The 411 on Fillers

Many of you have been writing in asking about the latest injectables to hit the market.  Xeomin vs. Botox, Restylan, Sculptra, Radiesse... etc.  While I haven't tried fillers myself,  I do have the answers for you thanks to Dr. Terrence Keaney, a board-certified dermatologist and an Assistant Clinical Professor of Dermatology at The George Washington University in Washington D.C.


There are so many different types of dermal fillers and injectables on the market today.  What are the most common and how do they differ? 

The dermal filler market is predominately composed by hyaluronic acid ("HA") dermal fillers (Belotero, Restylane, Juvederm) vs collagen stimulator dermal fillers (Radiesse and Sculptra).  HA fillers are composed of different concentrations of crosslinked HA, a naturally occurring molecule found throughtout the body including the skin. HA fillers provide volume to the areas of the face where they are injected and are slowly metabolized over time. Radiesse works by stimulating the skin to produce to new collagen over time, it has more versatility in treating different areas  - including the face and hands -  and can have a longer duration of action. 

How does someone know which filler is right for them?

There are many fillers on the market with very different properties.  Given the complexity of the different products, patients should not be deciding what filler is best for them.  Every face is different and a combination of filler products may be needed for optimal outcome.  That is why is critical that patients choose experienced aesthetic physicians to evaluate their face and create an appropriate, natural treatment plan. Experienced physicians also are more skilled at product placement and identification/treatment of any side effects. 

What factors play into how long they last?

Depends on the type of the product.  HA fillers tend to vary due to the degree of HA crosslinking.  Radiesse’s duration depends on the patient's new collagen creation in response to the product – but often lasts more than a year.

When investing in fillers, what should one be aware of?

Patients should have appropriate treatment expectations.  The treatment goal should be to achieve a natural result that respects the patient's anatomy, age, gender, etc.  Radical transformation to look like someone else should not be expected and could lead to unnatural results and side effects.