What Are the Different Types of Dermal Fillers Available?

Not all dermal fillers are the same. Some add volume immediately and can be dissolved, others gradually stimulate collagen, and a few are permanent. Each type has its own advantages, limits and ideal indications. Here is an overview of the main categories.

Hyaluronic Acid Fillers: Natural-Looking and Versatile

Hyaluronic acid (HA) is a substance naturally present in the skin that retains water and provides hydration and volume. HA fillers are the most widely used in the world. They come in many textures, from very soft gels for fine lines and lips to firm gels for the cheeks and jawline. Their main advantage is reversibility: they can be dissolved with hyaluronidase. They generally last six to eighteen months. In Canada, HA ranges include JUVÉDERM®, RESTYLANE®, BELOTERO®, TEOSYAL®, STYLAGE®, SAYPHA® and REVANESSE®, a range developed and manufactured in Canada. See our hyaluronic acid fillers category.

Calcium Hydroxylapatite Fillers: Volume and Structure

Calcium hydroxylapatite (CaHA), as in RADIESSE®, consists of microspheres suspended in a gel. It provides immediate volume and stimulates collagen production. It is used for deep folds, the jawline, the cheeks and, in diluted form, for skin quality on the face and body. It cannot be dissolved with hyaluronidase. Results often last a year or more.

Poly-L-Lactic Acid Fillers: A Collagen-First Approach

Poly-L-lactic acid (PLLA), as in SCULPTRA®, does not give immediate volume. It gradually stimulates the skin’s own collagen over several sessions spaced a few weeks apart. Results appear progressively and can last up to about two years. It suits patients who want a gradual, natural improvement in volume and firmness. See our biostimulators category.

PMMA Fillers: Permanent Results

Polymethylmethacrylate (PMMA) fillers contain microspheres that remain permanently in the tissue, surrounded by collagen. They offer long-lasting results but cannot be removed easily, and late complications such as nodules are difficult to treat. For these reasons, they are much less commonly used than resorbable fillers.

Autologous Fat Injections: Using the Patient’s Own Tissue

Fat grafting uses the patient’s own fat, harvested by liposuction from another area, purified and reinjected. It can provide long-lasting volume, but it is a surgical procedure, and part of the fat is resorbed, which makes the result less predictable.

Skinboosters

Skinboosters are very fluid HA gels, injected superficially to improve hydration, radiance and fine lines rather than to add volume. See our skinboosters category.

Choosing the Best Type of Dermal Filler

  • For reversible, natural-looking volume: an HA filler.
  • For structure and skin firmness: CaHA.
  • For gradual collagen stimulation: PLLA.
  • For skin quality: a skinbooster.

The choice is made with a qualified injector, depending on the area, goals, skin and medical history. In Canada, who may inject fillers depends on the province and the professional college. See our article on what dermal fillers are made of.

References

Cohen, J. L. (2007). Understanding, avoiding, and managing dermal filler complications. Dermatologic Surgery, 33(2), S92–S99. https://doi.org/10.1111/j.1524-4725.2007.33324

Rzany, B., DeLorenzi, C., & Monheit, G. (2015). Facial filler injection techniques. In N. Sadick (Ed.), Aesthetic dermatology: Current perspectives (pp. 75–91). Springer. https://doi.org/10.1007/978-3-319-13266-3_6

Bellafill. (n.d.). The long-lasting filler for smile lines and acne scars. https://www.bellafill.com/

Silhouette Spa and Laser. (2023). The difference between types of dermal fillers. https://silhouettespaandlaser.com/the-difference-between-types-of-dermal-fillers/

Common Questions About This Topic

How can I make sure a dermal filler is legitimate?

Choose a qualified injector who obtains products through legitimate supply channels, such as Kinami Health for licensed clinics, and who records the product name and lot number in your file. Avoid products sold directly to the public online.

Which dermal filler lasts the longest?

Among resorbable fillers, biostimulators such as PLLA and CaHA generally last longest. PMMA is permanent but cannot be easily removed.

Can you mix filler types?

Yes, different fillers can be used in different areas or layers as part of a planned treatment. See our article on mixing dermal fillers.

Which filler looks the most natural?

HA fillers suited to the area, injected in appropriate volumes, generally give the most natural results. Biostimulators also give a natural, progressive improvement.

Do dermal fillers hurt?

Most patients feel only slight discomfort. Numbing creams and products containing lidocaine make the treatment more comfortable.

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