Filler—it seems like everyone is talking about it, and everyone is getting it (or at the very least, is curious about it). Blame it on our ever-increasing consumption of social media or perhaps just the ever-increasing idolization of the Jenner-Kardashian clan, but the treatment is most definitely on the rise, and people are booking treatments not only at a faster rate but at a younger rate as well. (And hey, as someone who got her first pump of lip filler at the age of 24, I'm definitely a contributing statistic.)
“In our youth-based culture, it’s become all about slowing down the clock,” the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) cites. “The number of patients under 30 seeking cosmetic tweaks continues to grow, and 51% of AAFPRS members agree that more patients now emphasize early maintenance with increasing numbers of men and women in their 20s and 30s opting for preventive measures to forestall bigger procedures and surgery. In fact, more than half of facial plastic surgeons saw an increase in 2016 in cosmetic surgery or injectables with patients under 30.”
Of course, filler isn't for everyone, and some people have zero interest in the cosmetic treatment. Alas, that doesn't necessarily mean said camp doesn't care (or want) the types of skin perks and youth-enhancing benefit fillers can yield. Therefore, we've been wondering what our other options are. What are our filler alternatives? Is there a certain skincare potion we can buy, a specific regimen to follow, or an epic facial to book that will reap results similar or perhaps superior to that of a syringe? Unfortunately, not exactly.
"Despite many marketing claims, there is no skincare product that can replace volume the way injectable filler can," clarifies Nancy Samolitis, MD, an anti-aging expert and board-certified dermatologist specializing in cosmetic and laser dermatology at Facile in West Hollywood. "The reason is that our skin is designed to protect us from the environment, and its natural barrier function does not allow large molecules (including hyaluronic acid) to penetrate deep enough to mimic the effects of filler. I know—I'm sorry!"
That said, there are most definitely some important things to know and most definitely some important things that can help. Here, we're diving into all things filler and all things filler alternative. And to help, I've recruited some of the best East and West Coast celebrity dermatologists to lend their expert intel. Keep scrolling! Your plump and dewy skin awaits—regardless of whether or not you decide to go the filler route.
First of all, what is filler?
Although there are many types of injectable fillers, the dermatologists I spoke with explained to me that hyaluronic acid fillers are the most commonly used within the industry. Hyaluronic acid (HA for short) is a sugar naturally found in our skin and body, which lubricates and holds up to 1000 times its weight in water, imparting our skin with that plump, dewy radiance and that covetable "sculpted" texture.
"Manufacturers have modified native HA to make it last longer (injected native product would last only a couple of days before being naturally degraded in the body) so that it can act to restore volume and smooth lines that have occurred over time," explains Jennifer Herrmann, MD, FAAD, of Moy Fincher Chipps Facial Plastics & Dermatology in Beverly Hills.
"Depending on what a patient and I agree will help best address their needs, I choose a filler with specific properties that can help either lift or smooth the skin," Herrmann says. Prior to filler injections, she tells me that they'll discuss expectations, relevant medical history, prior injections or surgeries, and the projected care and maintenance plan.
Why are people obsessed with it?
"When fillers were new (back in the '90s), their primary function was to fill in wrinkles only," explains Samolitis. However, as our understanding of facial aging has progressed, she says, new fillers have been developed to plump and enhance our lips, fill unwanted hollowness under our eyes, lessen the look of laugh lines, and more.
Additionally, Dendy Engelman, MD, FACMS, FAAD, of Medical Dermatology & Cosmetic Surgery adds that fillers may reap long-term benefits since they help build collagen and elastin. But as she points out, fillers are largely used to help deeper textural issues like the issues listed above and other moderate to severe facial wrinkles and folds—fine lines and wrinkles can be treated with Botox or topical products. "If a patient needs to restore volume or has deeper folds, fillers are usually necessary to add support and structure. A topical cream or most in-office treatments can't act as substitutes for volume loss and repositioned (fallen) fat pads," adds Herrmann.
That said, there is a fine line as far as fillers go, and using too much (especially in delicate areas where our skin is thinner) can lead to complications like lumps and bumps. Your best call? Find a trusted, board-certified dermatologist in your area for a consultation. They'll be able to advise whether fillers, Botox, laser, or just strategic topicals will be your best treatment plan.
So what can you do instead?
Unfortunately, there just isn't a magical skincare regimen or a specific product that will replace or exactly replicate the effect of filler. That said, preventative skincare (aka what you're doing now!) can make a major difference in the texture and future of your skin along with other lifestyle habits and practices. Like, um, your sun protection strategy.
"Many of the aging changes that people seek filler to correct are caused by sun damage," Samolitis points out to me. "Although most people consider sun damage to primarily cause dullness and discoloration, it also causes loss of skin thickness and volume of underlying fat." Instead of (or in addition to) fillers, Samolitis suggests treating the underlying sun damage with skincare in tandem with skin-rejuvenating procedures like peels, micro-needling, laser resurfacing, regular facials, etc. Again, your derm will be able to advise a strategy and treatment plan that will be best for your personal goals.
As Ronald Moy, MD, FAAD, of Moy Fincher Chipps explains, Botox/Dysport/Xeomin/Jeuveau will better for treating things like frown-line and crow's-feet wrinkles, whereas rejuvenating and tightening procedures like radio frequency skin tightening or carbon dioxide laser resurfacing can yield better, longer-lasting results for the skin under the eyes. Ahead, we're listing all of the best filler alternatives, according to Engelman, Herrmann, Moy, and Samolitis.
1. DNA Repair Enzymes & Epidermal Growth Factor
"Skincare products with DNA repair enzymes and epidermal growth factor will repair the past sun damage and thicken/tighten aged skin so that fillers can be postponed," says Moy. "I like DNA Renewal's growth factor, as it's plant-based and made from bio-engineered barley plant from Iceland. It's really the best skincare ingredient that can tighten and thicken skin because it stimulates epidermal stem cells and increases collagen."
2. Antioxidants Like Vitamin C & Idebenone
"Antioxidants like topical vitamin C can keep the skin looking tighter and fresh and can aid in collagen synthesis," says Herrmann. "But again, while topical treatments can help the skin stay looking as young as possible, they cannot replace the bone and soft tissue loss as well as the falling of fat pads, which accompany aging, that filler can better address."
Engelman agrees, adding that antioxidants are a great way to postpone injectables. "Due to pollution, UVB/UVA rays or environmental aggressors, as well as internal stressors, free radicals are formed, which are highly destructive molecules that can wreak havoc on your skin. Free radicals are unstable compounds in search of a missing electron. When they 'steal' electrons from other molecules, it leaves those molecules unstable as well, and they then search for the missing electron. Because this produces a domino effect, this further weakens the skin barrier, leaving it vulnerable to premature aging (i.e., fine lines and wrinkles and uneven skin texture)."
In a nutshell, boosting your skincare routine with antioxidants will help protect your skin against free radical assaults by neutralizing the oxidative stress that can cause cell damage and telltale signs of aging. Engelman suggests looking for skincare products containing the most powerful antioxidant, Idebenone, like the below.
"Retinoic acid (retinol/retinoid) is an extremely effective cell-communicating ingredient that has the ability to connect to almost any skin cell receptor site and tell it to behave like a healthy, younger skin cell," Engelman explains.
Retinoids, she says, can also function as an antioxidant, interrupting the damage (and wrinkle-inducing!) process caused by free radicals. With consistent use, clients can see improvements in fine lines/wrinkles, tone, and texture, etc. since the retinoid is strengthening the skin barrier.
4. Hyaluronic Acid—Lots of It
According to Samolitis, skincare products containing hyaluronic acid will help trap much-needed water and hydration into the skin (great for long-term plumpness and glow goals), but the HA itself won't actually go into the dermis of the skin like filler can.
However, Engelman loves the two-step system above which includes a daily serum and Micro-Cone patches to help improve look of expression lines and other fine wrinkles while you sleep. No, it won't yield filler-esque results, but it's better than nothing and will help significantly with texture issues over time.
5. Exfoliating Acids
Samolitis also adds that there are several skincare ingredients that can maximize the thickness of the dermis (the layer of skin that contains HA and collagen) which will be exfoliating heavy hitters that encourage skin turnover like glycolic (and other) acids and retinol—as we covered above!
Engelman is a fan of polyhydroxy acid, which she says will exfoliate surface skin cells and enhance natural cell turnover. Not only will this brighten your complexion, but it also gives your skin added protection against environmental aggressors that contribute to signs of aging like lines, wrinkles, and hollows people typically seek out filler for.
Sunscreen is also critical for the prevention of accelerated damage, says Herrmann. And as Samolitis points out, consistent sun protection applied at an early age will help prevent some of the changes that occur that require filler to correct.
7. Other Facial Rejuvenation Treatments
Botox or Dysport: "If someone has lines caused by muscle movement, filler may not be the best option, and Botox or Dysport may be a better alternative," explains Herrmann. And as Moy mentioned earlier, these treatments are better for those with more superficial (aka less severe) skin concerns like fine lines, crow's-feet, and frown lines. Filler, he says, will be the best choice when there is a depression in the skin, a valley in what is normally flat skin, or a depressed scar or a skin hollow.
Microinfusion: "We do a procedure at Facile called microinfusion that uses very fine micro-needles to stamp tiny droplets of thin filler into the top layer of the skin," shares Samolitis. "It is different from traditional filler injections because the filler is going more superficially but is blended with vitamins and a small amount of Botox to maximize texture improvement and skin brightening without the risk of lumps or changing your contour. It is a great starter procedure for someone who is nervous about traditional filler injections. The results last about a month and continue to build with additional treatments."
Laser Resurfacing: According to Herrmann, if someone has significant sun damage and deep diffuse wrinkling, they may benefit more from full-face laser resurfacing, which can give much more natural results. It can also be a more effective treatment for those looking to treat the under-eye area.
Radio Frequency Skin-Tightening Treatments: "If minimal volume loss or sagging has occurred, adding a series of radio frequency heat treatments can help firm skin in a very noninvasive, no-downtime way," Herrmann adds. "Such treatments aid in collagen synthesis and can help reverse early signs of skin aging like lightly visible laugh lines, and sharpen or firm the jawline, minimizing faint jowls."
The Ultimate Filler-Alternative Skincare Routine
"Cleanse! If you only have five minutes, the most important thing to do is to remove the
day's grime and gunk," says Engelman. She suggests sticking with a gentle cleanser that won't strip your skin of natural oils and likes this one from Elizabeth Arden—especially for those with dry, sensitive skin.
"Regular exfoliation (this can be daily with cleanser, weekly with home peels, or monthly with clinical peels and facials) to keep dull, thickened, sun-damaged skin at bay is key for maintaining a plump, dewy complexion," says Samolitis.
Engelman recommends incorporating a toner like Biologique Recherche Lotion P50 ($112) which has phenol and salicylic acid to help exfoliate and tone the skin effortlessly and easily every day at home.
"Next comes your application of antioxidants (such as vitamin C) followed by sunblock to provide sun and environmental protection from damage," instructs Samolitis.
For evening, Engelman says to follow your toner application with retinol (in lieu of your morning vitamin C) which will increase turnover, allowing older, dull cells to be removed from the surface of the skin. "Finish with a hydrating cream and use a product with ceramides, which will support the skin barrier while keeping skin firm," she concludes.
Last but not least, eye cream! This one from Revision Skincare is one of Engelman's favorites.