FDA APPROVED DERMAL FILLERS

There are 19* BRANDS of FDA approved facial dermal fillers available to providers for cosmetic injections. Each has multiple and specific indications (lips, cheeks, etc.) and most have 2 versions – one which includes lidocaine in the formulation (an anesthetic) and one that does not.

But let’s start at the beginning.

I am a very visual learner so when I’m educating clients about dermal fillers in general, I frequently use a shoe analogy. When someone says, “dermal filler” is like saying “shoe”. Two CATAGORIES of shoes are summer and winter. Then, there are many different TYPES of shoes (sneakers, boots, sandals, etc.). Similarly, there’s 2 CATAGORIES of dermal fillers absorbable and non-absorbable. These CATAGORIES are comprised of 4 different TYPES of dermal fillers.  Next, we can break it down into the 19 approved FDA BRANDS. Here’s the rundown.

CATEGORY A: Absorbable (temporary) materials
TYPES:

I. Hyaluronic acid is a type of sugar (polysaccharide) that is present in body tissues, such as in skin and cartilage. It is able to    combine with water and swell when in gel form, causing a smoothing/filling effect. Sources of hyaluronic acid used in dermal fillers can be from bacteria or rooster combs (avian). In some cases, hyaluronic acid used in dermal fillers is chemically modified (crosslinked) to make it last longer in the body. The effects of this material last approximately 6 – 12 months.
BRANDS:
1. Restylane
2. Restylane Lyft (formerly Perlane)
3. Restylane Defyne
4. Restylane Refyne
5. Restylane Silk
6. Restylane Kysse
7. Juvederm Ultra
8. Juvederm Ultra Plus
9. Juvederm Voluma
10. Juvederm Vobella
11. Juvederm Vollure
12. Bellotero Balance
13. RHA 2
14. RHA 3
15. RHA 4
16. Revanesse Versa

II. Calcium hydroxyapatite is a type of mineral that is commonly found in human teeth and bones. For wrinkle filling in the face or for the hand, calcium hydroxyapatite particles are suspended in a gel-like solution and then injected into the wrinkle in the face or under the skin in the back of the hand. The effects of this material last approximately 18 months. While in the body, calcium hydroxyapatite will be visible in x-rays and may obscure underlying features.
BRAND:
17. Radiesse

III. Poly-L-lactic acid is a biodegradable, biocompatible man-made polymer. This material has wide uses in absorbable stitches and bone screws. PLLA is a long lasting filler material that is given in a series of injections over a period of several months. The effects of PLLA generally become increasingly apparent over time (over a period of several weeks) and its effects may last 2 years or more years.
BRAND:
18. Sculptra Aesthetic              

CATEGORY B: Non-absorbable (permanent) materials
TYPES:

IV. Polymethylmethacrylate beads are a non-biodegradable, biocompatible, man-made polymer. This material is used in other medical devices, such as bone cement and intraocular lenses. PMMA beads are tiny, round, smooth particles that are not absorbed by the body. When used as a soft tissue filler, PMMA beads are suspended in a gel-like solution that contains cow (bovine) collagen and injected into the face. Collagen is a type of protein that is a major part of skin and other tissues in the body. Small area skin testing prior to use in larger areas is ideal.
BRAND:
19. Bellafill (formerly Artefill)

Each of these BRANDS has unique characteristics that influence their longevity and the ideal depth and location for injection.  Of note, an HA is the only type of dermal filler that has an antidote, hyaluronidase, which dissolves the HA almost immediately. 

And that’s the rundown of the 19 FDA approved dermal fillers. Please reach out with any questions through contact me or join the discussion on IG @ tracyholzmannp.

Endnotes:

The FDA Summary of Safety and Effectiveness Data as well as health care provider and patient labeling for each approved dermal filler may be found by searching the FDA approval database using product code "LMH" (dermal fillers for the face).

The count of 19 does not include dual versions of the same product – with and without lidocaine, (i.e. Restylane and Restylane-L).