The most widely used filler in the cosmetic field is Hialuronic Acid Fillers (HA Fillers).

Allergic reactions are almost unknown with HA Fillers, quite different to earlier collagen fillers of years ago, in which the beef or pork proteins could trigger an allergic reaction.

There are many HA Fillers on the market and this benefits the patient, as healthy competition between pharmaceutical manufacturers encourage better priced packages and wider research. As long as a product is CE marked and has reliable pharmaceutical backing, the “best” product will be the product your injector has the most experience in!

The range of HA Fillers has widely increased and consists of almost pure HA, which hydrates the skin, to “softer” HA Fillers which is used in thin skinned areas, eg. eye area (and which lasts 3 – 6 months), up to thicker HA Fillers which gives more “lift” as the molecules are more cross-linked (and which lasts 6 – 9 months) and ultimately the very thick filler which is used for larger volume replacement and body treatments, eg. augmentation of breasts, buttocks and calves (which can last up to 24 months).

These fillers are fully reversible, using the enzyme, Hialuronidase.


This group of fillers gives the immediate filling effect of an HA Filler. Add to that the collagen inducing effect of the calcium spheres (calcium hydroxyapatite) and you have a treatment which can last up to 18 months.

These fillers, of which Radiesse® and Redexis® are examples, have wide application in the face (temples, cheeks, nose, naso-labial lines, ‘sad corners’ of the mouth, chin and jaw-line) as well as being suitable for the back of the hands. This filler is also trusted to soften disfiguring defects after life saving surgery or accidents. It stays exactly where it has been injected and is a great tool for the correct indication(s) in the hands of an experienced injector.


This type of filler is a suspension once reconstituted and not in gel form like most other fillers. It is exclusively injected in the deeper layers of the tissue, where the PLLA stimulates collagen formation after 6 weeks as it is broken down by the body. Even up to a year after treatment, the process of volume increase might still be ongoing.

In the initial phase of the treatment (1st month), daily firm massage by the patient ensures that the collagen is formed evenly in a sheet-like (flat) fashion and prevents any nodule formation.

The overall effect of this treatment can last 2 – 5 years and even though both patient and practitioner need to show patience in waiting for the transformation, over correction should be avoided at all cost, as this treatment is not reversible at all.

PLLA, of which Sculptra® is an example, can be used for rejuvenation of the back of the hands as well. So PLLA is used in the temples, cheeks, naso-labial lines, ‘sad corners’ of the mouth, chin, jaw-line and chest area.