What are Dermal Fillers, and How are They Used?

Injectable dermal fillers are soft tissue and wrinkle fillers approved by FDA as medical devices. Generally, these products are injected into the skin to help fill in facial wrinkles, restoring a smoother appearance. In addition, fat taken from other body areas is often used with the same goals. Alexander says that most of the fillers achieve a smoothing or filling effect, which lasts for about six months or longer in most people.

FDA has approved only one permanent wrinkle filler, which contains the polymethylmethacrylate beads. These are tiny round, smooth, biocompatible plastic particles that are not absorbed by the body. The filler is FDA-approved only for correcting facial tissue around the mouth.

In addition, FDA has approved a number of injectable dermal fillers that are temporary because the body eventually absorbs them. These products are used for correcting soft tissue defects in the face, such as moderate to severe facial wrinkles and skin folds, lip and cheek augmentation, and to restore or correct the signs of facial fat loss in people with human immunodeficiency virus (HIV). Not all products have been approved for the indications mentioned above. Please refer to the FDA's list of approved dermal fillers for more information on a specific dermal filler.

These temporary fillers include the following materials:

  • Collagen injections, made of highly purified cow or human collagen
  • Hyaluronic acid gel, a protective lubricating gel, produced naturally by the body
  • Calcium hydroxylapatite, a mineral and a major component of bone
  • Poly-L-lactic acid (PLLA), a biodegradable, biocompatible, synthetic material

FDA has not approved dermal fillers for increasing breast or buttock size or for injections anywhere else than the face.

What are the Risks?

"As with any medical procedure, being injected with dermal fillers poses some risks," Alexander says. "You should ask what you can expect and contact your health care professional if you are concerned about a particular side effect."

The most common side effects include:

  • bruising
  • redness
  • swelling
  • pain
  • itching

Additional side effects less commonly reported include:

  • infections
  • lumps and bumps
  • discoloration or change in pigmentation

What About Botox?

Botox Cosmetic and other botulinum toxin type A products such as Dysport and Xeomin are indicated for treatment of wrinkles. They are injectable drugs, but not dermal fillers. They work by keeping muscles from tightening so the wrinkles don't show as much. FDA has approved these products only for the temporary improvement in the appearance of frown lines and crow's feet.