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Lawrence A. Schiffman, D.O., FAOCD - Board Certified Dermatologist

Lawrence A. Schiffman, D.O., FAOCD - Board Certified Dermatologist


The Different Types of Dermal Fillers and How They Can Help You

Published October 4th, 2021 by Thepracticeagency

Dermal fillers are on the rise, and an estimated 2.6 million people got this procedure in 2016 compared to 1.8 million people in 2010.

If you have heard of dermal fillers but don't know what they're made of or how it works, you came to the right place. 

Read on to learn about the benefits of fillers and how they can improve your appearance. 

What Are Dermal Fillers?

Derma fillers are a gel-like substance injected into specific areas of the body by a professional healthcare provider. The primary purpose of fillers is to smooth wrinkles, restore volume, enhance the structure of the face, or fill in scars. 

Your dermatologist will inject the filler into areas of your skin that have lost volume. Once injected, you can begin to see your skin regain its youthfulness. 

What Are Fillers Made Of?

Although there are a few different types of fillers, most of them have hyaluronic acid as their main ingredient. Hyaluronic acid is a substance that we can naturally find in our bodies, which binds to water. 

Because they're mostly made of hyaluronic acid, most fillers are reversible and will lose their effectiveness over time. 

Types of Dermal Fillers

As we mentioned earlier, most fillers are made with hyaluronic acid, but there are a few other formulas dermatologists, and other providers use. These are a few of the most common types of fillers. 

Calcium Hydroxylapatite

The brand name of calcium hydroxyapatite (CH)is Radiesse. CH is a mineral compound found in our bones. Because CH is a biosynthetically produced filler, it's free of animal products or testing. 

People with allergies prefer to use CH because it lowers their chances of having an allergic reaction. 

Before it was used as a dermal filler, it was commonly used in reconstructive surgery and dentistry. 

The most popular uses of CH include enhancing the fullness of the cheeks, nasolabial folds, frown lines, and marionette lines. It can also help add volume in people who have facial wasting due to HIV or those taking certain medications.

Hyaluronic Acid

As we mentioned before, hyaluronic acid (HA) is one of the most common types of fillers. Several brands, such as Juvederm, Puragen, Captique, Hylaform, and others, use HA. 

In the body, you can find high concentrations of HA in the soft connective tissues, joint fluids, cartilage, and the fluid around your eyes. 

Not only is it common as a dermal filler, but doctors inject it into the aching joints of those who have arthritis. 

HA fillers improve the appearance of acne scars, smoker's lines, marionette lines, crow's feet, and cheek depressions. 


The brand name of Polyalkylimide is Aquamid. Aquamid is another biocompatible substance that does not activate allergies and does not require allergy testing. 

It's also a transparent substance, and it won't interfere or show up on x-rays. Once the Aquamid gets injected into the skin, collagen will slowly begin to form, filling in the area and adding volume to the skin. 

Because a high dose of Aquamid can be injected in a single procedure, plastic surgeons and dermatologists use it to treat facial wasting due to HIV, add volume to thin lips, deeper wrinkles, and slightly modify jawlines and cheekbones. 

Polylactic Acid

Also known as its brand name Sculptra, polylactic acid has been used for more than 40 years as a biodegradable suture material. Unlike other fillers that show immediate results, you will have to wait between four to six weeks to see results from Sculptra. 

It takes several weeks to see results from Sculptra because rather than filling in the area, it stimulates collagen production. 

This fillet is also considered a semi-permanent filler since it stimulates your body's production of collagen. You will need three treatments once a month and occasional touch-ups, but the effects are long-lasting. 

If you want to enhance thin lips, deep nasolabial folds, or laugh lines, Sculptra is the best product. 

Polymethyl-Methacrylate Microspheres 

Polymethyl-Methacrylate Microspheres, also known as Bellafill, is another semi-permanent filler recommended to treat medium and deep wrinkles, nasolabial folds, thin lips, and furrows. Dermatologists also use Bellafill on pitted scars in the face. 

Bellafill is a top option for those looking for a more permanent filler that doesn't require quite as much touch-up. Like Sculptra, it can take up to three months for people to see results with Bellafill. 

The downside to Bellafill is that it can be visible under the skin and create unwanted results. To avoid Bellafill showing under the skin, you must choose a provider familiar with working with this filler. 

The proper way to inject Bellafill is using it in junction with tunneling or threading methods.

Areas Dermal Fillers Treat

Although it's a common belief that dermal fillers are primarily used in the face, fillers can serve many different purposes. For the most part, dermatologists and plastic surgeons can use dermal fillers in different parts of the body.

Chest: If your chest has suffered sun damage and has visible wrinkles, fillers can help you improve its appearance. Many providers will use Sculptra to stimulate collagen production and reverse the damage. 

Hands: Even if you take care of your face, wear sunscreen and apply filler, your hands can often reveal your age. The signs of aging on your hands include visible veins and tendons and loss of fat. 

Any filler that can help with facial wasting can be used on the hands to improve signs of aging. 

Under Eyes: Many people suffer from dark circles and hollow under eyes due to aging and lack of sleep. The right filler can help give your under eyes a rested and youthful appearance. 

Thighs: An estimated 90% of women and 10% of men suffer from cellulite. Cellulite is a pesky problem for many people and nearly impossible to get rid of. Filler can help improve the appearance of cellulite. 

Are You Ready to Give Dermal Fillers a Try?

Now that you know about the most common types of dermal fillers and their uses, it's time to talk to your dermatologist or plastic surgeon. 

Although facial fillers are not a permanent solution, they can significantly improve the signs of aging around the lips, under eyes, jawline, and even hands and thighs. 

Are you in the Miami area looking for a board certified dermatologist? Contact us today to learn more or schedule an appointment.

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What Are Facial Fillers and Why Are They So Popular?

Published July 12th, 2021 by Thepracticeagency

Over the past three decades, facial fillers have become one of the most popular and widely sought-after cosmetic treatments. You've probably noticed the impossibly ageless influencers flooding your Instagram feed for years.

If you're considering jumping on the filler bandwagon, you'll be glad to know the stigma of facial injections is long gone. What you may not know is what types of fillers are right for you, your skin, and your budget.

You'll also want to be well-versed in the best (and worst) places to apply facial fillers. Whenever you're planning to inject something into your body, it's important to do your research first.

Luckily, we've done the research for you.

A Brief History of Fillers

If you want to understand the speedy rise in popularity of the facial filler, you'll need to start at the beginning.

The history of facial fillers begins in the early 1990s. The original facial filler ingredient was collagen taken from cows. It was injected via syringe and the results lasted for only a few months.

In the early years of facial fillers, the topic was quite taboo. Fillers were not subtle like they are today. They were used to alter appearances in a significant way.

In 2003, facial fillers as they are known today came onto the scene. The first hyaluronic acid injectable, Restylane, gained approval from the FDA. It wasn't until then that fillers became a commonplace topic in the cosmetic industry.

In 2004 poly-L-lactic acid arrived. People loved it because the effects of the injections lasted for years rather than months. In 2007 mixing lidocaine with facial fillers became a popular way to decrease the pain of injection.

By 2011 we had Belotero Balance, a hyaluronic acid filler so soft it resisted clumping or bumps. This made it possible to smooth even the shallow lines around eyes and lips.

In 2015 Kylie Jenner shared her lip filler journey with the world. After that, lip fillers became one of the most common cosmetic treatments. We were off to the races. Facial injections had officially gone from taboo to trendy.

What Do Facial Fillers Do?

Facial fillers are gelatinous substances injected underneath the skin by a licensed cosmetic dermatologist

The majority of clients seek out facial fillers to reduce signs of aging. As we get older, our facial tissues become thinner. We develop lines around our eyes, nose, and mouth. Our cheeks also tend to hollow out as we age.

Facial fillers fill in those smile lines, plump up your cheeks, and smooth out wrinkles. Basically, they return to us our youthful fullness, smoothness, and confidence.

Others use facial fillers to enhance the natural contours of their face.

Types of Facial Filler Injections

Every person's skin is different and every type of skin responds best to different things. When deciding what type of filler to get, make sure you choose what is right for you.

Poly-L-lactic Acid

Poly-L-lactic acid is a synthetic substance that is safe to use inside the body. It is the same substance used to make stitches that dissolve. Poly-L-lactic acid smoothes fine lines by regenerating the skin's natural collagen.

The results of poly-L-lactic acid can last over two years. It is great for filling in deep wrinkles. Sculptra is a popular brand of filler that uses poly-L-lactic acid.

Hyaluronic Acid

Hyaluronic acid is used in many of the most popular facial fillers because it is a natural sugar found in the body. It helps to moisturize the skin and give it more volume and elasticity.

The results of hyaluronic acid fillers last from six to 12 months. After that, the body's natural processes absorb the filler. The fillers Juvéderm and Restylane are made from hyaluronic acid.

Calcium Hydroxylapatite

Calcium hydroxyapatite also occurs naturally in the body. It is found mostly in the bones and helps to boost the body's production of collagen.

The results of using calcium hydroxyapatite last for about 12 months on average. Radiesse is a nonreversible filler made from calcium hydroxylapatite.

Autologous Fat Injections

Fat injections are a unique type of facial filler because they require a minor surgery. To create a facial filler from fat, a cosmetic surgeon harvests fat from another part of your body. 

They purify the fat and then inject it into the face to add volume and smooth out wrinkles.


Neurotoxins are not facial fillers. They are injectable forms of protein that help to relax the muscles of the face. When we contract our facial muscles, wrinkles form over time.

Neurotoxins relax and temporarily paralyze the muscles of the face, causing fine lines and wrinkles to smooth out. Botox is an example of a very common neurotoxin.

Best Spots to Apply Facial Fillers

Where you decide to apply facial fillers depends on your skin type and the results you want to achieve. The most traditional and effective areas to inject facial fillers are the lips, cheeks, and nose.

Fillers can also soften the lines at the corners of the mouth. Many people use facial fillers to reduce the appearance of smoker's lines or to fill in acne scars.

The following is a breakdown of the most common places to apply filler and which types of facial fillers are best for each area.

  • Smooth brow furrows, crow's feet, and frown lines (Botox or other neurotoxins)
  • Smooth under the eyes and tear troughs (Juvéderm, Restylane, fat injections)
  • Lift and plump cheeks (Restylane)
  • Smooth marionette lines (Juvéderm, Restylane)
  • Plump lips (Juvéderm, fat injections)
  • Soften nasolabial folds (Juvéderm, Restylane, Radiesse, Sculptura)
  • Smooth vertical lip lines (Juvéderm)
  • Smooth chin wrinkles (Juvéderm, Restylane, Radiesse)
  • Fill acne scars (Juvéderm, Radiesse)

What to Expect During Treatment

The first thing you will do is meet with a cosmetic dermatologist or cosmetic surgeon to discuss your facial filler treatment options and desired outcomes. This is called a pre-treatment consultation.

You'll also go over your medical history, allergies, concerns, medications, as well as your skin and neurological conditions with the dermatologist. This is important to determine what filler is best suited and safest for your skin.

During the treatment, the cosmetic surgeon will clean the area of your skin. They may also apply a topical ointment to make the area numb so you don't feel discomfort.

Then the cosmetic surgeon will inject the filler underneath your skin. You will likely see results right away. This can depend on the type of filler.

You may experience slight bruising and swelling over the next couple of days. Any reaction your skin has should be temporary.

You can expect to return to your regular activities immediately, but it's always best to take a day to rest.

Finding the Right Practitioner

When preparing for any treatment involving facial fillers, it is important to consult an experienced, licensed skincare professional. If you live in the Miami area, that trusted professional is the Miami Skin Dr.

Lawrence A. Schiffman, D.O., FAOCD is a board-certified dermatologist with over a decade of experience specializing in skin, hair, and nails. Book an appointment today at either the Aventura or Doral Miami Skin Dr. offices.

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