Injectable fillers are the rising stars of the plastic surgery world. They’re quick, convenient, and the results are instant. Fillers have gotten so popular, in fact, that there are now more formulas available than ever before. Most fillers are composed of hyaluronic acid (HA), a “sugar” found naturally in the skin that is responsible for hydrating and plumping up the tissues. Different HA fillers may be made from the same substance, but they behave very differently under the skin. Plastic surgeons love being able to customize treatments for their patients and patients love the results that HA fillers deliver.

While it’s great for patients to have options, it can also get a little overwhelming. These days, there’s a product for a range of different needs, showcasing the filler’s versatility. But how do you choose the one that’s right for you? And what are the differences between all those hyaluronic acid fillers on the market?

HA Fillers, Explained

Hyaluronic acid fillers work by reintroducing a natural substance into the skin that tends to decline with age. The HA molecules in the fillers attract water and help to replace volume that is lost as we age. They can also improve the appearance of naturally thin lips by increasing volume and adding contour. HA fillers are always temporary, but they are typically long-lasting and allow patients to schedule touch-ups only once or twice a year on average. The two most popular brands of HA fillers are Juvederm and Restylane, and these brands make a variety of different HA fillers for many different facial rejuvenation needs. Let’s take a look at what makes these fillers different from one another–and why it matters.

Different Molecule Size

One of the most striking variations between different HA fillers is the weight and density of the HA molecules in the formula. Some fillers use molecules of all the same weight, while others combine them to make the gel act a little differently. These differences in molecular weight might seem insignificant, but they can influence how long a filler lasts and how well it does its “job” of replacing facial volume. The number of particles per cubic centimeter of the product determines how thick the gel will be, and the molecule size affects how the HA behaves and how long it lasts.

Gel Thickness

In recent years, the bigger brands have started to cross-link their HA molecules. This means that they combine different weights of HA molecules in order to create a gel that is more versatile and lasts longer. Juvederm calls their proprietary method of cross-linking “Vycross technology.” Thicker gels are used for larger areas or areas beneath the skin, like Juvederm Voluma. This formula is used to rejuvenate and plump up the cheek area for a more youthful look. Juvederm Volbella and Restylane Silk, however, are thinner because they are formulated for the delicate lip area. These injectables may not be as strong as a thicker gel, but they look more natural in this area than a more robust gel would. Belotero is another good example of a thinner HA product that looks more natural in delicate areas.

Local Anesthetic

Dr. Buckingham and his nurse injectors perform injectable filler procedures using a microcannula. Most patients find the treatment easy to tolerate, and blunt tipped flexible microcannulas allow for safer injections, fewer entry points, cover a larger area and reduce patient pain and bruising. Some formulas of HA fillers use a local anesthetic within the gel itself (typically lidocaine) to make the treatment more comfortable. Patients who are allergic to lidocaine may not be eligible for some formulas for this reason.

Target Area

In the past, fillers were just for filling in static wrinkles. These days, the different HA fillers on the market are geared toward specific areas of the face. Juvederm Voluma is for the cheeks, while Restylane Silk is intended for the lip area. These formulas are optimized for different parts of the face, making them more effective and long-lasting.


Fillers tend to last longer than Botox. Basic fillers last around 4-6 months. Newer fillers, however, use cross-linking and can last for up to 18 months or longer. Density and molecule size make a difference in how long fillers last. Fillers in high-movement areas are specifically designed to withstand additional movement, for instance.

Choosing a Filler

If all the different HA fillers make you feel overwhelmed, don’t worry. While it’s good to know how different fillers work, you don’t have to become an expert. You don’t need to be the one to choose your ideal filler! You might come into your initial consultation with an idea of which filler you want, but your plastic surgeon will have in-depth knowledge of the differences between each formula. He or she will talk to you about your goals and make a recommendation. A reputable plastic surgeon customizes each procedure to suit his or her patient’s individual needs.

If you need help choosing a filler in the Austin area, come to Buckingham Center for a consultation with Dr. Edward Buckingham. Dr. Buckingham is a board-certified facial plastic surgeon with extensive experience in administering different HA fillers. He has an artistic touch and strives to create natural-looking results for each patient. Offering a wide range of fillers, Dr. Buckingham is a top choice for patients in Austin and all over the United States. To schedule a consultation, call Buckingham Center today at 512.401.2500 or fill out our online contact form.

Back to Blog

Schedule A Consultation Book Your Opportunity to Learn More

Contact Us
Contact us media
Accessibility: If you are vision-impaired or have some other impairment covered by the Americans with Disabilities Act or a similar law, and you wish to discuss potential accommodations related to using this website, please contact our Accessibility Manager at 512-222-5635.
Contact Us