Hyaluronic acid (HA) dermal fillers are among the most commonly used injectable products in aesthetic medicine, with multiple FDA-approved options available for different clinical applications. While many fillers share similar core components, they vary significantly in crosslinking technology, firmness (G′), and clinical behavior in tissue. These differences influence how each product performs in specific treatment areas such as lips, fine lines, and deeper facial folds.
This page compares FDA-approved HA dermal fillers by primary indication, focusing on objective characteristics and publicly available manufacturer information. Because many fillers are used off-label in clinical practice, this comparison is limited to FDA-approved indications to provide a standardized and transparent framework for evaluation.
Please note: All brand names are registered trademarks of their respective manufacturers. There is no “generic” hyaluronic acid dermal filler approved for use on patients.
Key Facts: Hyaluronic Acid Dermal Fillers
- All FDA-approved dermal fillers in this comparison are composed of hyaluronic acid (HA), but differ in crosslinking technology, firmness (G′), and clinical behavior.
- FDA indications vary by product and include lip augmentation, correction of perioral lines, and treatment of moderate to severe facial wrinkles and folds such as nasolabial folds.
- Fillers are typically selected based on treatment area and injection depth, with lower firmness products used for superficial lines and higher firmness products used for structural support.
- Crosslinking technologies (e.g., VYCROSS®, NASHA®, XpresHAn Technology™, CPM®, RHA®) influence flexibility, cohesivity, and how the product integrates into tissue.
- Many fillers are used off-label in clinical practice, but this page focuses on FDA-approved indications to provide a consistent comparison framework.
- Commonly cited properties such as G′ (stiffness), cohesivity, and flexibility are measured under laboratory conditions and may vary depending on methodology.
- Clinical outcomes depend on injection technique, patient anatomy, and product selection, not solely on the filler used.
1️⃣Lips
Lip augmentation requires fillers that balance softness, flexibility, and integration to allow for natural movement while maintaining shape and volume. Products used in this area are typically lower to medium in firmness (G′) and are designed to perform well in dynamic tissue.
The table below includes hyaluronic acid fillers with FDA approval for lip augmentation. While additional products may be used off-label, only those with formal FDA indication for lips are included here.
| Product | Manufacturer | Technology | Relative Firmness (G′) | FDA Indication | Duration |
|---|---|---|---|---|---|
| JUVÉDERM® Ultra XC | Allergan Aesthetics® | Hylacross | Medium | Lip augmentation and perioral lines | ~12 months |
| JUVÉDERM® VOLBELLA® XC | Allergan Aesthetics® | Vycross | Low | Lip augmentation and perioral lines | ~12 months |
| Restylane®-L | Galderma® | NASHA | Medium | Lip augmentation | ~6–12 months |
| Restylane® Kysse | Galderma® | XpresHAn | Medium | Lip augmentation and upper perioral rhytids | ~12 months |
Note: Many dermal fillers are used off-label for lip augmentation based on clinician experience. This table includes only products with FDA-approved indications for lips.
Fine Lines (Superficial Dermal Fillers)
Correction of fine lines and superficial rhytids requires fillers with low viscosity and strong tissue integration to minimize visibility and irregularities when placed in the superficial dermis. These products are typically lower in firmness (G′) and are designed to spread evenly within the tissue.
The table below includes hyaluronic acid fillers with FDA-approved indications relevant to fine lines or superficial dermal placement. Only on-label indications are included.
| Product | Manufacturer | Technology | Relative Firmness (G′) | FDA Indication | Duration |
|---|---|---|---|---|---|
| JUVÉDERM® VOLBELLA® XC | Allergan Aesthetics® | Vycross | Low | Lip augmentation and correction of perioral lines | ~12 months |
| Restylane® Silk | Galderma® | NASHA | Low | Lip augmentation and perioral rhytids | ~6–12 months |
| Belotero® Balance | Merz Aesthetics® | CPM (Cohesive Polydensified Matrix) | Low | Correction of moderate to severe facial wrinkles and folds (including nasolabial folds). Using this product on “Fine Lines” would be considered Off-Label use. | ~6–12 months |
Note: Many dermal fillers are used off-label for superficial fine lines based on clinician experience. This table reflects FDA-approved indications, which may differ from common clinical use.
3️⃣Moderate to Severe Facial Folds
Correction of deeper facial folds such as nasolabial folds generally requires fillers with greater structural support and persistence than those used for superficial lines. Products in this category are typically placed in the mid-to-deep dermis, with some designed for deeper placement into the deep dermis or superficial subcutaneous tissue.
The table below includes FDA-approved hyaluronic acid fillers for moderate to severe facial wrinkles and folds, such as nasolabial folds. Only on-label FDA indications are included here.
| Product | Manufacturer | Technology | Relative Firmness (G′) | FDA Indication | Typical Duration |
|---|---|---|---|---|---|
| JUVÉDERM® Ultra XC | Allergan Aesthetics® | Hylacross | Medium | Correction of moderate to severe facial wrinkles and folds, such as nasolabial folds | ~12 months |
| JUVÉDERM® Ultra Plus XC | Allergan Aesthetics® | Hylacross | Medium-High | Correction of moderate to severe facial wrinkles and folds, such as nasolabial folds | ~12 months |
| JUVÉDERM® VOLLURE® XC | Allergan Aesthetics® | Vycross | Medium | Injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds, such as nasolabial folds, in adults over 21 | ~18 months |
| Restylane®-L | Galderma® | NASHA | Medium | Correction of facial wrinkles and folds, such as nasolabial folds | ~6–12 months |
| Restylane® Lyft | Galderma® | NASHA | High | Correction of facial wrinkles and folds, such as nasolabial folds | ~12 months |
| Restylane® Refyne | Galderma® | XpresHAn | Medium | Injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds, such as nasolabial folds | ~12 months |
| Restylane® Defyne | Galderma® | XpresHAn | Medium-High | Injection into the mid-to-deep dermis for correction of moderate to severe deep facial wrinkles and folds, such as nasolabial folds | ~12 months |
| BELOTERO BALANCE® (+) | Merz Aesthetics® | CPM (Cohesive Polydensified Matrix) | Low | Injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds, such as nasolabial folds | ~6–12 months |
| RHA® 2 | Revance Therapeutics® | Resilient Hyaluronic Acid | Low-Medium | Injection into the mid-to-deep dermis for the correction of moderate to severe dynamic facial wrinkles and folds, such as nasolabial folds | ~15 months |
| RHA® 3 | Revance Therapeutics® | Resilient Hyaluronic Acid | Medium | Injection into the mid-to-deep dermis for the correction of moderate to severe dynamic facial wrinkles and folds, such as nasolabial folds | ~15 months |
| RHA® 4 | Revance Therapeutics® | Resilient Hyaluronic Acid | Medium-High | Injection into the deep dermis to superficial subcutaneous tissue for the correction of moderate to severe dynamic facial wrinkles and folds, such as nasolabial folds | ~15 months |
| Revanesse® Versa™ | Prollenium Medical Technologies® | Crosslinked HA | Medium | Injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds, such as nasolabial folds, in adults 22 years of age or more | ~12 months |
| Revanesse® Versa™+ | Prollenium Medical Technologies® | Crosslinked HA | Medium | Injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds, such as nasolabial folds, in adults 22 years of age or more | ~12 months |
Note: This table is limited to FDA-approved hyaluronic acid fillers with on-label indications for moderate to severe facial wrinkles and folds, such as nasolabial folds. Many fillers are used off-label elsewhere in clinical practice. RHA® 2/3/4 are on-label for dynamic facial wrinkles and folds such as nasolabial folds; Belotero Balance® (+) is on-label for moderate to severe facial wrinkles and folds such as nasolabial folds; and Revanesse® Versa and Versa™+ are FDA-approved for the same folds indication.
FDA Approval Year and Lidocaine Content
The table below summarizes the approximate initial FDA approval year for each hyaluronic acid dermal filler listed above, along with whether the currently marketed formulation contains lidocaine. While many of the original formulations without lidocaine may still be available, the vast majority of use today involves fillers with lidocaine.
| Product | FDA Approval Year (U.S.) | Contains Lidocaine |
|---|---|---|
| JUVÉDERM® Ultra XC | 2006 (XC version ~2010) | Yes |
| JUVÉDERM® Ultra Plus XC | 2006 (XC version ~2010) | Yes |
| JUVÉDERM® VOLBELLA® XC | 2016 | Yes |
| JUVÉDERM® VOLLURE® XC | 2017 | Yes |
| Restylane®-L | 2003 (L version ~2012) | Yes |
| Restylane® Silk | 2014 | Yes |
| Restylane® Kysse | 2020 | Yes |
| Restylane® Lyft | 2015 (as Perlane-L → Lyft) | Yes |
| Restylane® Refyne | 2016 | Yes |
| Restylane® Defyne | 2016 | Yes |
| BELOTERO BALANCE® (+) | 2011 (+ version ~2021) | Yes |
| RHA® 2 | 2021 | Yes |
| RHA® 3 | 2021 (lip indication 2023) | Yes |
| RHA® 4 | 2021 | Yes |
| Revanesse® Versa™ | 2017 | No (original version) |
| Revanesse® Versa™+ | 2019 | Yes |
Note: Approval years are approximate and reflect initial FDA approval or major labeled updates. Many products have undergone subsequent indication expansions or formulation changes.
Dermal Filler Product Details
The following summaries provide additional detail on commonly used hyaluronic acid dermal fillers, including FDA-approved indications and key product characteristics. Links are provided to official prescribing information and supporting references where available.
FDA indications listed are based on publicly available prescribing information. Clinicians should review full labeling and use independent clinical judgment when selecting products. Many hyaluronic acid fillers are used off-label in clinical practice. The indication statements below are limited to FDA-approved U.S. indications.
JUVÉDERM® Ultra XC
- Manufacturer: Allergan Aesthetics®
- Technology: Hylacross
- FDA-Approved U.S. Indications: Correction of moderate to severe facial wrinkles and folds, such as nasolabial folds; lip augmentation in adults over age 21
- Typical Duration: About 12 months
- References:
Official labeling / directions for use |
Manufacturer overview
JUVÉDERM® VOLBELLA® XC
- Manufacturer: Allergan Aesthetics®
- Technology: Vycross
- FDA-Approved U.S. Indications: Lip augmentation and correction of perioral rhytids in adults over age 21
- Typical Duration: About 12 months
- References:
FDA approval / labeling |
Manufacturer patient labeling
Restylane®-L
- Manufacturer: Galderma®
- Technology: NASHA
- FDA-Approved U.S. Indications: Mid-to-deep dermal implantation for correction of moderate to severe facial wrinkles and folds, such as nasolabial folds; submucosal implantation for lip augmentation in patients over age 21
- Typical Duration: About 6–12 months
- References:
Official instructions for use |
Manufacturer HCP overview
Restylane® Kysse
- Manufacturer: Galderma®
- Technology: XpresHAn
- FDA-Approved U.S. Indications: Injection into the lips for lip augmentation and correction of upper perioral rhytids in patients over age 21
- Typical Duration: About 12 months
- References:
Official instructions for use |
FDA approval summary
Restylane® Silk
- Manufacturer: Galderma®
- Technology: NASHA
- FDA-Approved U.S. Indications: Lip augmentation and correction of perioral rhytids in patients over age 21
- Typical Duration: About 6–12 months
- References:
Official instructions for use |
Manufacturer HCP overview
BELOTERO BALANCE® (+)
- Manufacturer: Merz Aesthetics®
- Technology: CPM (Cohesive Polydensified Matrix)
- FDA-Approved U.S. Indications: Injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds, such as nasolabial folds
- Typical Duration: About 6–12 months
- References:
FDA labeling / approval document |
Official instructions for use
JUVÉDERM® Ultra Plus XC
- Manufacturer: Allergan Aesthetics®
- Technology: Hylacross
- FDA-Approved U.S. Indications: Correction of moderate to severe facial wrinkles and folds, such as nasolabial folds
- Typical Duration: About 12 months
- References:
Official labeling / directions for use |
Manufacturer overview
JUVÉDERM® VOLLURE® XC
- Manufacturer: Allergan Aesthetics®
- Technology: Vycross
- FDA-Approved U.S. Indications: Injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds, such as nasolabial folds, in adults over age 21
- Typical Duration: About 18 months
- References:
FDA approval / labeling |
Manufacturer patient labeling
Restylane® Lyft
- Manufacturer: Galderma®
- Technology: NASHA
- FDA-Approved U.S. Indications: Implantation into the deep dermis to superficial subcutis for correction of moderate to severe facial folds and wrinkles, such as nasolabial folds; cheek augmentation and correction of age-related midface contour deficiencies; correction of dorsal hand volume deficit
- Typical Duration: About 12 months for facial folds
- References:
Official instructions for use |
Manufacturer HCP overview
Restylane® Refyne
- Manufacturer: Galderma®
- Technology: XpresHAn
- FDA-Approved U.S. Indications: Injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds, such as nasolabial folds, in patients over age 21
- Typical Duration: About 12 months
- References:
Official instructions for use |
Manufacturer HCP overview
Restylane® Defyne
- Manufacturer: Galderma®
- Technology: XpresHAn
- FDA-Approved U.S. Indications: Injection into the mid-to-deep dermis for correction of moderate to severe, deep facial wrinkles and folds, such as nasolabial folds, in patients over age 21; augmentation and correction of mild to moderate chin retrusion in patients over age 21
- Typical Duration: About 12 months for folds
- References:
Official instructions for use |
Manufacturer HCP overview
RHA® 2
- Manufacturer: Revance Therapeutics®
- Technology: Resilient Hyaluronic Acid
- FDA-Approved U.S. Indications: Injection into the mid-to-deep dermis for correction of moderate to severe dynamic facial wrinkles and folds, such as nasolabial folds, in adults aged 22 years or older
- Typical Duration: About 15 months
- References:
FDA labeling |
FDA summary of safety and effectiveness
RHA® 3
- Manufacturer: Revance Therapeutics®
- Technology: Resilient Hyaluronic Acid
- FDA-Approved U.S. Indications: Injection into the mid-to-deep dermis for correction of moderate to severe dynamic facial wrinkles and folds, such as nasolabial folds, in adults aged 22 years or older; lip augmentation and lip fullness in adults aged 22 years or older
- Typical Duration: About 15 months for folds
- References:
FDA labeling |
FDA PMA record
RHA® 4
- Manufacturer: Revance Therapeutics®
- Technology: Resilient Hyaluronic Acid
- FDA-Approved U.S. Indications: Injection into the deep dermis to superficial subcutaneous tissue for correction of moderate to severe dynamic facial wrinkles and folds, such as nasolabial folds, in adults aged 22 years or older
- Typical Duration: About 15 months
- References:
FDA summary of safety and effectiveness |
FDA labeling family document
Revanesse® Versa™
- Manufacturer: Prollenium Medical Technologies®
- Technology: Crosslinked hyaluronic acid
- FDA-Approved U.S. Indications: Injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds, such as nasolabial folds, in adults aged 22 years or older
- Typical Duration: About 12 months
- References:
FDA summary of safety and effectiveness |
FDA PMA record |
Manufacturer directions for use
Revanesse® Versa™+
- Manufacturer: Prollenium Medical Technologies®
- Technology: Crosslinked hyaluronic acid with lidocaine
- FDA-Approved U.S. Indications: Injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds, including nasolabial folds, in adults aged 22 years or older
- Typical Duration: About 12 months
- References:
FDA PMA supplement record |
Manufacturer directions for use |
Professional directions for use PDF
General Background References
How to Choose a Hyaluronic Acid Filler
Clinical Guidance
Selecting an appropriate hyaluronic acid filler depends on matching the product’s physical properties to the treatment area, depth of injection, and desired clinical outcome. While many fillers share similar base components, differences in crosslinking technology, firmness (G′), and flexibility influence how each product performs in tissue.
- Lips: Require fillers with moderate flexibility and integration to allow natural movement while maintaining shape. Products with lower to medium firmness (G′) are typically preferred.
- Fine Lines: Superficial rhytids are best treated with low-viscosity fillers that integrate smoothly into the dermis and minimize the risk of visibility or irregularity.
- Moderate to Severe Folds: Deeper folds generally require fillers with greater structural support and resistance to compression. These products are typically placed in the mid-to-deep dermis or superficial subcutaneous plane.
Additional considerations include:
- Crosslinking Technology: Influences product cohesivity, spread, and duration.
- Injection Depth: Superficial vs. deep placement affects product selection.
- Duration: Varies by product and treatment area.
- FDA Indications: Provide a standardized reference but may not reflect all clinical uses.
This section is intended as a general clinical overview. Individual product selection should be based on clinician experience, patient anatomy, and a thorough understanding of each product’s labeling and safety profile.
Crosslinking Technologies and Rheologic Differences
Hyaluronic acid fillers are not identical even when they share the same base ingredient. Manufacturers use different crosslinking and manufacturing approaches to create gels with different physical characteristics. The most objective distinctions are the technology family used to make the gel, the intended depth and indication on FDA labeling, and the rheologic properties described in the medical literature.
For example, some technologies are marketed for greater projection and structural support, while others are designed for softer integration or dynamic movement. These distinctions do not make one technology universally “better” than another, but they do help explain why different products are selected for lips, fine lines, or deeper folds.
| Technology | Manufacturer / Family | Definite Distinction | Representative Products |
|---|---|---|---|
| HYLACROSS™ | Allergan Aesthetics® / JUVÉDERM® | Uses high-molecular-weight hyaluronic acid and is described by the manufacturer as highly cohesive. | JUVÉDERM® Ultra XC, JUVÉDERM® Ultra Plus XC |
| VYCROSS® | Allergan Aesthetics® / JUVÉDERM® | Proprietary crosslinking technology used in selected JUVÉDERM® fillers to create smooth gels with longer-lasting correction in certain indications. | JUVÉDERM® VOLBELLA® XC, JUVÉDERM® VOLLURE® XC, JUVÉDERM® VOLUMA® XC |
| NASHA® | Galderma® / Restylane® | One of Galderma’s two main Restylane® gel technologies; commonly associated with firmer gels intended for projection and definition. | Restylane®-L, Restylane® Silk, Restylane® Lyft |
| XpresHAn Technology™ | Galderma® / Restylane® | Galderma’s technology for more flexible gels intended to move with facial expression. | Restylane® Kysse, Restylane® Refyne, Restylane® Defyne |
| CPM® (Cohesive Polydensified Matrix) | Merz Aesthetics® / BELOTERO® | Patented technology with variable density within the gel matrix; marketed for tissue integration. | BELOTERO BALANCE® (+) |
| Resilient Hyaluronic Acid / Preserved Network Technology | Revance Therapeutics® / RHA® Collection | Manufactured to preserve longer HA chains and marketed for dynamic facial movement. | RHA® 2, RHA® 3, RHA® 4 |
What the Rheology Literature Measures
Published filler comparisons often discuss rheologic terms such as G′ (storage modulus), cohesivity, and stretch or flexibility. These are measurable physical properties, but values can vary depending on laboratory method, temperature, frequency, and whether the comparison is performed under standardized conditions. For that reason, product family and FDA indication are usually more stable anchors for comparison than a single number taken from different studies.
- G′ (storage modulus): reflects gel stiffness or resistance to deformation.
- Cohesivity: reflects how well a gel stays together as a unit.
- Flexibility / stretch: reflects how a gel deforms and recovers under movement.
Review articles and experimental studies suggest that different filler families can behave differently with respect to integration, flexibility, and resistance to enzymatic degradation, but these comparisons depend on the specific products tested and the methods used. Because of that, this page uses technology family and FDA-approved indication as the main comparison framework.
Selected Sources
- JUVÉDERM® Science and Performance (official technology overview)
- JUVÉDERM® official technology overview
- Restylane® HCP technology overview
- BELOTERO® CPM® technology overview
- RHA® filler science overview
- de la Guardia et al. Rheologic and Physicochemical Characteristics of Hyaluronic Acid Fillers
- Fundarò et al. The Rheology and Physicochemical Characteristics of HA Fillers
- Micheels et al. Comparison of diffusion and integration properties of CPM and VYCROSS fillers
- Faivre et al. Comparison of hyaluronidase-mediated degradation kinetics across filler families
Frequently Asked Questions About Hyaluronic Acid Dermal Fillers
Are all dermal fillers made of the same material?
No. This page compares only hyaluronic acid (HA) dermal fillers, but not all fillers on the market are made of HA. Even within the HA category, products differ in crosslinking technology, firmness, cohesivity, flexibility, and FDA-approved indications.
What is the difference between fillers used for lips, fine lines, and deeper folds?
Different treatment areas require different physical properties. Lip fillers generally need a balance of softness and structure, fine lines require smooth integration in superficial tissue, and deeper folds typically require more structural support and resistance to compression.
What does G′ mean in dermal filler comparisons?
G′ (storage modulus) is a rheologic measure of gel stiffness or resistance to deformation. In general, higher G′ fillers provide more structural support, while lower G′ fillers tend to be softer and may integrate more easily into superficial tissue. However, G′ is only one part of filler behavior and should not be interpreted in isolation.
What is the difference between NASHA®, VYCROSS®, XpresHAn Technology™, CPM®, and RHA® technology?
These are different manufacturing or crosslinking technology families used by filler manufacturers. They influence how a filler behaves in tissue, including its flexibility, cohesivity, intended depth of placement, and clinical use pattern. This page compares those technologies descriptively rather than ranking them.
Are fillers with FDA approval for one area also used in other areas?
Yes. Many hyaluronic acid fillers are used off-label in clinical practice based on injector experience and patient anatomy. However, this page organizes products primarily by FDA-approved indications to provide a consistent and objective comparison framework.
Does FDA approval mean one filler is better than another?
No. FDA approval means a product has been cleared or approved for specific labeled indications based on the evidence submitted for that use. It does not mean that one filler is universally better than another for every patient or every treatment goal.
Do all of the fillers in this comparison contain lidocaine?
Most currently marketed hyaluronic acid fillers in this comparison contain lidocaine, but not every original formulation did. For that reason, this page includes a separate table showing both FDA approval year and whether the marketed product contains lidocaine.
Why are some products listed in more than one table?
Some fillers have FDA-approved indications that overlap categories, such as both lip augmentation and perioral lines, or folds and other structural indications. A product may therefore appear in more than one section when it is relevant to multiple labeled uses.
Why is Belotero Balance® (+) mentioned in the fine lines section if its FDA indication is for folds?
Belotero Balance® (+) is FDA-approved for moderate to severe facial wrinkles and folds such as nasolabial folds. It is often discussed in relation to superficial fine-line treatment because of its integration characteristics, but any mention of fine lines on this page is framed carefully as a clinical relevance point rather than a separate FDA indication.
What is the most important factor when choosing a hyaluronic acid filler?
The most important factor is matching the product to the treatment area, tissue depth, and patient anatomy while understanding the product’s FDA labeling and physical behavior. Product selection is only one part of a successful outcome; injection technique and clinical judgment are equally important.