Types of Dermal Fillers: HA, CaHA, PLLA & PMMA Explained

In the world of aesthetic treatments, dermal fillers are among the most popular non-surgical solutions for facial rejuvenation. These injectable treatments help restore volume, smooth out wrinkles, and enhance facial features. With a variety of fillers available, it can be overwhelming to choose the right one. In this blog, we'll take a closer look at the most common types of dermal fillers—Hyaluronic Acid (HA), Calcium Hydroxyapatite (CaHA), Poly-L-Lactic Acid (PLLA), and Polymethyl Methacrylate (PMMA)—and explore the various brands associated with each, helping you understand which option may be best for your needs.

How Are Dermal Fillers Classified?

Dermal fillers are commonly classified not only by their ingredients but also by how they work, how long they last, and whether they stimulate collagen production. Understanding these differences helps patients and practitioners choose the most appropriate treatment.

By Mechanism of Action

• HA fillers mainly restore lost volume and hydration.

• CaHA, PLLA, and PMMA provide structural support while promoting varying degrees of collagen production.

By Longevity

• HA: 6–12 months (face)

• CaHA: 12–18 months

• PLLA: 18–24 months or longer

• PMMA: 5 years or longer

Results vary depending on the treatment area, product formulation, and individual metabolism.

By Reversibility

HA is currently the only commonly used filler that can be dissolved with hyaluronidase. CaHA, PLLA, and PMMA are not reversible after injection, making proper treatment planning especially important.

1. Hyaluronic Acid Filler

Many of the best-known dermal fillers are made of hyaluronic acid, as it's an incredibly versatile product with a high safety profile. It's also a substance that's naturally produced by the body and can hold up to 1000 times its weight in water, for instant volumizing and hydrating effects. HA fillers are typically soft and gel-like. The results are temporary, lasting 6 to 12 months or longer before the body gradually and naturally absorbs the particles. Most HA fillers are infused with lidocaine to help minimize discomfort during and after treatment.

Brand names include: Revisage® , Macrolite®

Best For:

· Facial volume restoration (cheeks, temples)

· Lip enhancement

· Smoothening wrinkles and fine lines (nasolabial folds, crow's feet)

· Under-eye hollows

· Breast and buttock enlargement

Duration:

Hyaluronic acid face fillers typically last 6 to 12 months, while body fillers for breast and buttock augmentation last 12 to 18 months, depending on factors like the treatment area, lifestyle, and skin type. Regular maintenance sessions can help sustain optimal results over time.

2. Calcium Hydroxyapatite Filler

Calcium Hydroxyapatite (CaHA) is a naturally occurring substance primarily found in our bones. In filler form, the CaHA particles are microscopically small and suspended in a smooth gel. CaHA fillers are generally thicker than hyaluronic acid fillers, offering not only immediate volume restoration but also stimulating collagen production for long-lasting results. These fillers typically last about 12 months for most patients.

Brand names include: CHArmacy®

CHArmacy® combines CaHA with Hyaluronic Acid (HA) for the best of both worlds. The CaHA microspheres provide immediate volume and structure to the skin, while the HA component hydrates and smooths the skin. Over time, the CaHA promotes collagen synthesis, improving skin elasticity and overall texture.

Best For:

· Deep wrinkle treatment (nasolabial folds, marionette lines)

· Facial volumization (cheeks, chin)

· Collagen stimulation for long-term skin rejuvenation

Duration:

Results typically last 12 to 18 months, with collagen stimulation continuing to enhance skin quality even after the filler has broken down.

3. Poly-L-Lactic Acid Filler

Poly-L-Lactic Acid (PLLA) is a biodegradable, synthetic substance,it's known as a stimulator, that stimulates the body's natural collagen production. Unlike other fillers that add volume directly, PLLA fillers work gradually by encouraging the skin to produce more collagen over time, leading to a more youthful appearance. Results appear gradually and take four-to-six weeks to peak. Poly-L-lactic acid is typically used to treat deeper facial wrinkles, and results can last more than 2 years. now Devolux has new technology products can last 3 years，and also use for body sculpt.

Brand names include: Devolux®

The Devolux® series products are advanced biostimulators, primarily formulated with poly-L-lactic acid (PLLA). Among them, Devolux® Vital is a liquid formulation that combines PLLA with hyaluronic acid, specifically designed for facial volumization. The hyaluronic acid delivers immediate wrinkle-filling effects, while the PLLA stimulates collagen production, ensuring long-lasting results for up to two years. Devolux® Plus, on the other hand, is a lyophilized powder that blends PLLA with hyaluronic acid, featuring a particle size of 60-100μm. It is designed for breast and buttock augmentation and can last up to 2 years.

Best For:

· Overall facial volumization (cheeks, temples, chin)

· Deep wrinkles and sagging skin

· Long-term collagen stimulation for a natural youthful appearance

Duration:

The results of Devolux® are long-lasting, typically 2 to 3 years, as the body continues to produce collagen even after the filler has been absorbed.

4. Polymethyl Methacrylate Filler

Polymethylmethacrylate (PMMA) is a synthetic, biocompatible material that has been widely used in medicine for much of the past century. PMMA filler serves as a semi-permanent filler, composed of polymethylmethacrylate microspheres suspended in a smooth collagen gel base. Unlike hyaluronic acid fillers, PMMA microspheres act as a "scaffold" within the skin, encouraging the body to produce its own collagen over time. This newly formed collagen creates a foundation that restores volume and reduces the appearance of wrinkles. This injectable is particularly effective for treating medium to deep wrinkles and folds, with results that can last for up to five years.

Brand names include: PrimeFill®

PrimeFill® is an advanced dermal filler comprising 20% non-absorbable polymethylmethacrylate (PMMA) microspheres, each with a uniform diameter of 30 to 50 microns, suspended in 80% cross-linked sodium hyaluronate. This unique formulation stimulates the skin's natural collagen production, delivering long-lasting results. PrimeFill® is designed to provide benefits that last over 5 years. It is particularly effective for treating smile lines and acne scars but can be used on various areas of the face, excluding the lips.

Best For:

· Permanent wrinkle reduction (nasolabial folds, chin lines)

· Facial volumization (cheeks, jawline)

· Long-term results without the need for frequent touch-ups

Duration:

PrimeFill® offers permanent results, making it ideal for patients who want lasting volume restoration without the need for ongoing treatments.

Comparison Table: HA vs CaHA vs PLLA vs PMMA Dermal Fillers

*Body HA fillers formulated for larger-volume augmentation may have longer persistence than facial HA fillers, depending on the formulation and treatment area.

Which Dermal Filler is Right for You?

Choosing the right dermal filler depends on your aesthetic goals, the areas you wish to treat, and how long you want the results to last. Here's a quick guide to help you decide:

· Revisage® (HA filler) is perfect for patients looking for quick, effective results with minimal downtime. Ideal for fine lines, lip enhancement, and moderate volume loss.

· CHArmacy® (CaHA filler) is ideal for those seeking deeper wrinkle treatment and overall facial volumization, with the added benefit of collagen stimulation for long-term skin health.

· Devolux® (PLLA filler) is great for patients who prefer gradual, natural-looking results and long-lasting collagen stimulation. Best for overall volumization and sagging skin.

· PrimeFill® (PMMA filler) is the best option for patients seeking permanent results for deeper wrinkles and more significant facial volume restoration.

Consult with an experienced aesthetic professional to determine which filler best suits your needs and aesthetic goals.

Can Different Dermal Fillers Be Combined?

Yes. In modern aesthetic medicine, combination treatment has become increasingly common because different filler materials serve different clinical purposes. Rather than relying on a single product, experienced practitioners may use complementary fillers to address multiple signs of facial aging while maintaining natural-looking results.

Common Combination Approaches

HA + PLLA

One of the most widely used approaches combines hyaluronic acid with PLLA. HA provides immediate volume correction and facial contouring, while PLLA gradually stimulates collagen production over the following months. This strategy can deliver both short-term improvement and longer-term tissue regeneration.

HA + CaHA

HA and CaHA may also be used together in selected patients. HA is often chosen for softer, mobile areas such as the lips or tear troughs, whereas CaHA provides stronger structural support for areas like the jawline, chin, or cheeks. Their different rheological properties allow practitioners to customize treatment according to facial anatomy.

Clinical Considerations

Combination treatments are not simply about using multiple fillers—they require individualized planning. Treatment sequencing, injection depth, product selection, and facial anatomy all influence the final outcome. For this reason, combination procedures should only be performed by qualified medical professionals with a thorough understanding of facial anatomy and filler characteristics.

When appropriately planned, combining different filler technologies can often achieve more balanced, natural, and comprehensive facial rejuvenation than a single filler alone.

Conclusion

For professional-grade products, choosing trusted brands ensures safety, efficacy, and satisfaction.

Dermal fillers offer a range of solutions tailored to different needs, and with these trusted brands, achieving aesthetic goals has never been more effective or accessible. Consult a qualified professional to determine the ideal filler for you!

FAQ

Which dermal filler lasts the longest?

PMMA generally provides the longest-lasting results, often exceeding five years. PLLA follows with gradual collagen stimulation lasting two years or longer, while CaHA and HA typically last 12–18 months and 6–12 months, respectively.

Which filler is best for first-time patients?

HA fillers are often recommended for first-time patients because they provide immediate results and can be dissolved with hyaluronidase if needed.

Which fillers stimulate collagen production?

PLLA offers the strongest collagen stimulation, while CaHA and PMMA also promote collagen formation. HA mainly restores volume rather than stimulating collagen.

Can different fillers be used together?

Yes. Different fillers may be combined to treat multiple concerns in a single treatment plan, depending on the patient's anatomy and aesthetic goals.

Are all dermal fillers reversible?

No. Only HA fillers can be dissolved with hyaluronidase. CaHA, PLLA, and PMMA are not reversible once injected.

Which filler looks the most natural?

Natural-looking results depend more on proper product selection and injection technique than on the filler material itself.