As you age, your skin becomes thinner, loses fat, and loses some of the plumpness and smoothness it once had. To restore what’s lost to time, many people opt for injectable dermal filler treatments. Summit Health’s Daniel Demesh, MD, shares answers to common questions you may be asking about this type of cosmetic treatment. 

What are injectable dermal fillers?

Dermal fillers are gel-like substances injected beneath the skin to restore volume and enhance contour in certain areas of the face and hands. Fillers can help smooth lines, soften creases, and plump facial areas including:

• Around your nose and mouth
• Cheeks and temples
• Lips
• Chin

Dermal fillers reduce signs of aging and can improve symmetry among facial features. They’re one of the most popular cosmetic procedures because of their immediate results, minimal recovery time, and very few risks.

What are dermal fillers made with?

Cosmetic treatment providers use a variety of FDA-approved dermal filler products, which are categorized by the substance they’re made with:

• Hyaluronic acid (HA) is the most commonly used dermal filler. HA naturally occurs in your skin, helping to keep it plump and hydrated. These fillers are soft and gel-like and often used under the eyes, in the lips, or in other more delicate facial areas.
• Calcium hydroxylapatite (CaHA) is also naturally occurring in your body. As a filler, tiny calcium particles make up part of a water-based gel that’s thicker than HA. Therefore, CaHA is typically used for deeper lines and folds, such as smile lines, or to rejuvenate the hands.
• Poly-L-lactic acid is a synthetic substance used in dissolvable stitches. Products made with this substance are called collagen stimulators, meaning it helps your skin produce its own collagen over time. Poly-L-lactic acid fillers are typically used for deeper facial wrinkles.
• Polymethylmethacrylate (PMMA) is another synthetic substance with a long history of medical use. In this filler, the PMMA forms tiny balls (microspheres) that are suspended in a collagen-based gel. The microspheres stay in place, supporting the skin for a smoother-looking effect.
• Fat grafting is more involved than other injectable fillers because it requires surgery. For this treatment, a surgeon would perform liposuction to remove fat from another area – your abdomen, for example – remove extra fluid, and then inject it into your face to restore volume.

Are dermal fillers the same as products like Botox®?

There are differences between dermal fillers and cosmetic neurotoxins like Botox®. While both are injectable treatments to reduce signs of aging, they work in different ways. Neurotoxins relax facial muscles associated with dynamic wrinkles formed by facial expressions, such as frown lines. Meanwhile, dermal fillers restore volume, treating lines and creases not due to muscle activity.

In addition, neurotoxin treatment results take a little longer to appear and don’t last quite as long as dermal filler treatments. Some patients choose to have both treatments in conjunction to achieve their desired results.

As with any cosmetic treatment, it’s good to learn more about your options and weigh them carefully by talking with your treatment provider.

How do I know which dermal filler is best for me?

Seek the guidance of an experienced provider. Because dermal fillers vary in texture, thickness, and injection depth, your provider can guide you toward the optimal products for your area of concern.

Choose an experienced, knowledgeable provider whose aesthetic and treatment philosophy aligns with yours. Your provider will begin with a pre-treatment consultation to evaluate your area of concern, review your medical history, and discuss treatment options and risks.

What is a treatment like?

After the area to be treated is cleaned, your provider will inject the filler under your skin. You may be given a topical anesthetic before injection to numb the area. Many fillers include lidocaine, which helps with discomfort. A procedure takes 15 minutes or less.

In many cases, you should be able to see immediate results. You can return to normal activities right after treatment, although your provider may suggest taking a day off from exercise or strenuous activity.

How long do results last?

How long results last depends on the product used and the area treated. Patients can repeat treatments to maintain results.

• Hyaluronic acid fillers: six to 12 months
• Calcium hydroxylapatite fillers: about 12 months
• Synthetic fillers (poly-L-lactic acid and PMMA): two years or more

Fat grafting is intended to be long-lasting, but results can vary depending on the patient and area treated.

Does insurance cover dermal fillers?

Dermal fillers are not covered by insurance. Their cost depends on which and how many fillers are used.

Where can I learn more?

To learn more about the benefits of dermal fillers and which product is right for you, make an appointment for a consultation. We have plastic surgeons, facial plastic surgeons, and dermatologists on staff who are skilled in injectables. Offices are spread throughout New Jersey and New York with locations in Berkeley Heights, Clifton, Florham Park, Morristown, Livingston, and Riverdale, New Jersey as well as a brand-new location at 1865 Broadway in New York City where Dr. Demesh currently practices.