Not every wrinkle-filler is right for every type of wrinkle. The least risks and best results come from using the right one correctly. That’s why you should only have fillers injected by a board-certified dermatologist or plastic surgeon with ongoing, special training.

Here is a breakdown of available wrinkle fillers. It includes their basic ingredients, how they work, their pros and cons, and the best areas for treatment. Your doctor can help you choose the right one for you.

Hyaluronic Acid Wrinkle Fillers

How long the results last varies from several months to over a year or two. Some research shows that repeated injections may help stimulate the body’s own natural production of collagen. That will help reduce the number of lines and wrinkles. There is also some evidence that less filler is needed over time to achieve the same look.

Hyaluronic wrinkle fillers include:

• Belotero Balance
• Captique
• Elevess
• HylaForm
• Juvederm 24HV
• Juvederm 30
• Juvederm 30HV
• Juvederm Ultra
• Juvederm Ultra Plus
• Juvederm Voluma XC
• Perlane
• Perlane-L
• Prevelle Silk
• Restylane
• Restylane-L
• Restylane Silk

Synthetic Wrinkle Fillers

This smaller category of wrinkle fillers includes lab-made substances that are not related to anything found naturally in the skin.

All the fillers in this group have similar side effects, such as redness, swelling, or bruising at the site of the injection. Other side effects include nodules or bumps under the skin that can be seen and felt and that, in rare instances, may require surgery to remove.

The benefits include a longer-lasting effect. And at least one filler offers permanent filling of lines and creases. Remember, products with longer-lasting effects are more likely to cause side effects. And when not used correctly, synthetic wrinkle fillers may cause disfigurement.

Synthetic wrinkle fillers include:

• Radiesse
• Sculptra
• Silicone

Collagen Wrinkle Fillers

Scientists made the first wrinkle fillers from a purified form of collagen extracted mostly from cows. Although it worked well and offered a natural-looking fill, the results didn’t last long. Most collagen injections began to break down as early as 1 month after treatment. Because these wrinkle fillers were made from an animal source, they also had a higher rate of allergic reaction and required allergy testing beforehand.

New ways of processing the collagen have helped lower the risks. Plus, new forms of synthetic collagens are making these injections safer and more useful to a wider range of people. Although the results don’t last as long as other wrinkle fillers, many believe the results are more natural looking.

Side effects of collagen injections include some risk of allergic reaction (mostly for those still using cow sources), as well as bruising and redness at the site of the injection.

Collagen injections include:

• ArteFill
• Cosmoderm
• Evolence
• Fibrel
• Zyderm
• Zyplast

Autologous Wrinkle Fillers

Fat is the most commonly used substance in this category. Your own fat is surgically removed from your thighs, buttocks, or stomach, treated, then injected. You will need to have two procedures (one to remove the fat and one to inject it). Both procedures can be done in one visit. Additional fat purification steps done in the lab can be costly and time-consuming. Results can be semi-permanent, although you may need a series of injections done over time.

Platelet-rich plasma injections (“vampire lift”) are another type of autologous wrinkle filler/volumizer. Blood is drawn from the arm, treated, then injected into the face. The effects can last 12 to 18 months.

Risks are similar to other wrinkle fillers, including bruising, redness, and swelling at the site of the injection. Because the fillers come from your body, these injections do not require FDA approval.

Minimizing Risks and Increasing Good Outcomes for All Wrinkle Fillers

Wrinkle fillers are among the safest cosmetic procedures in use today. But there are things you can do to help ensure your treatment is safe:

• Don’t let price be your guide. If you are offered a wrinkle filler treatment that costs far less than the standard treatment, it’s likely some compromises are being made, either in the skill of the provider or the quality of the product. Never risk making a bargain with your face.
• All wrinkle fillers should be done in a medical setting with sterile instruments. Treatments done in homes, hotels, spas, or resorts are not being done in medical environments, regardless of who is doing them.
• Do not get injectable wrinkle fillers from sources outside a doctor’s office. Know what you are being injected with, and ask your doctor if an FDA-approved wrinkle filler is being used and if it was purchased directly from the maker. There have been reports of everything from industrial-grade silicone to baby oil being used. If a provider won’t give you this information, don’t let them do the procedure.
• Use sunscreen daily to help preserve the filler and help protect against post-inflammatory pigment changes due to the needle sticks from injections.