Richmond’s Laser Skin Care Specialists

Hyaluronic Acid Fillers – Juvéderm®, Restylane®, Belotero®

What is Hyaluronic Acid?

Hyaluronic acid (HA) fillers are used to treat moderate to severe wrinkles and folds in the face, especially in the nasolabial creases.

Fillers are also commonly used to improve the following:

  • Nasolabial folds
  • Forehead creases
  • Dark circles under eyes
  • Thin lips
  • Perioral lines
  • Marionette lines
  • Oral commissures
  • Hollow cheeks
  • Depressed scars

Which HA Filler do I Need?

Your medical provider will make recommendations based on the appearance of your skin and your cosmetic goals.   In general, Belotero, Juvéderm XC, and Restylane are intended for more superficial injections, and also may be selected for delicate areas such as the lips and the thin tissues near the eyes. Perlane and Juvéderm Voluma are thicker products used to add volume deeper in the fatty subcutaneous tissues of the face. To see full details about each product, refer to the manufacturer’s web site:

Belotero Balance is injected into the superficial or deep dermis and is indicated for nasolabial lines.  Some physicians prefer Belotero for deep injections under the eye shadows, as it creates less of a blue translucency compared to other HA fillers.  Injections around the eyes are off-label uses.

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Juvéderm is available in three different densities, determined by the number of chemical crosslinks between the Hyaluronic acid molecules.  Juvéderm XC is designed for more superficial injection into nasolabial lines.  Juvéderm Ultra Plus is slightly firmer, for deeper folds and wrinkles.  Juvéderm Voluma is the firmest, and is designed for deep subcutaneous injections into the cheek fat, and may be considered an alternative to Radiesse.

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Restylane was one of the first hyaluronic fillers to market and is indicated for temporary improvement of moderate to severe facial wrinkles and for lip augmentation. Perlane is a thicker formulation used for deeper injections.

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How Long do HA Fillers Last?

The results can be seen immediately, and may last 6-12 months. This may vary based on the location injected, the structure of the skin, and the age and lifestyle of the patient.

What are the Risks of Hyaluronic Acid Injections?

The risks of injection are small, and usually temporary.  Bruising is a potential side effect of any injection procedure, so discontinue any aspirin or blood thinners a week before treatment if your primary physician feels it is safe to do without. Small nodules may be noticed, and should be firmly massaged 5 times daily during the first week to help distribute the product evenly. Overcorrection, undercorrection, asymmetry or other disappointment may be improved with additional injections or the passage of time. Allergic reactions are rare, and pretreatment skin testing is not required.  Care is required not to inject directly into blood vessels, which could cause blockage of blood flow and tissue damage.  Injection of a blood vessel near the eye could cause blindness.