Hyaluronic Acid: These fillers are made from a clear gel material that is naturally present throughout the human body. HyaluronicAcid (or HA for short) moistens our cells, lubricates joint movement and has a role in the normal function of our immune system. HA is well-recognized by the body as being a normal and natural substance, so this is an extremely well tolerated filler, even for sensitive areas such as the lips and under-eye areas.
The fillers in this category are Juvederm, Restylane, Perlane and Belotero. They last about 4-6 months in most areas, except for the under eye areas, where they can last up to a year or more. This is the only filler that is reversible; there is an enzyme called hyaluronidase that can erase the HA fillers in a short time, in case there are ever any issues with HA filler results.
Calcium Hydroxyapatite: Radiesse is the only filler in this category available in America. It’s made of the same type of calcium that makes up our bones, so once again it is a material that is very well tolerated by the body and problems with this filler are very rare. Radiesse treatment lasts about 10-12 months before another treatment is necessary.
PLLA (poly-L-lactic acid): Sculptra is the filler in the PLLA category. PLLA is a dissolvable material that has been used in medicine and surgery for years: it is the main ingredient in a type of dissolving suture (surgical stitch) material. The Sculptra particles actually don’t fill with their own volume, they actually induce the bodyto produce more of its own collagen. It takes time; whereas the other fillers have instant gratification on the day of treatment, Sculptra takes a few (3-4) treatments spread out by a month each. The benefit is that it lasts a very long time. Filling with Sculptra can last up to 3 years before another treatment is necessary. Also, because a larger amount of volume is obtained with Sculptra, it’s often best for larger regions like overall face or cheek volume improvement. Sculptra is very well tolerated but the incidence of problems with injections seems to be very related to the expertise of the person doing the injecting. For Sculptra and Artefill it’s critical to have only the most highly qualified person inject either of these materials.
PMMA (poly-methylmethacrylate): Artefill is the only PMMA filler available in the US at this time. Poly-methylmethacrylate is a human-made product of microscopic round particles. These particles remain within the tissues and continue providing a filler effect for years. In fact, though it’s usually reported that ArteFill lasts for 5 years, it is likely that this filler is permanent and that the fill effects likely lasts well beyond that. Some patients prefer a more conservative option, while others are excited about a much longer lasting filler reducing or eliminating the need for continuing periodic injections.