What Are Dermal Fillers Made Of? Hyaluronic Acid & More

What’s really inside those tiny syringes that sculpt cheekbones and smooth out wrinkles? Dermal fillers aren’t just magic gel—they’re made from ingredients with real science behind them. Whether you’re considering a subtle lip enhancement or want to restore lost facial volume, knowing what your filler is made of isn’t optional—it’s essential. Hyaluronic acid, calcium-based compounds, poly-L-lactic acid, and even synthetic beads each bring their own strengths, lifespans, and risks. One is soft and reversible.

Another’s firm and long-lasting. And some stay with you for years. This isn’t just about chasing a look—it’s about understanding what’s going under your skin, how it’ll behave, and how it fits into the bigger picture of your face, age, and lifestyle. A good injector won’t just offer you a brand—they’ll offer the right tool for your goals. This blog is your backstage pass into what dermal fillers are made of, how they work, and which one might be right for you.

Understanding Dermal Fillers

Dermal fillers are injectable treatments designed to restore volume, smooth lines, and enhance facial contours. But they’re not all the same—what they’re made of affects how they behave under your skin. Some fillers are soft and pliable, ideal for lips or under-eyes. Others are dense and structured, perfect for cheekbones or jawlines. Most fillers today are made from biocompatible substances that your body naturally absorbs over time. This means results are temporary, but also safe and reversible in most cases. The key is knowing what’s inside the syringe before it goes into your face. Whether you're going for plump lips or sculpted cheeks, the right material makes all the difference.

Hyaluronic Acid Fillers

The most common type of dermal filler is made from hyaluronic acid (HA)—a sugar molecule naturally found in your skin. HA fillers are praised for their hydration and versatility. They attract water, giving the skin a soft, supple bounce. Brands like Juvederm, Restylane, and Belotero fall into this category. The effects typically last 6 to 18 months depending on the area treated and the formulation used. One major benefit? HA fillers can be dissolved with an enzyme called hyaluronidase if results need to be reversed or adjusted. That makes them a favorite for first-timers and those looking for a more flexible aesthetic solution. Plus, HA fillers blend well into the skin, making them ideal for tear troughs, lips, and smile lines.

Calcium Hydroxylapatite Fillers

Another type of filler is calcium hydroxylapatite (CaHA), a mineral-like substance found in human bones. It’s used in thicker fillers like Radiesse, known for creating structure and volume in deeper areas like the cheeks, jawline, and hands. CaHA fillers not only lift but also stimulate your skin’s natural collagen production over time. They last slightly longer than HA fillers—about 12 to 24 months—but they can’t be dissolved like HA. That’s why it’s essential to receive these fillers from experienced injectors. The texture of CaHA is firmer, making it excellent for people looking for sharper definition or long-term improvement in facial volume loss due to aging.

Poly-L-Lactic Acid Fillers

Then we have poly-L-lactic acid (PLLA), the star ingredient in Sculptra. It’s not a traditional filler in the volumizing sense—it works more as a collagen stimulator. Rather than immediately plumping the area, Sculptra gradually rebuilds facial volume by prompting your body to regenerate collagen. It’s especially effective for treating hollow temples, sunken cheeks, or deep folds in the skin. Results take a few months to fully develop, but they can last up to 2 years or more. This filler is best suited for people seeking long-term rejuvenation and willing to wait for subtle, natural-looking changes. However, it requires a series of sessions and skilled hands to avoid lumps or unevenness.

PMMA and Permanent Fillers

A less common but more permanent filler type is polymethyl methacrylate (PMMA), found in products like Bellafill. PMMA fillers use tiny synthetic beads suspended in collagen gel. Once injected, the collagen provides immediate volume, while the beads remain to support the skin long-term. These fillers are often used for deep acne scars or nasolabial folds that haven’t responded well to temporary fillers. Since PMMA is not absorbed by the body, the effects can last 5 years or longer—but reversibility is not an option. That makes them suitable only for experienced patients with predictable results from previous fillers. If you're new to cosmetic injections, starting with temporary fillers is strongly advised.

What Is PMMA and How It Works

Polymethyl methacrylate (PMMA) is a synthetic, biocompatible material used in permanent fillers like Bellafill. Unlike hyaluronic acid or collagen-stimulating fillers, PMMA does not dissolve or get absorbed by the body over time. Instead, it provides long-lasting volume by forming a supportive scaffold under the skin. The microspheres in PMMA fillers remain in place, and your body gradually builds collagen around them, offering results that can last 5 years or more.

Because PMMA is non-absorbable, it's typically reserved for more experienced providers and for patients who have already tried temporary fillers and want a more lasting solution. It's often used for deep nasolabial folds, acne scars, or areas requiring structural support. However, its permanence also means it comes with higher risk—mistakes or poor placement can’t be reversed easily. Choosing a skilled injector is absolutely critical.

·         Made of biocompatible microspheres that stay in place

·         Stimulates natural collagen production around the injection

·         Commonly used for deep smile lines and acne scars

·         Results can last 5+ years with proper technique

Risks and Limitations of Permanent Fillers

While PMMA offers longevity, it's not ideal for everyone. The main concern is that it’s permanent. If the filler is placed incorrectly or the patient experiences side effects, there’s no easy reversal like there is with hyaluronic acid fillers. In rare cases, PMMA can lead to granulomas—small lumps or nodules formed by your immune response to the foreign material. These may require steroids or even surgical removal.

Additionally, your face changes with age. A filler that looks good today may not match your facial structure 10 years from now. PMMA doesn’t adjust or dissolve, making future cosmetic treatments more complicated. That’s why most dermatologists recommend starting with temporary fillers first. Permanent options should only be considered after years of consistent results and a full understanding of your facial anatomy.

·         Cannot be dissolved or removed easily

·         Risk of lumps or granulomas if not injected correctly

·         May look unnatural as your face ages

·         Best suited for experienced patients and injectors

Comparing PMMA to Semi-Permanent Fillers

PMMA is just one end of the filler spectrum. When compared to semi-permanent fillers like Radiesse (calcium hydroxylapatite) or Sculptra (poly-L-lactic acid), PMMA offers longer results but less flexibility. Radiesse and Sculptra gradually fade, giving you room to adjust treatments as your facial structure evolves. They also stimulate collagen but are reabsorbed by the body over time, typically lasting 1–2 years.

In contrast, PMMA is a one-and-done approach. While that can be appealing, it requires absolute confidence in your injector’s skill and your long-term aesthetic goals. Semi-permanent fillers offer a safer “middle ground” for patients who want more lasting results than HA but aren’t ready to commit to permanent materials. It's always better to build up gradually than to regret rushing permanence.

·         Semi-permanent fillers allow more flexibility over time

·         Both stimulate collagen, but PMMA stays permanently

·         PMMA requires higher injection accuracy

·         Radiesse and Sculptra fade naturally over 12–24 months

Choosing the Right One for You

Every filler material has its strengths, and the best one for you depends on your treatment goals, skin type, and facial anatomy. If you want soft hydration, go for hyaluronic acid. For deeper structural support, calcium-based or PLLA fillers are great. If you need permanent correction for something like acne scars, PMMA may be considered. Always consult with a certified provider who can tailor the filler type to your specific needs. A good injector will prioritize not just the material, but also the technique—ensuring your face retains natural movement and proportional beauty. In the end, it’s not just about what’s in the syringe. It’s about trust, skill, and understanding what’s best for your face.

Factors That Influence the Best Choice

Choosing the right filler depends on more than just the brand name—it’s about your age, skin type, concerns, and lifestyle. Younger clients often benefit from hyaluronic acid fillers for soft enhancements, while older patients may need collagen stimulators for volume loss. Your facial structure, metabolism, and even your profession (hello, camera-facing jobs) can affect which filler will give the best results.

It’s also important to consider how often you’re willing to return for maintenance. HA fillers are reversible and adjustable, making them ideal for beginners. Collagen-stimulating fillers require more planning and patience but offer long-term skin improvements. Permanent fillers, like PMMA, should only be chosen after multiple consultations. Always ask for a personalized treatment plan that considers both aesthetic goals and medical safety.

·         Skin type, age, and facial anatomy all matter

·         HA fillers offer short-term flexibility and reversibility

·         Collagen-stimulators suit long-term volume loss and aging

·         Permanent fillers require a confident, long-term decision

Starting Slow—Beginner-Friendly Fillers

If you’re new to dermal fillers, the safest place to start is hyaluronic acid (HA). These fillers are soft, moldable, and dissolvable with an enzyme called hyaluronidase. Brands like Juvéderm and Restylane allow you to experiment with subtle lip plumps or cheek contouring without major commitment. You can always build up volume over time rather than risking too much too soon.

Your injector might even suggest starting with a “baby filler” approach—small amounts placed strategically to give you natural results. This is especially important for first-timers nervous about looking overfilled. Most patients get comfortable with their look and then explore other filler types over time. Think of HA as the training wheels of aesthetic medicine: safe, adjustable, and great for learning what you like.

·         Great for first-timers who want flexibility

·         Can be dissolved if results don’t meet expectations

·         Allows gradual build-up over multiple sessions

·         Natural-looking and suitable for most facial areas

When to Combine Fillers with Other Treatments

Sometimes, the best results come from combination therapies. Fillers work best for volume loss and contouring—but if you also have pigmentation, fine lines, or sagging skin, combining treatments may offer a more complete result. For instance, pairing HA fillers with microneedling can boost collagen while restoring volume. Botox is another popular combo, reducing dynamic wrinkles while fillers add plumpness.

During your consultation, discuss your skin concerns in full. A skilled injector will guide you on whether you need one product or a combination. This approach is especially useful for midface rejuvenation, tear trough corrections, or lifting the jawline. The goal isn’t to chase trends—it’s to create harmony between skin texture, tone, and volume.

·         Fillers improve volume and shape, not texture

·         Combine with Botox for wrinkle prevention

·         Add microneedling or laser for skin quality boost

·         Tailored plans give more natural and lasting results

Conclusion:

Dermal fillers aren’t a one-size-fits-all fix. What goes into your face should never be a mystery. Whether it’s the water-loving hyaluronic acid giving your skin a youthful bounce, or the dense structure of calcium-based fillers shaping your jawline, every material brings its own purpose. You’ve seen how some fillers slowly fade and others stick around for years. You’ve seen how collagen stimulation takes patience—but offers transformation. You’ve seen how permanence, like PMMA, demands experience and trust. So if you're planning to get fillers—or even just considering it—don’t just ask about the price or the name brand. Ask what it’s made of. Ask how your skin will change not just today, but next year. Because in the world of cosmetic injectables, it’s not just about volume—it’s about vision. And the right filler, in the right hands, isn’t just cosmetic. It’s deeply personal.