A New Type of Fillers Available Now

• 11/06/2025 03:50

Although dermal fillers have emerged since the 1970s when bovine collagen injections were initially introduced, the advent of hyaluronic acid fillers in the early 2000s truly transformed the landscape. Over the past two decades, with the progress of research and more products and applications being sanctioned by the U.S. Food and Drug Administration (FDA), patients have had numerous fillers to select from, among which are the popular Restylane and Juvéderm lines.

A New Type of Fillers Available Now

Now, with the introduction of a new collection of hyaluronic acid (HA) fillers from Revance, another attractive choice has been incorporated. The company's resilient hyaluronic acid (RHA) fillers come in four distinct versions, each intended for a specific depth of injection and area of the face - although currently only RHA 2, RHA 3, and RHA 4 are accessible, while RHA 1 is undergoing FDA approval. RHA fillers are crafted to address dynamic wrinkles and creases while adapting to your facial motions, for a natural-looking outcome. Here's what you need to be aware of before attempting the RHA Collection of dermal fillers.

What distinguishes the new RHA fillers from others in the market?

Every existing HA filler in the market has significantly shorter hyaluronic acid chains compared to those naturally present in our skin. To create a long-lasting, stable filler resembling natural HA, during the gentle manufacturing process, the HA chains are pushed through a grid and crosslinked with other substances, such as the chemical BDDE, or heated at high temperatures (which compromises the integrity of the chain) before crosslinking. "The concept behind RHA was to generate the chains by heating the hyaluronic acid at a lower temperature - and because it was heated at a lower temperature, it could preserve the integrity of the chains, making them much longer and more comparable to native chains," states Dr. Ava Shamban, a board-certified dermatologist in Beverly Hills, California, who served as the investigator in the first two of RHA's U.S. clinical trials.

"The RHA fillers possess longer HA chains that can form a network of reversible, mobile bonds and require less BDDE crosslinking for stabilization," remarks Dr. Hema Sundaram, a board-certified dermatologist in Rockville, Maryland, and Fairfax, Virginia, who served as a principal investigator for the FDA studies and a clinical investigator and consultant for Teoxane Laboratories in Europe (the manufacturer of RHA fillers). The variance between RHA II, III, and IV lies in the amount of crosslinking in each, with IV having the greatest (making it ideal for injection into the deep dermis to superficial subcutaneous tissue) and II having the least.

"It turns out that the processing truly determines the functionality of the HA," says Dr. Shamban. "So as you might anticipate, if the HA is more similar to what we already have in our bodies, it will look and feel more natural and it will move in harmony with our native HA." Unlike fillers that tend to be more rigid and remain stationary, RHA is claimed to actually move with the face, so when you smile and then relax your face, speak, or express emotions, it appears more natural. It's important to note, however, that the needle, cannula, or other injection instrument, depending on the size, can frequently split the hyaluronic chains in half before they even reach the face, so it's unclear whether the chains actually maintain their length throughout the entire process.

Related: 7 New Fillers and Neurotoxins Launching in 2024

Where can RHA fillers be utilized?

While each of the four fillers in the collection has distinct indications and treatments, they are all approved "for the correction of dynamic facial wrinkles and folds that are moderate to severe, such as nasolabial folds." Off-label, Dr. Shamban has employed the fillers in the midface and under-eye areas as well as in the so-called accordion lines and radial cheek lines. "I've used it everywhere, and I've been truly impressed by the beautifully natural contour it creates," she says. The dermatologist also feels at ease layering the fillers, so if a patient desires something deeper and then also more topical, for superficial lines and wrinkles, she is confident that the result will offer a natural appearance. "In countries where RHA I is already approved, it's regarded by many as the standout product of the RHA range," says Dr. Sundaram. "Injectors find it valuable for the tear troughs and for superficial injection into fine lines."

Most significantly, the RHA products do not seem to have the undesirable swelling side effect associated with many other fillers. "This appears to integrate into the tissue in a superior manner - and more rapidly," says Dr. Shamban.

How do RHA's durability and price compare to those of its rivals?

The effects of filler treatment can persist anywhere from three months to two years, depending on the product and treatment area, but the RHA collection is approved to last up to 15 months, three months less than Juvéderm Vollure XC's 18-month approval.

RHA's initial pricing is relatively similar to that of other fillers, but since Revance is marketing it as a "designer brand," it might eventually carry a higher price. Dr. Shamban believes that even with a higher cost, it's a worthwhile investment, as long as you go to a provider who is knowledgeable and can tailor a treatment plan that aligns with your objectives.

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