Skip to content

Dermal Fillers: A Review of Absorbable and Non-absorbable Skin Fillers

Dermal fillers used for cosmetic purposes have gained a significant amount of popularity in recent times. These fillers are an effective means of augmenting facial features by reducing the visibility of fine lines and wrinkles while adding volume to the face. Dermal fillers comprise various elements, including calcium hydroxylapatite, hyaluronic acid, and collagen, which are injected into the skin to make wrinkles and lines less prominent.

People are increasingly opting for non-surgical procedures like dermal fillers to acquire a youthful and revitalized appearance. These fillers have a broad range of applications and can be used to augment the lips, plump up cheeks, diminish wrinkles and fine lines on the face, and even enhance the appearance of scars and other skin flaws.

The popularity of dermal fillers can be attributed to several factors. First and foremost, they are non-surgical, which means that there is no recovery time or downtime associated with the procedure. This makes them an attractive option for people who want to achieve a more youthful appearance without the risks and recovery time associated with surgery. Additionally, dermal fillers are relatively quick and easy to administer, with most procedures taking less than an hour to complete.

Dermal Fillers: What are they? How they work? Side effects, cost and reviews.

Safety during cosmetic procedures, as well as the effectiveness of the formulas, is strictly controlled by FDA – Food and Drug Administration. They set the rules and regulations of injecting “cosmetic dermal fillers” having based their approval on supervised clinical studies.(1) We can choose from a broad variety of options without having to worry about any serious side effects or adversities – we can freely enjoy what modern cosmetic dermatology has to offer. (2) Let’s take a closer look at some of the most popular FDA – approved dermal fillers.

We can divide FDA – approved cosmetic fillers into two important categories: the fillers containing materials that are absorbed by the body over time and the fillers containing non – absorbable ingredients. (3) Currently, when it comes to the latter, FDA allows only one non – absorbable filler but we are going to come back to that later. Furthermore, some of them have adjunctive lidocaine as a safe local anesthetic to provide maximal comfort and minimal pain during the procedure. More on how cosmetic fillers work.


Hyaluronic Acid

Hyaluronic acid is a glycosaminoglycan (sugar) molecule which is a 100% natural component of our skin. It has an extremely high amount of binding sites so it can accumulate a truly immense volume of water in one place. For the same reasons, it gives the skin hydration, moisture, smoothness as well as the aforementioned volume. Its injections’ effects last mainly up to 9 – 12 months however they can last even longer than that before hyaluronic acid gets completely absorbed by the skin. (4)

Cosmetic Dermatology Treatments
  • Hyaluronic acid fillers with addittion of lidocaine: Restylane Lyft with Lidocaine, RHA 2, RHA 3, RHA 4, Revanesse Versa +, Juvederm Volbella XC, Restylane Lyft with Lidocaine, Restylane Silk, Juvederm Voluma XC, Restylane Injectable Gel, Juvederm Ultra XC, Juvederm Ultra Plus XC, Prevelle Silk, Elevess
  • Fillers with only hyaluronic acid: Revanesse Versa, Juvederm Vollure XC, Belotero Balance, Restylane Injectable Gel, Juvederm 24HV, Juvederm 30, Juvederm 30HV, Restylane Injectable Gel, Captique Injectable Gel

What is the difference: Juvederm vs. Restylane

The hyaluronic acid fillers with lidocaine are injected into the deep dermis and the superficial subcutaneous tissue (the 2nd and the 3rd skin layers) usually for the correction of moderate to severe facial folds and wrinkles such as the nasolabial folds or wrinkles around the mouth (perioral rhytids). They are also used for lip and cheek augmentation as well as replenishing the volume deficit due to aging or other conditions. The youngest allowed age is 21 years old.

Simple hyaluronic acid fillers are indicated for similar purposes – the correction of moderate to severe facial wrinkles and folds, especially the nasolabial folds and lip augmentation. Being 21 is yet again a requirement however these formulas are injected into the mid to deep dermis, not embracing the subcutaneous tissue. Learn about the most popular dermal fillers.

There are over 2,500,000 cosmetic procedures per year.

Collagen Fillers

Cosmetic Dermatology: Dermal Fillers

Collagen is another natural substance that is present in our skin, if only there. It is a building protein that gives firmness and elasticy. (5) Additionally, it stabilizes blood vessels in the skin so they aren’t as fragile and susceptible to damage. The effects of collagen fillers generally last for 3 – 4 months.

– Collagen fillers: Evolence Collagen Filler, Cosmoderm 1 Human – Based C, Fibrel, Zyplast (R), Zyderm Collagen Implant

Likewise, they are used in the correction of moderate to deep facial wrinkles and folds (the nasolabial folds in particular), nontheless they can be applied differently: in the correction of acne scars or contour deficiencies. They are injected in the superficial layer of the dermis called the papillary dermis.

Calcium Hydroxylapatite

Calcium hydroxylapatite is found in human teeth and bones. There, it gives them structure and density. That’s why fillers with this ingredient are often used in lipoatrophy (facial fat loss) to restore volume in the face or even in the dorsum of the hands. Moreover, they also work well in correcting moderate to severe facial wrinkles and folds, yet again with emphasis put on the nasolabial folds. The effects last for approximately 18 months.

  • Calcium Hydroxylapatite fillers: Radiesse 1.3CC, Radiesse 0.3CC, Radiesse

PLLA Poly – L – Lactic Acid

This one is man – made however it is completely compatible with the human skin as well as totally biodegradable. The injections are given in a series over a period of several months so that the effects become more and more visible with time. The results last up to 2 years.

Since PLLA is used as a constituent of stitches, it has to supply with cohesion, density but also be skin – friendly. Therefore it is great in facial atrophy restoration as well as in the correction of the nasolabial folds and other facial wrinkles.


PMMA Polymethylmethacrylate

Polymethylmethacrylate (PMMA) is a synthetic, biocompatible polymer that is used in a variety of medical and cosmetic applications. In the field of cosmetic medicine, PMMA is often used as a dermal filler to add volume and smooth out wrinkles and lines in the skin. It is a transparent and colorless material that is commonly used in a variety of medical and industrial applications.

In the medical field, PMMA is most commonly used as a bone cement for the fixation of artificial joints, particularly in the hip and knee. It is also used in the construction of craniofacial prosthetics, such as artificial eyes and ears. PMMA is also used in the manufacture of dental prosthetics, such as dentures and crowns, and in the production of contact lenses.

PMMA has several properties that make it suitable for use in medical applications. It is biocompatible, meaning that it does not produce any adverse reactions when it comes into contact with living tissue. It is also resistant to degradation by enzymes and other biological substances, making it durable and long-lasting. PMMA is also strong and rigid, which makes it suitable for use in load-bearing applications, such as in the fixation of artificial joints.

PMMA is prepared by the polymerization of methyl methacrylate, a monomer that is derived from the petrochemical industry. The polymerization process involves the addition of a chemical initiator, such as benzoyl peroxide, to a solution of methyl methacrylate. The initiator acts as a catalyst, causing the monomers to react with each other and form long chains of polymer molecules. The resulting polymer is then purified and molded into the desired shape.

PMMA fillers are injectable products that are used to add volume to specific areas of the face, such as the cheeks, lips, and nasolabial folds (lines running from the nose to the corners of the mouth). The procedure is generally quick and relatively painless, and the results are immediate.

One of the main advantages of PMMA fillers is their longevity. Unlike hyaluronic acid fillers, which typically last 6-12 months, PMMA fillers can last for up to 2 years or longer. This makes them a good option for those looking for longer-lasting results without the need for frequent touch-up treatments.

  • PMMA filler: Artefill

With addition of collagen and lidocaine, its only indication is the correction of the facial wrinkles and folds around the mouth, including the well – known nasolabial folds.


The indications listed above are approved by FDA.


Every medical procedure has its smaller or bigger side effects; moreover, such misfortunes mostly do not happen, especially concerning cosmetic fillers.

The more common side effects which are likely to subside with time:

  • redness
  • swelling
  • pain
  • bruising
  • tenderness
  • irritation/itching/rash.

The less common side effects:

  • allergic reaction
  • wounds
  • infection
  • newly – formed bumps (nodules or granulomas) which may need surgical intervention.

Dermal Fillers References

  1. Beware What You Inject: Complications of Injectables—Dermal Fillers
  2. Dermal Fillers (Soft Tissue Fillers)

1 thought on “Dermal Fillers: A Review of Absorbable and Non-absorbable Skin Fillers”

  1. important to stress the significance of bio compatible products over others. We have seen some get burned by using other things that have turned out to have poorer cosmetic effect and increased risk

Leave a Reply

Your email address will not be published. Required fields are marked *