What is Dermal Fillers
Dermal fillers are injectable treatments used to restore lost volume, smooth wrinkles, and enhance facial contours. They are sometimes called “soft tissue fillers,” but their role goes far beyond simply filling lines.
A skilled injector can use fillers to lift tired cheeks, soften deep folds, brighten under-eye hollows, define the jawline, or add subtle lip enhancement. The goal is not to change your face, but to refresh it — making you look more rested and confident without surgery.
Fillers come in many forms and brands. Some are soft and flexible for delicate areas like the lips and under-eyes, while others are firmer to provide structure in the cheeks or chin. Certain fillers even stimulate your body’s own collagen, offering gradual, long-lasting improvement.
Because each formula behaves differently, the choice of filler must be tailored to the area being treated, your anatomy, and your goals. Understanding the options — and their pros and cons — is essential for setting realistic expectations and, most importantly, for choosing a qualified injector who knows how to use them safely.
Fillers vs. Botox – The Quick Distinction
- Botox = relaxes muscles → best for frown lines, crow’s feet, forehead.
- Fillers = add volume → best for folds, hollows, lips, cheeks, jawline.
They’re often combined in a “liquid facelift.”
Only Doctors Can Inject Fillers in Belgium
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The Main Types of Fillers
Hyaluronic Acid (HA) – The Most Popular Choice
HA fillers are the most widely used worldwide. They are biodegradable, reversible with hyaluronidase, and versatile enough to treat almost every area of the face. Results appear immediately, lasting 6–18 months on average.
Brands and sub-brands:
- Juvederm®: Volbella (lips, under-eyes), Volift/Vollure (nasolabial folds), Voluma (cheeks, chin, temples), Volux (jawline).
- Restylane®: Silk (lips, fine lines), Kysse (lips), Refyne/Defyne (folds, marionette lines), Lyft (cheeks, hands), Contour (midface), Eyelight (under-eyes).
- Teosyal® RHA Collection: Redensity II (tear troughs, EU), RHA 2 (lip lines), RHA 3 (folds), RHA 4 (deep volume/jawline).
- Belotero®: Balance (+) (tear troughs, fine lines), Intense (folds), Volume (cheeks).
- Revolax®: Fine (wrinkles), Deep (nasolabial folds), Sub-Q (chin, jawline).
- Saypha® (ex-Princess): broad HA line widely used in Europe.
Each formula differs in softness, cohesivity, and lift. A filler perfect for lips would be too soft to define a jawline, while a structural filler for the chin would feel too firm under the eyes.
Calcium Hydroxylapatite (CaHA) – Radiesse®
Radiesse is a thicker filler that also stimulates collagen. It works best in the jawline, chin, cheeks, and hands.
- Duration: 12–18 months.
- Not for lips or tear troughs.
- Cannot be dissolved, so injector skill is crucial.
Poly-L-lactic Acid (PLLA) – Sculptra®
Sculptra is a collagen stimulator, not a gel filler. It restores volume gradually over several months.
- Best for temples, cheeks, and jawline.
- Duration: up to 2 years.
- Requires a series of treatments, plus massage after each session.
- Not reversible.
Polymethylmethacrylate (PMMA) – Bellafill®
A semi-permanent filler combining PMMA microspheres with collagen.
- Approved for acne scars and deep folds.
- Lasts 5+ years.
- Higher risk of long-term nodules. Rarely used in Europe.
Fat Transfer – The “Natural Filler”
Fat can be harvested from your body and reinjected into the face. It’s partially permanent, but results vary.
- Used for larger volume restoration (cheeks, temples, under-eyes).
- Requires surgery (see our Fat Transfer article).
Where Different Fillers Work Best
- Lips → soft HA fillers (Juvederm Volbella, Restylane Kysse)
- Tear troughs → Restylane Eyelight, Juvederm Volbella, Teosyal Redensity II (EU), Belotero Balance (+)
- Cheeks & midface → firm HA (Voluma, RHA 4) or Radiesse
- Nasolabial folds → medium HA (Restylane Defyne, Belotero Intense)
- Jawline & chin → dense HA (Volux, Revolax Sub-Q) or Radiesse
- Temples → Voluma or Sculptra (collagen stimulator)
- Hands → Radiesse or HA
- Off-label use: Some doctors inject large volumes of Sculptra (or similar PLLA fillers like Lanluma) for a non-surgical BBL (Brazilian Butt Lift). This is available in the USA, UK, and Denmark, but not approved in Belgium. Safety concerns limit its use in much of continental Europe.
Benefits of Fillers
- Immediate improvement (HA) or gradual collagen boost (Sculptra, Radiesse)
- Non-surgical, minimal downtime
- HA can be dissolved if needed
- Customizable to the patient’s anatomy
Risks and Safety
Most side effects are mild and temporary: swelling, redness, bruising, or tenderness. But fillers also carry serious risks when performed incorrectly:
- Vascular occlusion (when filler enters a blood vessel) → can cause necrosis, blindness, or stroke if not treated immediately.
- Migration: filler may move from its intended spot, especially with large bolus injections.
- Granulomas and nodules: delayed inflammatory reactions, more common with long-lasting fillers.
- Perception drift: psychological risk where patients lose perspective over time, leading to unnatural overfilling.
Find a Certified Injector Near You →
Looking for natural results with safe, approved products? Use our directory to find licensed doctors and clinics offering dermal fillers in Belgium.
Why Are Some Fillers Available in Europe but Not in the USA?
In Europe, dermal fillers are regulated as medical devices. To be sold, they must carry a CE mark, which is granted by independent organizations called Notified Bodies. This process checks safety, quality, and clinical data. In the USA, fillers are regulated as medicinal products by the FDA (Food and Drug Administration), which requires separate clinical trials and approval.
That’s why some fillers — like Teosyal, Saypha, or Revolax — are widely used in Europe but not FDA-approved in the US. It doesn’t necessarily mean they are unsafe; it simply reflects different regulatory systems.
How Long Do Fillers Last?
- HA fillers: 6–18 months
- Radiesse: 12–18 months
- Sculptra: 2+ years
- Bellafill: 5 years or more
- Fat transfer: partially permanent
Recent imaging studies have shown that HA fillers may last longer than expected, sometimes years after injection. While this can be positive, it also highlights why repeat treatments should be conservative — layering new filler on top of old can lead to swelling or distortion.
Choosing the Right Filler at a Glance
Only HA fillers can be dissolved with hyaluronidase. Other fillers (Radiesse, Sculptra, Bellafill) require the injector to “get it right” from the start.
First-time filler → Most people start with a hyaluronic acid product such as Juvéderm, Restylane, Teosyal, Belotero, or Revolax. These are safe, reversible, and give immediate results.
Lips and under-eyes → Softer gels like Juvéderm Volbella, Restylane Kysse, Teosyal Redensity II, Belotero Balance+, or Restylane Eyelight blend smoothly into delicate tissues.
Cheeks, chin and jawline → For structure and lift, firmer fillers are chosen, such as Juvéderm Voluma, Juvéderm Volux, Restylane Lyft, or Radiesse.
Temples → Juvéderm Voluma or Sculptra (PLLA) are often used, since they restore volume where hollows can make the face look tired.
Hands → Radiesse and certain hyaluronic acid fillers are reliable choices for hiding veins and tendons.
Long-lasting options → Patients seeking more permanence may choose Bellafill (PMMA) or fat transfer, which provide durable correction but are not easily reversible.
Dermal Filler Brands
- Juvéderm (Allergan, US) – A smooth hyaluronic acid filler line using Vycross® technology. It covers lips, cheeks, chin, jawline and temples, with results lasting up to two years. Swelling under the eyes is possible, and it tends to be at a premium price point.
- Restylane (Galderma, Sweden) – One of the longest-standing HA families, using OBT® technology. It includes Restylane Eyelight for under-eye hollows, Lyft for cheeks and hands, and Kysse for lips. The gels feel slightly firmer than Juvéderm, which some injectors prefer for support.
- Teosyal RHA (Teoxane, Switzerland) – Designed for dynamic areas of the face, these fillers move naturally with expression. They are popular in Europe for folds around the mouth and jawline contouring, but less known in the US.
- Belotero (Merz, Germany) – Uses Cohesive Polydensified Matrix® technology. Belotero Balance+ is approved for under-eye hollows, while Intense and Volume target folds and cheeks. Excellent for fine detail work, but usually shorter in duration.
- Revolax (Across, Korea) – A budget-friendly HA filler used in Europe and the UK for folds, chin, jawline and lips. Reliable and firm, but with fewer long-term clinical studies than older brands.
- Radiesse (Merz, Germany/US) – Made of calcium hydroxylapatite microspheres, it provides strong lift for the jawline, chin, cheeks, and hands. It also stimulates collagen and lasts 12–18 months. It cannot be dissolved and is not suitable for lips or under-eyes.
- Sculptra (PLLA, Galderma) – A collagen stimulator that gradually restores volume in the temples, cheeks, and jawline, with results lasting two years or more. Requires multiple sessions and is not reversible. In higher volumes, it is used off-label for “non-surgical BBL,” a practice available in the US, UK, and Denmark, but not in Belgium.
- Bellafill (Suneva, US) – A PMMA-based filler combined with collagen, lasting five years or more. It is mainly used for acne scars and deep folds. Allergy testing is advised, and its use in Europe is limited.
- Fat transfer – A surgical option using the patient’s own fat, harvested by liposuction and reinjected to restore volume in cheeks, temples, or under-eyes. It can be long-lasting but unpredictable, since not all transferred fat survives.
Costs in Belgium
- Per syringe (HA): €250–500
- Radiesse/Sculptra: €350–600+ per session
- Fat transfer: surgical, usually €2000+
A full-face rejuvenation often requires multiple syringes.
Find a Certified Injector Near You →
Final Thoughts
Dermal fillers are one of the most powerful and flexible tools in aesthetic medicine. In the right hands, they restore balance and freshness without changing who you are. In the wrong hands, they can create problems that are difficult to reverse.
The key is not the brand or the syringe, but the expertise of the injector. A skilled doctor knows which filler to use where, how much is enough, and when to stop. Great filler work shouldn’t announce itself. It should simply make you look like you — rested, balanced, and unmistakably natural.
