American Society of Plastic Surgeons
For Medical Professionals
 

What are the different types of fillers?

Collagen is a natural protein that supports the skin. Injectable collagen formulas derived from human dermis include Cosmoderm® or Cosmoplast®. Zyderm® and Zyplast® are forms of bovine collagen that, unlike human derived collagen, require prior allergy testing. The results may last 2 to 4 months.

Hyaluronic Acid is a natural substance found in our bodies. It is well suited to plump thin lips and fill facial creases such as nasolabial folds. It may also be appropriate for some surface wrinkles and concave scars. The results may last 6 months or longer.

Hydroxylapatite is a mineral-like compound found naturally in human bones, suspended in a gel-like formulation. It is the heaviest of facial fillers and is recommended to fill deeper creases such as nasolabial folds, marionette lines and frown lines, as well as to enhance fullness of the cheeks and other facial contours.

Human fat, harvested from your own body, can be reinjected to enhance facial fullness, fill deep creases and to build up shallow contours. Fat injection requires a more extensive procedure than other injectable fillers because it uses liposuction techniques to extract the fat prior to injection.

PMMA (polymethylmethacrylate) fillers contain 20% tiny PMMA microspheres suspended in 80% purified collagen gel. An FDA-approved PMMA filler is recommended for the correction of facial wrinkles known as smile lines.

Treatment results last up to a year or more in some cases and are highly variable. (Fat can be stored for your own future treatment. The duration of results from preserved fat is not as favorable as fat used at the same time it is harvested.)

A note about the FDA and injectable fillers:

The U.S. Food and Drug Administration reviews and approves pharmaceutical fillers in the same manner as medical devices. However, some fillers may be used on an off-label basis, meaning they are approved medical treatments but not directly reviewed for a specific application. The options discussed in this brochure are among the current fillers preferred by plastic surgeons. Some are available for general use, others are not; regulatory status may be subject to change.

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