Making the Decision to Use Cosmetic Fillers


Elizabeth Hanes, RN    

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American doctor talking to woman in surgery

Even if you take great care of your skin by cleansing regularly and using SPF moisturizers, eventually your face, including your lips, will lose some of its fatty tissue. This normal part of the aging process leads to thinner, sagging skin, which in turn causes lines and skin folds to appear. One of the easiest ways to reduce the appearance of these lines and plump up thinning lips is to restore your facial volume through the use of cosmetic fillers (also called dermal fillers). Here’s what you need to know about these products.

1. Cosmetic fillers are approved for use by the United States Food and Drug Administration (FDA).

All types of cosmetic filler products offered by physicians have been approved for use by the FDA. In fact, even though most cosmetic fillers aren’t permanent, they are considered a “medical device implant.” This means these products have been subjected to rigorous testing for safety and efficacy. Of course, any medical procedure involves risk. But, generally speaking, cosmetic fillers are considered safe for most people.

2. Dermal fillers restore volume and treat large skin folds, not wrinkles.

While products like botulinum toxin are used to treat crow’s feet and other wrinkles, cosmetic fillers treat larger skin folds. The FDA has approved injectable dermal fillers to treat:

  • Narrow lips - to provide a plumper pout

  • Nasolabial folds - those lines that extend from the sides of your nose to your mouth, also called “laugh lines” or “smile lines”

  • Flattened cheeks - to restore volume and give an apple-cheeked appearance

  • Thin hands - to restore a more youthful appearance

3. There are four types of temporary fillers - and one permanent type.

Most women opt for temporary fillers. As soon as these products are injected, the body begins to absorb them. The effects of these fillers can last for up to two years, depending on the particular product you and your doctor choose. The four approved types of temporary fillers are:

  • Hyaluronic acid - one of the “original” cosmetic fillers. This product consists of long chains of polysaccharide bonds that combine with water to swell and smooth the skin. Hyaluronic acid fillers usually produce effects for up to one year.

  • Collagen - a natural protein made by the human body. Injectable collagen is derived from bovine (cow) cells, or sometimes from human cells. Collagen is rapidly absorbed by the body and only lasts a few months.

  • Calcium hydroxylapatite - a “second generation” cosmetic filler that uses microscopic mineral grains to support its filler effect. The effects of these fillers may last up to 18 months in the body.

  • Poly-L-lactic acid (PLLA) - a more-specialized filler that consists of the same type of material used in absorbable sutures. It generally is used for restoring facial volume and requires multiple injections to reach maximum effectiveness. Its effects can last up to two years.

The FDA has approved one type of permanent filler, called polymethylmethacrylate beads (PMMA microspheres), for filling in skin folds around the mouth. These microbeads cannot be absorbed by the body, nor can they be removed by a doctor. Many doctors will not inject you with a permanent cosmetic filler unless you have previously tried a temporary filler and approved of the effect it gives your face.

4. You may be able to get cosmetic filler injections in the time it normally takes to pick up lunch.

Dermatologists, plastic surgeons and specially-trained nurses administer cosmetic filler injections right in the office. Usually, the whole procedure takes only a few minutes. You can be back at work looking more youthful in the time it would normally take you to pop out for lunch.

5. Most side effects of cosmetic fillers are mild and temporary.

It’s impossible to receive an injection without a little pain, but most women tolerate the side effects of cosmetic filler injections with ease. The most commonly reported side effects occur immediately and go away within hours to days. These include:

  • Pain

  • Bruising

  • Redness

  • Swelling

  • Itching

You should call your doctor if you experience any of these more rare side effects:

  • Fever

  • Blurred vision

  • Loss of skin pigmentation

Cosmetic fillers are a generally safe way to turn back the clock on your facial appearance. Adding a bit of plumpness to your lips and smoothing out your laugh lines can help you look as young as you feel.

PHYSICIAN CONTRIBUTOR Close up of woman receiving injection in lips

Advances in Cosmetic Fillers

Dr. David Harvey talks about the latest opportunities for brightening up lips and aging gracefully with cosmetic fillers.
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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Feb 3, 2018

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Medical References

  1. Soft Tissue Fillers (Dermal Fillers). U.S. Food and Drug Administration.
  2. Filling In Wrinkles Safely. U.S. Food and Drug Administration.
  3. Dermal Fillers. American Society of Plastic Surgeons.