Dermal fillers (aka soft tissue fillers) are more than mere wrinkle fillers: they can plump lips, smooth creases and folds, and fill in the under-eye hollows known as tear troughs.Â
Fillers can also add volume to cheeks and temples, reduce the appearance of pitted acne scars, sculpt the jawline, and add projection to a weak chin. Some people even choose to get a nonsurgical nose job using injectable fillers.Â
For patients who are seeing the early stages of age-related volume loss, a "liquid facelift" that combines injectable fillers with a neuromodulator like Botox can restore a more youthful appearance, possibly delaying the need for more invasive plastic surgery procedures like facial fat transfer.
That said, dermal fillers will not provide the same level of facial rejuvenation as a cosmetic surgery like a facelift. Results are far more subtle and temporary.Â
Hyaluronic acid is the most popular FDA-approved facial filler ingredient because it's so easy to dissolve in the event of a complication or change of heart. Fillers can also be made of calcium hydroxylapatite (Radiesse), poly-L-lactic acid (Sculptra), or nonabsorbable polymethyl methacrylate microspheres (PMMA or Bellafill).
Related: A Plastic Surgeon Answers Your Top 5 Questions About Dermal Fillers
Pros
Cons
Related: Nasolabial Fold Filler Is a Popular Ask. So Why Are Doctors So Reluctant to Inject?
The price you pay will depend on the type of filler and how many injections (expensed either by syringe or vial) you get, the experience level of your doctor, their practice location, and several other factors.
You can finance your treatment with CareCredit.
The dermal filler photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.
Hyaluronic acid is the most popular filler ingredient, so you have lots of choices.Â
JuvĂ©derm filler formulations each have a different viscosity and level of “liftability,” for different areas of the face.Â
Restylane also offers a range of HA fillers that target specific areas.
The RHA Collection (called Teosyal in Europe) is a relatively new line of hyaluronic acid fillers, designed to more closely mimic natural hyaluronic acid than traditional fillers and provide an exceptionally natural appearance.Â
RHA fillers can last 15 months or more.Â
Belotero (or Belotero Balance) is a thinner hyaluronic acid–based filler commonly used for delicate areas, like under the eyes.Â
It can also fill in fine lines throughout the face and neck, including lip lines, cheek lines, and horizontal neck lines. Results last for about six months.
Related: 10 Celebrities Who've Opened Up About Getting Fillers
First, you and your injector will discuss your desired result and the best type of filler to create it, as well as potential risks.Â
This is a great time to ask how much filler you'll need and get a personalized cost estimate, to avoid sticker shock when you go pay your bill.Â
Once you’ve worked out these details, here's what you can expect:
RealSelf Tip: Laws that govern who can perform dermal filler injections vary from state to state in the U.S. While some require a doctor to administer the injections, other states allow other medical professionals (nurses and PAs) to work under a doctor’s supervision. Look for a provider with proven experience who meets the medical requirements for your location.Â
You won't need any actual recovery time. That said, it's very common to have bruising and swelling at the injection site, so you may want to take some social downtime. It can take a few days to a few weeks for these side effects to resolve.Â
Bruises can usually be hidden with makeup, but it's still not recommended to get fillers too close to a big event.
Avoid sun, heat, workouts, and alcohol for at least 24 hours after treatment, to avoid making the swelling worse. Some doctors on RealSelf also recommend arnica gel or cream, to reduce pain and swelling.
Fillers can last anywhere from six months to several years, depending on which one you get, how much your doctor uses, and how quickly your body metabolizes it. Some HA fillers can last up to 18 months, while Bellafill typically lasts for five years (and possibly longer).  Â
“If you have a fast metabolism, you may notice that the filler goes away sooner,” says Beverly Hills, California, plastic surgeon Dr. Nima Shemirani in his medical review forJuvéderm. “On the bright side, after two to three rounds of injections, you will notice it will last longer and longer.”
Filler longevity is proving to be more complex than originally thought, however. In recent years, imaging studies have revealed that HA fillers can last much longer than advertised, with gels being visible on MRI and ultrasound up to a decade or more after being placed. Certain parts of the face, like the under eyes, seem to retain old filler longer than others.
Related: Why Your Lip Filler May Not Last as Long as You Expected
Facial fillers that are properly injected don’t permanently alter the face or carry lasting consequences. However, when fillers are overdone—generally in a misguided attempt to “lift” a face—they can cause a host of problems.Â
While long-term effects of dermal fillers are rare, excessive HA fillers can distort the face, giving a cartoonish or alien appearance. They can attract and bind a lot of water, making the face look swollen, doughy, and otherwise unnatural.Â
Globs of cheek filler or lip filler can upset muscle mechanics, changing the shape of the eyes (especially when smiling), making the mouth move in an odd fashion, and even interfering with clear speech. Too much filler around the eyes can block lymphatic channels, causing persistent puffiness and bags.
Related: Do Fillers “Ruin” Your Face? Doctors Explain.
To avoid the issues associated with overfilling, choose an injector who takes a conservative approach and does not subscribe to the notion that fillers need to be topped off according to some prescribed schedule, as unnecessary touch-ups are a leading cause of pillow face.Â
Again, HA fillers have been shown to last longer than manufacturers claim—and you want to avoid layering new filler over old, time and again.
Dermal filler treatments are considered safe when performed by an experienced injector, but they all come with risks and side effects.
Related: Filler Gone Wrong: The Most Common Filler Mistakes Doctors See—and How to Avoid Them
A lot of people think injectable botulinum toxins like Botox and Dysport are fillers, but while both are cosmetic injections, they work in an entirely different way: while fillers add volume, neurotoxins like Botox relax muscles to smooth lines, wrinkles, and creases (and prevent more from forming).Â
Botox is FDA-approved to treat crow’s feet, frown lines, and forehead lines, and can be paired with fillers during the same appointment for optimal facial rejuvenation results. During your consult, discuss your aesthetic goals with your provider to see which treatment is a better option.
RealSelf Tip: A growing number of providers are microdosing patients with Botox and fillers by microneedling them into the superficial layers of skin via treatments like Aquagold. Learn the benefits of this treatment technique.
Related: Can Botox Lip Flips Be a Better Option Than Filler?
Updated October 21, 2022