• Skin Worthy

The Best Types of Filler & How to Choose!

First and foremost, there is no one BEST filler and secondly don’t worry about which one to choose, leave that up to the pros!

Dermal fillers are becoming one of the most widely sought after cosmetic treatments. We are a busy clinic and we are always getting so many inquiries about dermal filler. The three most common questions I get with filler inquires:


-How much is a syringe? -Which brand/product line do you carry? -Can I use the leftover filler in my nose/lips/smile lines, ect. ?

With the excitement surrounding dermal fillers also comes so much stress around a patient having a good first experience with their treatment. Multiple google searches, a visit to realself.com, finding out what products their friends had, how much they had injected, and finally the collection of saved instagram posts of what they want (I do this all the time too) . Then finally comes the most important part- the consultation….and here's where you learn all about the process, we assess your goals, realities of what is achievable with your anatomy and finally the risks!


First let's quickly go over dermal fillers as there are many types: Hyaluronic Acid (Juvéderm, Teoxane, Belotero, Restylane, and many others) , Polylactic acid (Sculptra) , Calcium hydroxylapatite (Radiesse) , and polymethylmethacrylate or PMMA (Bellafill). All of these filler have different qualities, longevities and safety profiles. In today's blog post we will focus on the most popular and safest of dermal fillers which are made from hyaluronic acid.


As mentioned above, the most common type of facial filler is hyaluronic acid (HA) – a naturally occurring sugar found in areas of the body such as eyeballs, joints and skin. HA can hold 1000x its weight in water. Hyaluronic facial fillers help to maintain shape, even out depressions in the skin and provide hydration. It is a clear gel in appearance, and typically comes in a 1 ml syringe, which is only 1/5th of a teaspoon!






As we get older our bodies stop producing collagen and elastin, both of which contribute to our youthful looks.  Experts argue over when we start losing collagen; but the generally agreed upon age is around 25 and even worse, our collagen and elastin levels then decline at a rate of about 1-2% per year. AWESOME.


Here’s where we (the experts), come in as things get more complex than just the best price, most popular brand, or a desired outcome.


Hyaluronic acid fillers differ in the following ways:

  • come in different brands

  • have unique qualities in how they are produced

  • come in different thickness/firmness

  • draw hydration differently

  • can behave differently depending on what layer of the face they are placed


Then the trickiest part of all, patients all have different anatomy, tissues, and perhaps medical conditions that are brought to the injectors table. So things get complex. However it's important for patients to have a general idea on how these fillers work and how your injector will select the best filler for you.

To hugely over simplify the differences in filler we can categorize them into different sizes/stiffnesses, let's call these:

  • small/soft

  • medium/malleable

  • large/ firm

Now within these categories we have further division, and options, but we will save that discussion for your consultation. Let's go over each of these categories.


Small/Soft Molecule Dermal Fillers:

The bonds that hold the HA molecules together are more loosely knit, and there are less of them. This makes the quality of this filler more watery and thin, and this type of filler can be placed more superficially in the tissues, and in areas of thin skin. This type of filler can draw a lot of water, and can be used as a skin hydrator. Common uses for this type of filler is areas such as the tear troughs, necklace bands, barcode/lip lines, or as a lip hydrator itself. This type of filler won't bring structure, but instead can create a blurring or finessing appearance to the skin.








Medium/Malleable Molecule Dermal Fillers:

This type of filler is still considered relatively soft. The HA molecules and bonds holding them together are still flexible in nature, however they are now held closer together, where they are slowly adding some structure to the tissues. These types of fillers will be injected a little deeper, can start for lift soft depressions in the skin, and give soft natural volume. Common areas where these types of fillers are used are lips, nasolabial folds, the superficial temple, and the marionette.








Large/Firm Molecule Dermal Fillers:

These are the firmest, and most densely knit molecules of HA. These fillers are what we call the “lifters” of the bunch, and we use these in deep planes such as bone or deep fat pad replacement. These fillers tend to draw the least amount of water, and we depend on the concentration of the HA molecules to create volume, projection and foundation replacement. We tend to start with these fillers first in any patient where we have structure loss. Once these fillers are injected it is as if we are placing anchor in the skin that can provide tension on the tissues and start to drape the skin in the same way it looked in our more youthful years.





To summarize, each dermal filler has different physicochemical properties and works to achieve specific goals in certain anatomical areas, there isn't one magic filler. How we choose the ‘best ‘ product for our patients depends on our understanding of product we have tested, and your individual skin nuances—how much sun damage you have, for instance, or how elastic or inelastic your skin is. Keep in mind that what works for your friend may not be the best option for you. Every practitioner has different philosophies, techniques, and levels of experience. Be sure you and your injector communicate about realistic results and your expectations—it's your face, after all.


Can't wait to meet and educate you so much more on dermal fillers! 


- Barb



At Skin Worthy, we value educating our patients on their treatments and the products that are used, we encourage you to come in for a complimentary consultation. We will discuss your goals, assess your skin and decide the best plan of action for your specific needs.

call Skin Worthy 647-350-7546 to book your consultation today!



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