your guide to dermal fillers

Your Guide To Fillers: How They Work and Which Ones to Choose

Dermal fillers are one of the most popular cosmetic procedures today. According to the latest report by the American Society of Plastic Surgeons, 3.4 million dermal filler injections were performed in 2020 alone. That’s more than any light-based treatment or plastic surgery procedure in that timeframe.

If you are also considering getting this minimally invasive treatment, know that not all fillers are created equal. There are dozens of dermal fillers currently on the market, and they all have differences you need to be aware of. Finding the right one for yourself depends on your individual needs, your provider’s expertise and your budget. 

At Wink Medical Aesthetics, we offer a range of dermal fillers to Lakeway residents and visitors. Keep reading to learn more about your options, what makes one different from another, and how to make your pick.

What Are Dermal Fillers?

Dermal fillers are clear gels that are injected under the skin. They smooth out wrinkles and folds, add volume to facial hollows, contour the face and even improve the appearance of the skin. Most dermal fillers are injected into the face, but some can be used on the back side of the hands. 

Dermal fillers work by adding volume to the skin or increasing the skin’s collagen production. Their effect is visible almost immediately and continues to improve weeks after treatment. Results are temporary, with a duration of six months to two years, depending on the filler used. 

While the dermal filler market is filled with a lengthy list of brands, most have the same active ingredient: hyaluronic acid (HA). 

This sugar molecule is naturally produced by your body and known for its water-retaining ability. The chemically identical HA found in dermal fillers is made in a laboratory. Other fillers may contain ingredients like calcium hydroxylapatite, poly-l-lactic acid and polymethylmethacrylate.

How Dermal Fillers Work

As the name suggests, dermal fillers work by adding volume to the skin. One of the reasons for facial aging is a gradual loss of volume due to bone resorption, thinning skin and drifting of facial fat. The face begins to sag and form hollows and wrinkles as a result, creating an aged appearance. 

Dermal fillers plump the skin by attracting water into the tissues or boosting collagen and elastin production. When HA is injected into facial tissues, for example, it acts like a cushion underneath the skin, adding volume and smoothing the skin out. It also binds to water molecules, enhancing skin hydration.

Other dermal fillers, known as biostimulatory fillers, work by causing an immune response in the skin that triggers collagen and elastin production. 

Types of Dermal Fillers

The first dermal filler was FDA-approved in 1981 and contained bovine collagen. Better fillers have been developed since, with newer technologies allowing greater versatility and safety. The most popular fillers currently on the market include: 

Hyaluronic Acid (HA)

These products contain clear gels of HA that are injected underneath or directly into the skin. Once there, the HA gel acts like a very soft implant that moves naturally with your expressions and binds to water, increasing skin hydration and health. There’s also some evidence HA fillers stimulate collagen production.

The HA molecules in these fillers can be of small or large molecular weights and are usually cross-linked. Higher molecular weight HA binds more water than lower weight HA, and the cross-linking helps the HA hydrogel stay in place and last a long time. Most HA fillers last between six and 18 months, which depends on the type of filler and site of injection. 

If you are not happy with your HA filler results, your provider can inject an enzyme called hyaluronidase to dissolve your filler in a matter of hours. 


Man-made fillers used today include calcium hydroxyapatite (CaHA), polymethyl methacrylate (PMMA), poly-l-lactic acid (PLLA) and silicone. These fillers add instant volume while also stimulating collagen and elastin production. They are semi-permanent, meaning they dissipate over time but last significantly longer. Synthetic fillers cannot be reversed like HA fillers.


Most fillers are temporary, but some can last a lifetime. Bellafill is an example of an FDA-approved permanent filler used to diminish wrinkles and enhance facial contours. These have the highest viscosity of all dermal fillers, so the body cannot absorb and remove them. While they may have some advantages, problems can arise when the results are not as expected or when it triggers a chronic immune response

Fillers Offered at Wink Medical Aesthetics

At Wink Medical Aesthetics, we offer temporary and semi-permanent fillers from reputable manufacturers. Our brands include Restylane®, JUVÉDERM® and Sculptra®. Our wide range of dermal fillers means we can address nearly all cosmetic concerns and tailor each treatment to meet the patient’s unique concerns. 



The first filler of its kind and FDA-approved in 2003, Restylane® has stood the test of time. It contains non-animal HA and is used to treat smile lines, marionette lines, tear troughs and thin lips. 

Restylane® Refyne

Made with specialized XpresHAn Technology™, this filler does not affect your natural expressions while providing significant wrinkle reduction in the mid-face, notably smile lines and marionette lines.

Restylane® Defyne

Also made with XpresHAn Technology™ and being slightly stronger, this filler is ideal for deeper wrinkles. It is also used to enhance the chin for a balanced profile.

Restylane® Lyft 

For a slight cheek lift or fuller cheeks, this product does wonders. A version containing lidocaine is used to minimize the appearance of tendons, bones and veins in the back of the hand. 

Restylane® Contour

Another product with XpresHAn Technology™, this Restylane® filler adds volume to the cheeks while keeping you looking like you. We use this mainly for facial contouring.



With a thicker consistency than other JUVÉDERM® fillers, VOLUMA® XC corrects mid-face volume loss and weak chin and jawline structure. Its thick consistency makes it one of the longest-lasting fillers (two years on average).


With its cross-linked HA of different molecular weights, this filler adds natural-looking strength and support to address mid-face volume loss and wrinkles. It lasts about 18 months on average.


Got thin lips? We can add subtle volume to your lips with this filler. This product is made with Vycross Technology (VT), just like the two above. Volbella® also lasts a long time and offers natural-looking results. Other uses include smoker’s lines and tear troughs.


More cohesive than VOLBELLA® XC, this product can create fuller, smoother lips and reduce fine lines around the lips. It can also last up to a year.  


For smile lines and folds, this product creates noticeable smoothing and volume. You may enjoy your results for a year, if not longer.


Containing injectable poly-L-lactic acid, Sculptra® is an FDA-approved semi-permanent filler. It boosts your skin’s collagen and elastin production and works to treat nasolabial folds and other facial wrinkles. The results with this filler may last up to five years. 

Want to learn more about dermal fillers? Reach out to Wink Medical Aesthetics, where Michelle and her team would be happy to give you a consultation. For more information, call 512-263-2400.

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