Breakthroughs in US dermal fillers for facial soft-tissue augmentation.

Over the last 20 years, developments in injectable dermal fillers have led to a revolution in facial soft-tissue augmentation. The demand for dermal fillers for facial soft-tissue augmentation procedures has increased due in part to the less invasive nature of these products compared with surgical procedures. Available options in the United States have expanded from autologous tissues and animal-derived collagens to bacterially fermented biopolymers and synthetic implants. Beyond their physical composition, currently available products are further differentiated by their recommended depth of injection, suitability for different facial areas, and duration of aesthetic improvement. While older dermal fillers rely on the integrity of the injected material to achieve their clinical effects, some newer products are postulated to act by stimulating the patient's own biological and cellular processes. This article examines breakthroughs in facial soft-tissue augmentation that have expanded the palette of options available to physicians.