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HA Fillers Comparison Table


 

 

 

°DISCLAIMER: This chart was created as an educational resource only by compiling a combination of evidence-based data published by the manufacturer, by third-party publications, and educational resources available to both health care providers and consumers. The author acknowledges the potential for inaccuracies and attests that content is subject to correction and future updates. This information is not intended as a substitute for clinical expertise and judgement by a qualified healthcare provider.

*Longevity owes to a variety of factors, which include clinical trials study design, methodology, amount of filler injected, and treatment area. When comparing patient-to-patient variability, other factors such as the patient's metabolism and soft-tissue matrix need to be considered. 

**​Restylane was shown to maintain correction at 18 months following repeat injection at 4.5 months. This study led to a second submission to the FDA, known as a supplemental Premarket Approval Application for its label, giving a new indication for Restylane—longevity up to 18 months with repeat injection at 4.5 months. 

+ Values obtained from Dermatologic Surgery 2020;46:41-49

++ Values obtained from Plastic and Reconstructive Surgery - Global Open7(7):e2172, June 2019 

***G’ (pronounced G prime), quantified in pascals, ​is the elastic modulus or measure of gel stiffness, increases with degree of crosslinking, and estimates resistance to deformation. ​Examples: high elasticity= rubber band; low elasticity=syrup. The higher the G’ the more firm the product. The ability of a filler to lift soft tissue is directly related to the G prime, but also directly related to cohesivity. Increasing the cohesivity and decreasing the G prime is a fundamental feature of softer, homogenized HAs compared to particle-based (e.g., calcium hydroxylapatite), fillers which rely on a higher G prime to create lift. Even within the HA products, the Restylane filler family relies on a high G prime with its uniform particle size to achieve lift, while the Juvéderm family relies on higher cohesivity. 

BDDE stands for 1,4-butanediol diglycidyl ether. The majority of hyaluronic fillers are crosslinked with BDDE. 

Juvéderm Voluma (HA, Galderma) is another example of a filler that achieves a significant lift by employing high cohesivity, but a lower G prime compared to the Restylane Lyft. Both are FDA-approved as robust fillers for the mid-face. 

All fillers listed above are available in 1ml syringe sizes, ​except​for​​Juvéderm ​Volbella, which comes in a 0.55ml syringe. All ​except​for Belotero Balance are available with 0.3% Lidocaine. It is notable that Revanesse Versa (sans “Plus”) is available without lidocaine. It was omitted from the table for simplification. 

NASHA​= Trademark of Q-Med (owned by Galderma) stands for Non-Animal, Stabilized Hyaluronic Acid. 

xPresHAn​= Trademark of Galderma. ​XpresHAn Technology customizes the degree of hyaluronic acid (HA) crosslinking in each product, resulting in gels with a range of flexibility and support characteristics for different patient needs. The “x” stands for “cross-linking.” “Pres,” because gels are pressed through a mesh for calibration. “HA” stands for Hyaluronic Acid. The “n” was simply added to the end to make it sound more like a familiar word. G’ (elastic modulus) values were obtained from JDD: January 2012, Volume 11, Issue 1 (SUPPLEMENT) with respect to Emervel Classic, Lips, and Deep. Touch and Volume versions are not available in the US as of 6-2020 

Hylacross​= Trademark of Allergan. “Hyla-“ derives from “Hyaluronic Acid.” “Cross” implies “cross-linking.” 

Vycros​s = Trademark of Allergan. Uses a combination of low and high molecular weight HA to improve the cross-linking efficiency of HA chains. Vollure​® ​is known as Volift ® in countries outside the United States. 

CPM​= Trademark of Merz. Cohesive Polydensified Matrix  

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