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Books/Facial Aesthetics: The Anatomy of Natural Results/Dermal Fillers: A Comparative Guide to HA Fillers
Chapter 1211 min read

Dermal Fillers: A Comparative Guide to HA Fillers

Not all fillers are the same. Their structure, density, cross-linking type, and permanence differ. This section compares the main HA fillers (Juvederm, Restylane, Teosyal, Belotero).

Main ideas in this chapter

  • HA fillers differ in their cross-linking type; hardness and permanence depend on this difference.
  • Juvederm Volux, Voluma → deep, firm products; for jawline and cheekbones.
  • Belotero, Restylane Vital → soft, superficial products; for fine lines and skin quality.

HA cross-linking

Hyaluronic acid in its natural state is liquid and breaks down rapidly (a few hours) in the body. For it to be used as a filler, the molecules are linked together by cross-links. The intensity and type of this cross-linking determine the hardness of the filler and how long it will remain under the skin.

Juvederm family (Allergan)

Juvederm Ultra 3, Ultra 4: medium-density, for lips and nasolabial folds.

Juvederm Volbella: softest, for fine lips and tear troughs.

Juvederm Volift: medium deep; for mid-face, fine lines.

Juvederm Voluma: firm, deep; for cheek and chin support.

Juvederm Volux: firmest; for jawline and chin recontouring.

Restylane family (Galderma)

Restylane Kysse: developed for lip features; preserves natural movement.

Restylane Defyne, Refyne: "bends with you" feature in mimicry; for nasolabial and marionette lines.

Restylane Lyft: firm; for cheekbone and bone support.

Restylane Vital, Skinboosters: non-cross-linked; for skin quality.

Teosyal (Teoxane, Switzerland) and Belotero (Merz)

Teosyal RHA series: Dynamic Resilience technology — compatible with mimicry, preserves natural movement.

Belotero Balance, Soft, Intense: transition from soft to firm; from superficial lines to medium deep.

Belotero Volume, Revive: for deep volume and skin quality.

Attention:There are fillers sold as "permanent" or "semi-permanent" on the market (silicone, PMMA). These are irreversible products with a high risk of granuloma and chronic inflammation. They are banned in most European countries. Only HA-based, reversible fillers should be used.

Deep fillers (cheekbone, chin)

  • Juvederm Voluma, Volux
  • Restylane Lyft
  • Teosyal Ultra Deep
  • Belotero Volume

Soft fillers (lips, tear trough)

  • Juvederm Volbella, Ultra
  • Restylane Kysse, Defyne
  • Teosyal RHA 2, 3
  • Belotero Balance, Soft