Injectable fillers are used to minimize wrinkles, lines, and scars, or to give the face a more desirable shape. Fillers are made from a variety of different substances. A qualified physician can determine which filler is best.

The U.S. Food and Drug Administration (FDA) has approved several temporary fillers, including:

  • Collagen
  • Hyaluronic acid (e.g., Restylane, Restylane Silk Injectable Gel)
  • Poly-L-lactic acid (e.g., Sculptra Aesthetic)
  • Calcium hydroxylapatite (e.g., Radiesse)

The smoothing effect of these injectable dermal fillers usually last about 6 months, longer in some cases. Artefill is a permanent filler approved by the FDA. While temporary fillers are eventually broken down and absorbed by the body, Artefill contains plastic particles (polymethylmethacrylate beads) that are not absorbed, providing long-lasting results.

Prior to treatment, the area is cleansed, an anesthetic is applied - if necessary - and the filler is injected under the skin using a tiny needle. If anesthetic is not used, patients may feel some discomfort or pain during the injections. Side effects, which include bleeding, pain, swelling, bruising, and infection, may be treated using ice packs or medications. Temporary fillers require multiple treatments over time.

Collagen Injections

Many patients feel that collagen injections are less painful than other types of injectable fillers. Side effects include redness, bruising, swelling, or stinging and burning at the injection sites, but many patients do not experience side effects. Following treatment, most recover within 3 hours. Collagen treatments usually are effective for 3 to 6 months.

There are risks involved with collagen treatments. Collagen can come from two sources—humans and cows. Approximately 3 percent of patients are allergic to collagen from cows and physicians normally perform skin tests before the actual procedure to make sure the patient is not allergic.

Patients who have a condition that affects the immune system (e.g., lupus, rheumatoid arthritis) should not receive collagen injections. Other risks include infection and unsatisfactory results (e.g., problems with the shape of the face).

Hyaluronic Acid Injections

Hyaluronic acid often is used to improve the contour of the skin and to enlarge the lips. The procedure used is similar to the procedure used for collagen injections. However, results generally last longer (about 6 months) and fewer patients experience allergic reactions.

One popular brand of hyaluronic acid, Restylane, was approved by the Food and Drug Administration (FDA) in 2003 and is commonly used to improve lines near the nose and lips. Complications (e.g., swelling, bruising) usually are minor and resolve quickly. The injections may be painful and some patients may require an anesthetic prior to treatment.

In June 2014, the FDA approved Restylane Silk Injectable Gel to increase the volume of the lips and smooth wrinkles around the mouth. Restylane Silk should not be used in people who have severe allergies, bleeding disorders, or sensitivity to local anesthesia (e.g., lidocaine).

Poly-L-lactic Acid Injections

Sculptra Aesthetic is the brand name of an injectable filler that contains poly-L-lactic acid, which comes from corn. This filler often is used in patients who have HIV and experience facial fat loss. It takes some time for the full effects of Sculptra to be noticeable, but once treatments are complete, the results can last 2 years.

Due to the risk for an allergic reaction to ingredients in the filler, the patient's medical history should be reviewed thoroughly before Sculptra treatments.

Patients who have been treated with Sculptra may develop small bumps beneath the skin of the treatment area, often 6 months to a year after treatment. Although these bumps may disappear by themselves, it is recommended that patients who experience them see a dermatologist to rule out infection.

Calcium Hydroxylapatite Injections

Calcium hydroxylapatite is a mineral-like compound found naturally in bones. This produce is made without using animal products. Radiesse produces natural results. Side effects are rare and include swelling and redness at the injection site.

Calcium hydroxylapatite also may be used in people with HIV who suffer from facial fat loss (lipoatrophy) - a possible side effect of certain antiretroviral drugs.

Serious Side Effects of Injectable Fillers

According to the FDA, approved dermal fillers are generally safe and provide satisfactory results. Rare, but serious side effects can include:

  • Scarring
  • Blurred vision/partial vision loss
  • Severe allergic reaction

Injectable fillers should not be used in people with severe allergies, bleeding disorders, or active inflammatory conditions like cysts, severe acne, or rashes, and those who are predisposed to excessive scarring.

The FDA warns that injectable fillers may not be safe for use in women who are pregnant or breastfeeding, people under the age of 18, or in combination with other cosmetic procedures like BOTOX injections. Talk to your health care provider about the expected results and possible side effects before undergoing treatment. Do not purchase dermal fillers online.

Updated by Remedy Health Media

Publication Review By: the Editorial Staff at

Published: 27 Jul 2006

Last Modified: 19 Nov 2014