forms of hyaluronic acid

Juvederm for lip augmentation*

There are a few common forms of hyaluronic acid that have FDA approval for use as an injectable cosmetic serum. Hyaluronic acid is the main ingredient for temporary treatment of fine lines, wrinkles, and many other cosmetic ailments commonly pertaining to aging skin. It is also widely used for lip augmentation and non-surgical cheek lift.

What is Hyaluronic Acid?

HA is a carbohydrate polymer, or natural sugar, that is a major component of our connective tissue. It is found in the extracellular matrix of our muscles, tendons, and skin. It is also found in the synovial fluid that lubricates our joints.

Since the discovery that it can safely bind to 1,000 times its weight in water molecules, it has been used to augment tissue volume and skin hydration. In addition, hyaluronic acid fuses with collagen and elastin, improving the elasticity of the skin. The result is a plumper, firmer, more youthful-looking appearance at the injection site. The forms of hyaluronic acid available for cosmetic enhancement include:

  • Restylane
  • Juvederm
  • Belotero.


Restylane was the first hyaluronic acid filler to get its FDA approval, in 2003. It has a thicker consistency than its main competitor, Juvederm, and is synthesized from a non-animal hyaluronic acid base. This minimizes risk of allergic reaction in patients. Practitioners injecting this filler must be experienced and administer the treatment with extreme care so the outcome is even and bumps do not form. Restylane results last approximately 4 months.


Juvederm got its FDA approval in 2006. It is a thinner compound than Restylane, and is thus more likely to “run” after injection. This can be both good and bad, as it creates less risk of unwanted bumps forming, but can also allow the serum to spread to areas where it is not intended. Practitioners must be experienced to get the best results, which will last between 6 to 8 months.


Belotero Basic is the most recent HA filler on the U.S. market, with its FDA approval in 2011. (It also comes in Soft and Intense, available in Europe). It is thinner and more lightweight than both Restylane and Juvederm, but with a very high level of elasticity. Thus, it yields a smoother result and a more seamless perimeter between treated and untreated areas. It can also be injected closer to the surface of the skin than any other hyaluronic acid filler because it does not exhibit the Tyndall effect. Belotero lasts 6 to 12 months once injected and also requires injection by an experienced doctor.