The use of soft tissue fillers began in the late 1800’s, with the use of transplanted fat to correct cosmetic deformities. In the early 1900’s, injectable paraffin was popular, followed by silicone in the 1940’s. Both had undesirable side effects. Bovine collagen received FDA approval in 1981, and requiring allergy testing and had short duration.
The first hyaluronic acid (HA) filler was FDA approved in 2003. HA fillers are easy to use, last longer than collagen, and don’t require allergy testing. Juvederm, Restylane, and Perlane are commonly used HA’s for replacing volume and softening folds in the areas above and below the mouth, lips, and under the eyes, and typically last 6 to 12 months. Voluma, also an HA, is FDA approved to last up to 2 years and is the first HA approved for mid-face volume replacement for achieving cheek lift.
Radiesse is calcium based filler that may be used for deeper lines. Sculptra is a collagen stimulator that is considered semi-permanent and is used for more severe facial fat loss due to illness or aging. Artefill is another type of filler that provides structure and firmness to the skin.
The choice of fillers used will depend on the needs of the patient, the correction desired, and the preference and experience of the provider.