Types of dermal fillers

When it comes to facial fillers, there are many types and brands to choose from. Fillers offered at Ohio State include Juvéderm, Restylane, Radiesse, Aquamid, Sculptra, PMMA or Bellafill and other brands.

Contact your doctor’s office before scheduling an appointment to ensure your preferred filler is available.

At your first appointment, we’ll help you select one of these high-quality products based on your treatment goals:

Calcium hydroxylapatite (Radiesse and other brands)

This mineral-like compound is found naturally in bone tissue. It’s biosynthetically produced. Since this lowers your risk of an allergic reaction, you won’t need to have pre-treatment skin testing. This compound has a long safety record and stays in place without migrating, and complications are rare.

Calcium hydroxylapatite can give you natural-looking results. It’s used to minimize moderate or deep creases including smile lines, marionette lines (nose to mouth) and frown lines between the brows. It can also add fullness to cheeks and facial contours.

Hyaluronic acid or Restylane

Hyaluronic acid (HA) is a natural substance found in your body’s connective soft tissues. It’s also used to provide cushioning and pain relief for arthritic joints. In addition to Restylane, brands of HA-based products include Captique, Hylaform, Juvéderm, Puragen and many others.

HA can improve contour and reduce skin depressions caused by scars, injury or lines such as crow’s feet, frown lines and laugh lines. HA can be used to redefine lip borders and treat vertical smoker’s lines on lips.

Polyalkylimide (Aquamid and other brands)

This semi-permanent filler is biocompatible, which means it doesn’t cause allergic reactions, so no allergy test is required. It is radio-transparent, which means it won't appear on X-rays and cause potentially confusing medical readings.

After the doctor injects polyalkylimide gel, a thin layer of collagen naturally forms around it. This takes about four weeks. The collagen-encircled gel enables the doctor to inject a larger volume of filler where needed. It’s stable over time and can be removed later, if desired.

Our team can use this dermal filler to treat deeper wrinkles, plump up thin lips, and enhance cheekbones and jawline. It’s a good choice to replace significant loss of facial volume in conditions such as facial wasting.

Polylactic acid (Sculptra)

This non-toxic, biodegradable synthetic filler is a stimulator, which means that it stimulates your body's natural production of collagen. Polylactic acid is widely used to fill in laugh lines, plump thin lips and treat deep folds around your nose and mouth.

Unlike other facial fillers, you won’t see immediate results. Improvements become visible gradually over the next few months as new collagen is produced. Most people require three monthly treatments to achieve the desired effect. Each treatment re-stimulates your own collagen. It can take four to six weeks to see the full effect. This is semi-permanent, so you’ll need occasional touch-ups.

Polymethyl-methacrylate microspheres (PMMA or Bellafill)

We use this semi-permanent filler to treat medium-to-deep wrinkles, folds and furrows — particularly nasolabial folds, which extend from your nose to your mouth. It can help fill out pitted scars and give thin lips a boost. For facial wrinkles, PMMA may be an alternative to collagen replacement therapy or hyaluronic therapy. Our team can add more later, if desired, to achieve the results you want.

PMMA requires several injections to create volume. It can take up to three months before you see the full effects of treatment. A drawback of PMMA is that it can sometimes be visible under the skin as bumpy-looking if not properly applied. That’s why it’s important to choose a trusted medical expert who understands the appropriate technique, which involves injection at the dermal subcutaneous junction using threading or tunneling methods.

Choosing the right dermal filler

Dermal fillers vary in chemical composition, how long they last and their degree of softness. Doctors select softer fillers for areas such as the lips and sturdier fillers for adding contours to cheekbones. Your plastic surgeon will discuss the pros and cons of each approach and other considerations.

Your Ohio State aesthetic expert will help you to choose the most appropriate type of filler for the areas you want to treat. You’re encouraged to ask questions, and you’ll be fully informed, so you feel comfortable about your decisions.

How to prepare for treatment with dermal fillers

Before having facial filler treatment, you’ll consult with your Ohio State Med Spa team in Columbus, Ohio, or at a nearby outpatient location. We’ll talk about your goals and evaluate your health, medical condition and skin condition.

Be prepared to provide information about any medications or supplements you’re taking. We will also ask about any past surgeries or cosmetic procedures you may have had.

To qualify for dermal fillers, you should:

• Avoid smoking
• Be in good physical health
• Have healthy skin care habits
• Not have any medical conditions that could affect healing
• Have a positive attitude and lifestyle habits
• Have realistic treatment goals

What to expect if you have dermal fillers

Your skin will be cleansed and prepared for treatment, including something to help prevent infection. We may do facial mapping, which involves temporary marks on your face in areas to be treated.

You may get a topical anesthetic or an injected local anesthetic to ease any discomfort. Most people find facial filler injections to be uncomfortable, but reasonably tolerable.

Injections take a few minutes per area treated. Our aesthetic expert injects, massages and evaluates the site, and may add additional filler if needed.

Typical treatment times can range from 15 minutes to an hour. Once treatment is finished, your practitioner will remove any markings and may give you an ice pack to ease swelling and discomfort.

After dermal filler treatment

After your procedure you may experience some tenderness and redness, swelling or bruising in the areas treated. This should go away within one or two days. Other temporary effects can include numbness and lumpy or hard areas that should resolve as the solution settles.

With many fillers, you’ll see immediate results in areas treated. Your face appears fuller, and lines and skin flaws are diminished. Certain types of fillers take longer to work so results vary and may be delayed. We’ll discuss how soon you’ll see results and when you may need a touch-up treatment.

Most people can return to ordinary daily activities after treatment with no downtime. It’s best to avoid intense physical activity for a day or two. Topical ice and massage may help ease symptoms.

Risks of dermal fillers

Facial fillers are considered safe for most people when done by qualified aesthetic experts like the Ohio State Med Spa team. However, certain conditions and other factors could increase the risk of complications.

Potential risks of dermal fillers vary depending on individual health, skin condition, the type of filler selected, and areas treated. Possible risks include:

• Acne-like eruptions
• Bleeding or bruising
• Infection
• Lumps
• Redness and swelling
• Scarring
• Skin rash
• Uneven results
• Ulceration or skin loss

Although it happens very rarely, facial filler can be unintentionally injected into blood vessels instead of beneath the skin. This can affect circulation and lead to skin loss, wounds or more serious complications in the area affected.