Restylane Family of Products. Accessed February 23, 2016.

What Is Juvederm XC?. Accessed February 23, 2016.

Radiesse: Volumizing Filler. Accessed September 29, 2012.

Restylane® Silk Patient Brochure. FDA. Accessed February 23, 2016 

Sculptra Aesthetic: Anti-Age For the Modern Age. Accessed September 29, 2012

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