Guide to Wrinkle Fillers – Which is the best Wrinkle Filler?

You may already use some type of anti-wrinkle product on your face. Have you considered a wrinkle filler? Do you know anything about them and how they work?

We have all heard about Botox® injections – Botox® has been in the news for years. It has many cosmetic uses but did you know that Botox® is less useful as an anti-wrinkle treatment than some other products?

Botox® is a brand of botulinum toxin (another is Dysport®) that works by relaxing the muscles in the face that cause skin to fold or wrinkle. It is very effective for frown lines between the eyes, crow’s feet lines, and forehead lines. If, however, your wrinkles are not caused by repetitive muscle movements, it is unlikely that Botox® will have much effect. Results from Botox® last several months. Bruising is less common than with dermal fillers and the cost of Botox® is generally $400 to $600 per area treated.

Injectible dermal fillers to treat other types of facial wrinkles are growing in popularity. The products in this category have different characteristics. Some work best for wrinkles around eyes, others for upper lip wrinkles, and others are best for deep wrinkles. Most of them provide temporary improvement, lasting varying lengths of time, and eventually absorb into your body requiring repeated treatment to achieve or maintain the results.

Cosmetic wrinkle fillers

Hyaluronic acid wrinkle filler

This category includes Restylane®, Perlane®, Juvederm®, Hylaform®, Captique®, and the newest kids on the block, Elevess® and Prevelle®. The last two add a numbing component to ease the discomfort that comes along with the injections. These are non-permanent fillers. The effects of most of these products last an average of 6 months to one year.

Hyaluronic acid is a natural substance that exists in all living organisms. It helps keep our skin and joints lubricated and hydrated. As we age, the amount of natural hyaluronic acid in our body decreases causing us to develop wrinkled skin.

Hyaluronic fillers are suitable for smile lines (nasolabial folds), lines around the eyes, and a variety of other wrinkles. Restylane® appears to be the preferred choice for treating tear troughs. They are synthetic so very few patients are bothered by allergies to the product. If you are dissatisfied with the results, they can be reversed with the enzyme hyaluronidase.

Some fillers in this category are thicker than others. Thinner products are used on superficial wrinkles and thicker products are best suited for going deeper. The typical side effects that may occur are redness at the injection site, some minimal swelling or bruising, some lumpiness not visible to other people and, least commonly, an allergic reaction.

Cost – These fillers are packaged as prefilled syringes. They can vary in price from $400 to $1,000 depending on the product selected.

Hydroxyapatite wrinkle filler

Thiscategory includes Radiesse®.

Hydroxyapatite is calcium-based (similar to the material found in bone). It is suitable for a variety of wrinkles but is most commonly used for the nasolabial folds. The effects of Radiesse® last about 8 to 9 months.

You may experience mild irritation, swelling, itching, redness, bruising or tenderness at the injection site. If there are any adverse effects, this type of wrinkle filler can be difficult to remove.

Cost – Radiesse® treatment costs a bit more than the other dermal fillers and should cost anywhere from $750 to $1,000.

Poly-L-Lactic acid (PLLA) wrinkle filler

This category includes Sculptra®.

This type of wrinkle filler is a volume agent that adds volume to the skin. It is most suitable for filling sunken cheeks and hollow lower eyes. It is particularly useful for patients taking anti-HIV drugs who suffer from facial fat loss. The effects of Sculptra® may not be seen for several months following the injections but last about 2 years.

In the past, Sculptra® was known to cause small bumps under the skin in the treated area. Generally these bumps are not visible. Other side effects included bleeding, tenderness or discomfort, redness, bruising, or swelling. The newer technique involves diluting the Sculptra® and thereby reducing the number of bumps.

The typical side effects that may occur are redness at the injection site, some minimal swelling or bruising, some lumpiness not visible to other people and, least commonly, an allergic reaction. This type of wrinkle filler can be difficult to remove if there are adverse effects.

Cost – Sculptra® can cost between $2,000 and $3,000.

Collagen wrinkle filler

This category includes ArteFill®, the only U.S. FDA approved permanent filler for correcting smile lines, and Evolence®, which is a porcine collagen gel implant.

These products contain collagen. Because the material is not absorbed by the body, the results are far more permanent, lasting 5 years or longer. However, they should not be used by patients with collagen allergies. Evolence® should not be used in the lips. Artefill® can trigger serious scarring in people who form keloid scars and should not be used. The most common side effects in this category are mild swelling, reddening or bruising at the injection site.

Cost – Collagen fillers typically cost between $1,000 and $2,500 per syringe.


Complications can result with any of these wrinkle filler treatments, particularly if they are done in a non-medical setting, by an unqualified provider, or with an unknown substance. There are unauthentic products on the market and products that have not been properly stored or maintained. Almost anyone can perform this type of cosmetic procedure, so look for a physician who is skilled in treating facial wrinkles. Cheaper is not always better. When you go to an experienced doctor you are also paying for their experience and knowledge.

Comments are closed.