Injectables

Botulinum toxin type A is a purified protein injected into facial muscles to soften expression lines, sold under brand names including Botox, Dysport, Xeomin, and Jeuveau. It is the single best-studied cosmetic injectable, with dozens of randomized placebo-controlled trials and multiple meta-analyses behind its FDA-approved uses for frown lines, crow's feet, and forehead lines. Effects are temporary, typically 3 to 4 months, and the safety record over roughly 20 years of cosmetic use is strong when injected by trained practitioners. Newer intradermal uses for pore size and oiliness are far less proven.

2 graded uses

Calcium hydroxylapatite (CaHA) is a filler made of microscopic calcium spheres, the same mineral family as bone and teeth, suspended in a smooth gel. It gives immediate lift like an HA filler and also stimulates collagen as the gel carrier absorbs, with results typically lasting 12 to 18 months. FDA approved since 2006 for facial folds and HIV lipoatrophy and since 2015 for the backs of the hands, it has strong trial support for those uses. The popular newer practice of diluting it heavily and spreading it thin as a skin tightener has run ahead of the controlled evidence.

3 graded uses

Deoxycholic acid is a synthetic copy of a bile acid that dissolves fat cell membranes. Injected in a grid pattern under the chin, it permanently destroys submental fat over a series of sessions. It is FDA approved for that one use and the approval rests on four phase 3 randomized placebo-controlled trials, so the double-chin evidence is genuinely strong. The trade-offs are real: substantial swelling for days to weeks after each session, multiple sessions needed, and a small risk of temporary nerve injury causing an uneven smile. Every other body area is off-label with little published data.

2 graded uses

Exosomes are nanoscale packets that cells release to carry proteins and genetic signals to other cells; aesthetic products derive them from lab-grown stem cells, platelets, plants, or milk and apply them topically after microneedling or laser, or in some clinics inject them. Marketing has sprinted far ahead of the science. Human evidence consists mostly of small, short, often unblinded studies, frequently confounded by the device treatment given alongside. No exosome product has FDA approval for any use, and the FDA has warned against injected exosomes after serious adverse events. This is the clearest case in aesthetics of hype outpacing data.

3 graded uses

Hyaluronic acid (HA) fillers are gels made from a sugar molecule the skin already contains, cross-linked so it holds its shape after injection. They physically fill folds, restore lost volume in cheeks and lips, and can be dissolved on demand with the enzyme hyaluronidase. The evidence base is deep: more than 20 randomized trials support their use for nasolabial folds alone, and the main midface product held correction for 2 years in its FDA registration trial. Results and complication rates depend heavily on injector skill and product choice.

3 graded uses

Platelet-rich fibrin is made by spinning a small tube of your own blood without anticoagulant, producing a fibrin gel loaded with platelets and white cells that releases growth factors slowly after injection. It is marketed as a natural filler alternative for under-eyes, skin quality, and hair loss. Because it comes from your own blood, safety is excellent, but efficacy evidence is thin: systematic reviews find small studies, inconsistent methods, no standardized preparation, and results that often fade by 6 months. The under-eye marketing in particular runs well ahead of the data.

3 graded uses

Poly-L-lactic acid (PLLA) is a biodegradable polymer, the same material used in dissolvable sutures, injected as a suspension to trigger the body's own collagen production. Unlike HA filler, it does not add volume directly; correction builds gradually over 2 to 3 months as new collagen forms, and results last around 2 years. The evidence base is solid for facial volume restoration, anchored by four studies in HIV-related facial fat loss (its original FDA approval) and a 2025 systematic review of 20 facial studies. Claims about overall skin quality and tightening rest on weaker data.

3 graded uses

Skin boosters are lightly cross-linked or hybrid hyaluronic acid gels injected in tiny droplets across the skin surface, aiming to hydrate and smooth from within rather than fill any specific line. Skinvive by Juvederm became the first FDA-approved product in this class in May 2023, for cheek smoothness, backed by a randomized evaluator-blind trial. Profhilo, popular internationally, has a 2026 systematic review of 9 studies behind it, though mostly without control groups. These deliver measurable but subtle changes in hydration and surface smoothness, not lift or wrinkle correction.

3 graded uses