A new review article suggests that a high level of evidence supports the use of many dermal fillers on the market today, including hyaluronic acid-based fillers. Since 1997, the number of nonsurgical procedures performed in the United States increased 356%, with Botox taking the lead, followed by Hyaluronic acid fillers, according to the article that appears online in the Archives of Facial Plastic Surgery.

The filler revolution began in 2003 with the introduction of hyaluronic acid-based fillers, and what followed was a parade of other dermal fillers and volumizing agents. There have been 25 fillers approved by the FDA since 1981. Most recently, the FDA approved Belotero and LaViv.

Others fillers pending FDA approval include Juvederm Voluma and Juvederm Voluma-XD.
According to the review, a high level of evidence supports hyaluronic acid-based fillers, calcium hydroxylapatite and poly (methyl methacrylate) with collagen, and other hyalulronic acid formulations. That said, more research is needed for poly-L-lactic acid (Sculptra Aesthetic).

“As the world of facial-filling products continues to expand, it is evident that there are multiple opportunities for further research in these areas,” concludes review author Theda C. Kontis, MD, of Johns Hopkins Medical Institutes in Baltimore.