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Filler Up! A Lesson in Dermal Fillers: Restylane, Perlane, Juvederm, Voluma, Belotero, Radiesse

To me it seems like all over the television and movies are women running around with these full lips on perfectly placed mouths. As I’ve gotten older, and more self-conscious of my small mouth and thinner lips, I even chose to start wearing lip gloss instead of lipstick so as to call less attention to my non-movie star mouth. Sometimes as I applied makeup, I’d stick my lips out in a pout to see what they might look like fuller. It was inevitable that I would one day get lip injections.

My lip injections were done with Restylane, but there are many kinds of dermal fillers. They vary in their manufacturer, what they are best used to treat, and their molecular make-up. Some can be used for the same procedures, some are better for smaller more delicate areas, while some are better for deeper injection in larger areas like the cheeks or chin, or for deeper facial creases.

Dermal fillers are used to restore lost volume to the face and fill in creases. As we age, our skin may begin to look less refreshed and youthful. In young skin, there is an abundance of collagen, elastin and hyaluronic acid which give it volume, support and suppleness. As a part of the aging process, these natural support structures begin to break down. The result is facial lines, wrinkles and skin laxity.

We offer a variety of dermal fillers for lip injections, cheek augmentation, chin augmentation, filling out nasolabial folds, tear troughs, and much more. We are often asked what the differences are between them these dermal fillers. So this blog provides a description of what they are and what they are used for.

What I really like is that they make you look prrreeeeeetttyy. And it's instant gratification!!

Restylane, Restylane Silk, and Perlane

Manufacturer: Galderma

What’s it made of? Restylane and Perlane are both a clear gel formulation of hyaluronic acid (HA) that is specifically formulated to act like your body’s own naturally produced hyaluronic acid. HA hydrates your skin, ​helping to instantly plump up and eliminate moderate to severe facial wrinkles and folds, or add fullness to your lips.

They are available in several different solution intensities, which can affect how powerfully it can treat wrinkles. When the gel is produced, it’s formulated into differently sized gel microspheres depending on the level of concentrated acids used. The higher the hyaluronic acid concentration and the larger the gel particles, the longer lasting and more intense treatment becomes.

What is it used for? Smaller gel particle solutions, like Restylane, are ideal for lip injections, fine lines, and crow’s feet, or filling tear troughs (which can improve the look of dark circles). It can also be used to treat the lines from your nose to the corners of your mouth (nasolabial folds). Larger particle solutions, like Perlane, are for deep injection and are more effective against deeper facial creases and lines. Restylane Silk is new to the market and is ideal for thin delicate areas like vertical lip lines. Silk is great for adding definition or a hydrated appearance to lips, or giving a natural and subtle lip enhancement.

There is also a formulation of both Restylane and Perlane (Restylane-L and Perlane-L) that contains lidocaine, making procedures less uncomfortable.

Juvederm Ultra, Juvederm Ultra Plus, Juvederm Voluma

Manufacturer: Allergan (the maker of Botox)

What’s it made of? Juvederm comes in three different molecular sizes: Ultra, Ultra Plus and Voluma. Like Restylane and Perlane, these products are ​made up of ​Hyaluronic ​Acid (HA), but the Juvederm family of products have a patented technology, Hylacross, that produces a smoother​, longer lasting result. ​ (Keep in mind Restylane holds value by providing better results for thin skinned and delicate areas like tear troughs and fine lines). But these three Juvederm products are used in different areas to achieve specific results depending on the needs and desires of the individual.

Juvederm Ultra is the smallest of the Juvedermmolecule sizes and therefore is used for smaller issues like fine lines. Ultra is not often used as most injectors prefer Restylane or Belotero for fine line correction.

What’s it used for? Juvederm Ultra Plus ​ is ​the most popular dermal filler on the market and the product of choice by most injectors for moderate to severe facial folds ​​and lip augmentation​. ​ Juvederm Voluma is used for ​replacing volume and for contouring larger facial areas, and is often used in cheek augmentation. Voluma is proven to last twice as long as its sister products Ultra and Ultra Plus.

Belotero Balance and Radiesse

Manufacturer: Merz

What’s it made of? Belotero is very unique and has been compared by injectors to "collagen injections.” Remember when Collagen was used back in the day? Well, Belotero is not collagen, thank goodness, and therefore does not require a skin test a month before treatment. ​Belotero, like most other fillers, is made of hyaluronic acid ​ but it's unique chemical make-up allows for the product to integrate easily into the ​superficial layers of the ​ skin​. ​Its elastic and cohesive properties allow for the gel to spread evenly across the treatment area and into the surrounding tissues- kind of like how vinaigrette or olive oil falls through your salad in a bowl. ​

The viscosity of this product will allow for better filling of the smallest fine lines and other small textural issues. Belotero is the only filler on the market that can effectively fill in these tiny fine lines. All other fillers are too volumizing and will only make small, fine lines look worse.

What’s it used for? It is best used for superficial lines in delicate areas like vertical lip lines (thin lines that appear above the lip line)​, crow's feet, and is ideal for turning up the corners of the mouth. ​If you want a wrinkle filled, but don’t need volume, this is the filler for you.


What’s it made of? Radiesse is made of Calcium Hydroxyapatite (CaHA) microspheres suspended in an aqueous gel carrier. Once injected it provides immediate volume and correction but continues to work by stimulating the body to produce its own natural collagen. Over time the gel is absorbed and the body metabolizes the CaHA microspheres leaving behind your own natural collagen.

What’s it used for? To replace lost structure and provide volume in areas of deeper injection like the nasolabial folds. Radiesse acts like a scaffold under the skin, providing structure and stimulating your own natural collagen to grow. The production of natural collagen continues for several months. Results can last one year or more.

With all these dermal fillers, results are immediate, providing long-lasting volume or smoother, less lined skin.

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