Expert Doctor

Hyaluronic Acid vs. Collagen Fillers

Hyaluronic acid and collagen fillers are both dermal fillers used to add volume to regions of the face to remove fine lines, wrinkles and hallowed areas caused by aging. They’re also known as soft tissue fillers or injectable fillers. Hyaluronic acid (HA) and collagen fillers both work differently and the effects of each last for various periods of time. Collagen is naturally found in the body and is either derived from human cadavers or is bovine-based. Collagen works by plumping up the skin and is typically used for mild or superficial skin imperfections. Hyaluronic acid is also found in the body. HA plumps up the skin as well as traps water in large molecules. This helps the product last much longer before being naturally absorbed by the body.

Ideal Candidates

IDEAL CANDIDATES for hyaluronic acid or collagen fillers include:

  • Patients who want to remove fine lines, wrinkles, deep folds and/or mild sagging under the eyes
  • Patients with a hollowed look at the cheeks, temples or under the eyes
  • Any patient with smoker’s lines, or vertical lines around the mouth
  • Adult patients who desire to have fuller or better-defined lips
  • Any patient that desires minimal improvements to the facial region
  • Men or women looking for a non-surgical approach to mild facial rejuvenation
  • Patients with moderate or early signs of aging
  • Patients with a recessive chin, facial acne or deep acne scarring may benefit from hyaluronic acid fillers
  • First time patients may be better suited for hyaluronic fillers since most of these fillers can be reversed with an injection of an enzyme if the results are not as desired

The following patients are NOT GOOD CANDIDATES for hyaluronic acid or collagen fillers:

  • Any patient with unrealistic expectations
  • Women who are pregnant or lactating
  • Patients who do not want to undergo allergy tests, prior to treatment, are not viable candidates for animal-based collagen fillers

Advantages of Hyaluronic Acid Filler

There are several different types of hyaluronic acid fillers including Restylane and Juvederm. Each has a different consistency and that makes them suitable for various treatment goals. Prior to the procedure, the doctor and patient will discuss the patient’s concerns and choose the filler that will provide the best benefit. Patients do not need allergy testing prior to hyaluronic acid filler injections since the risk of an allergic reaction is very rare. This type of injection procedure can be performed in the doctor’s office and takes between 10 to 20 minutes. The treatment area will be cleansed and a topical anesthetic may be applied to help with the discomfort of the injection. Some filler also contain a small amount of lidocaine to minimize the pain. The doctor will use a pre-measured, sterilized syringe to make several small injections of the hyaluronic acid filler, under the skin, within the wrinkles or folds. The depth of the injection will depend on the treatment area and the type of filler. The doctor will massage the area to ensure the filler is evenly distributed.

Advantages of Collagen Fillers    

Collagen fillers are also performed in the doctor’s office in the same manner as hyaluronic acid fillers. Due to complications, which can arise from an allergic reaction from animal-based collagen, patients will need a skin test before the procedure. Collagen taken from a deceased human donor, that is sterilized and processed, does not usually require testing. During the skin test, the doctor will inject a small amount of collagen into the forearm and monitor it for one week to a month. Viable candidates for collagen injections can have collagen injections placed under the skin and within the wrinkles. The procedure takes approximately 30 to 60 minutes depending on how many areas of the face are being treated.

What are the Costs of Hyaluronic Acid and Collagen Fillers?

The cost of dermal fillers depends on the type of filler and how many syringes are needed to provide the desired results. Hyaluronic acid fillers cost $600 to $900 per syringe. Collagen fillers cost in the range of $500-$1200.

Recovery and Downtime

Since both types of fillers are non-invasive, and do not require any incisions or surgical trauma, the RECOVERY time for both is minimal to none. Patients can expect some temporary redness, bruising, puffiness and tenderness at the injection site. The area may also feel numb from the lidocaine and appear “overfilled” just after treatment due to swelling. These symptoms are common and will subside over a few days. Patients can ice the area to help alleviate discomfort and swelling but pain medications are not needed.

In terms of DOWNTIME, patients do not need to take any time off work. They can resume most activities directly after hyaluronic acid or collagen fillers. It is recommended that the patient avoid intense physical activity, as well as excessive sun or heat exposure, during the first 24-48 hours to minimize swelling and bruising.


The results from hyaluronic acid fillers can be seen immediately. This is especially true when injected as a volume enhancer. When used for wrinkles, the skin will appear smoother but the improvements will continue to progress over a few days as the swelling subsides and the skin flattens. Final results can usually be seen in one week. Hyaluronic acid fillers can last 6 months to 2 years depending on the type of filler and where it is placed. Fillers placed in high-motion areas, such as the lips, will not last as long as other regions of the face.

The results from collagen fillers can be seen within a couple of days as the skin becomes smoother. The effects of collagen can last approximately 3 to 6 months. However, the results from bovine-based collagen tend to dissolve more quickly than human-based collagen.

Over time, the body will gradually absorb HA and collagen fillers. Therefore, further treatments will be needed to maintain the results. “Touch up” injections, performed before certain fillers have completely been absorbed, may build on the results and cause them to last longer.

Limitations of Hyaluronic Acid and Collagen Fillers

The limitations of hyaluronic acid and collagen fillers include:

  • The degree of volume collagen can provide
  • Treating only superficial lines with a collagen filler since this type of filler is not optimal for treating signs of advanced aging
  • Optimal results may be limited with a single procedure
  • Patients with deep facial wrinkles and/or substantial sagging of the skin may not get the desired results with hyaluronic acid or collagen fillers

Risks of Hyaluronic Acid and Collagen Fillers

The risks involved with hyaluronic acid and collagen fillers are:

  • Allergic reaction to bovine-derived collagen
  • A reaction to the lidocaine in certain fillers
  • Infection
  • Skin rash with itching
  • Granuloma, or lumps, at the injection site
  • Asymmetry
  • Acne outbreak
  • Uneven skin tone around the treatment area
  • Abscess, or open sores, that cause scarring
  • Migration of the filler material
  • Fillers injected into a blood vessel can travel to other portions of the body and result in tissue damage, pulmonary complications or blindness

Considering Hyaluronic Acid or Collagen Fillers

Hyaluronic acid and collagen fillers are a safe and effective means for facial rejuvenation. HA and collagen fillers improve the look of the skin by removing fine lines and wrinkles and also filling in areas where volume is lacking. Patients who are considering hyaluronic acid or collagen fillers should consult with a board-certified doctor who specializes in all types of fillers and performs them regularly. The doctor should have extensive knowledge of the facial anatomy to minimize the risks and to ensure the most optimal outcome. The doctor should also perform a thorough examination, and review the patient’s medical history, to determine which type of treatment will work best for each individual patient.


Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Serena Mraz, MD in Vallejo, CA