What are The Differences Between Restylane, Juvederm, Belotero, and Versa, Hyaluronic Acid Dermal Fillers? (Updated 2023)

Summary

  • Based on research data, all four common FDA-approved hyaluronic acid based dermal fillers (Restylane, Juvederm, Belotero and Versa) are effective and well-tolerated.
  • Versa has a different manufacturing process that removes impurities and reduces adverse event.
  • Versa has a lower price for medical practices from the manufacturer.

In 2022, four common FDA-approved hyaluronic acid (HA) based dermal fillers (Restylane, Juvederm, Belotero, and Versa) are on the market to correct wrinkles and folds. Let’s go over each of the botulinum toxins and find the difference between them. Although our focus is on the Versa Challenge, we will give you an unbiased opinion on the 4 dermal fillers. Then, you’ll understand why we decided on Versa.

What are They?

HYALURONIC ACID DERMAL FILLERDETAILS ABOUT THE HYALURONIC ACID (HA)
JUVEDERMFDA approved in 2008, Juvederm is a family of fillers manufactured by Allergan made with Hylacross technology.
JUVEDERM XCXC initials indicates that lidocaine is added to the HA
JUVEDERM ULTRA PLUSThicker HA for correction of facial wrinkles and folds (Hylacross)
JUVEDERM VOLUMAHA for deeper injection in the cheek and chin made with Vycross technology.
JUVEDERM VOLBELLAUse for lips and under eye (Vycross)
JUVEDERM VOLLUREUse for moderate to severe facial wrinkles (Vycross)
BELOTEROFDA approved in 2011, Belotero is manufactured by Merz and is used for the correction of moderate-to-severe facial wrinkles and folds, such as nasolabial folds.
VERSAFDA approved in 2017, Versa is manufactured by Prollenium and is used for the correction of moderate-to-severe facial wrinkles and folds, such as nasolabial folds. Versa is manufactured using a special proprietary method to ensure that the HA spheres are all perfectly rounded and are exactly the same size.
VERSA LIPSFDA approved in 2020, Lips+ is manufactured by Prollenium and is used for the correction of lips.
RESTYLANEThe first FDA approved HA dermal filler in the USA in 2003. Restylane has a family of fillers manufactured by Galderma. This is the original HA filler made with NASHA technology.
RESTYLANE-LOriginal HA filler with lidocaine (NASHA)
RESTYLANE LYFTFormally called Perlane, this is used in the cheeks (NASHA)
RESTYLANE SILKUsed in lips (NASHA) 
RESTYLANE DEFYNEMade with new XpresHAn Technology for deeper nasolabial fold, marionette lines and chin
RESTYLANE REFYNEFor nasolabial fold and marionette lines (XpresHAn Technology)
RESTYLANE KYSSEFor lips (XpresHAn Technology)

Which One is Better?

This is a question that we get asked ALL OF THE TIME. For the sake of impartiality, let we show you a chart with many of the research publications that compare a dermal filler vs another.

ComparisonWhereSafety ResultEfficacy Result
Restylane Kysse with lidocaine vs Juvéderm Volbella with lidocaineLipsBoth products were well tolerated.Both products achieved durable improvement in lip fullness and aesthetic appearance. A significantly smaller amount of Restylane Kysse was required compared with Juvederm Volbella to achieve optimal treatment effect.
Juvéderm Volbella XC vs Restylane-LLips and peri-oralSevere injection site responses were reported less frequently with Juvederm Volbella than Restylane-L.Juvederm Volbella XC was safe and effective for lip and perioral enhancement, with treatment effects lasting through 1 year.
Juvéderm Volbella with Lidocaine vs Restylane-LLipsThere was less acute swelling and fewer severe injection site responses with Juvéderm Volbella with Lidocaine.Juvéderm Volbella with Lidocaine was non-inferior to Restylane-L at 3 months. Investigator assessments showed significant improvements in lip fullness, perioral lines, and oral commissures with Juvéderm Volbella with Lidocaine versus Restylane-L at months 6 to 12.
Juvéderm Volbella with Lidocaine vs Restylane-LLips and peri-oralJuvéderm Volbella with Lidocaine results in less short-term swelling and disruption in daily activities than Restylane-L.Investigator assessments showed significant improvements in perioral lines and oral commissures with Juvéderm Volbella with Lidocaine vs Restylane-L
Juvéderm Ultra XC vs Belotero BalancePeri-oralNo unexpected adverse events occurred.Juvéderm Ultra XC subjects showed a higher response rate and a greater improvement in their perioral lines than Belotero Balance subjects for up to 6 months.
Juvéderm Ultra vs Restylane®Correction of moderate NLFsJuvéderm Ultra had fewer severe responses than Restylane.Juvéderm Ultra is noninferior to Restylane
Belotero Basic/Balance, Restylane vs Juvéderm Ultra Plus XCNLFAdverse events were unremarkable across all HAs, with injection site erythema being the most frequent adverse event.All three HAs provided essentially equivalent results, except for 4-week evenness results, which favored Belotero. Injection volumes of the three HAs were also similar.
Juvederm ULTRA PLUS™ vs Perlane(®)NLFBoth treatments were well tolerated.Both fillers achieved a clinically relevant NLF correction. However, Juvederm ULTRA PLUS™ displayed greater longevity, with this correction maintained in a significantly larger percentage of NLFs after 6 months (physician’s evaluation) or 9 months (subject’s evaluation)
Revanesse VersaFacial VolumeHA treatment was shown to be safe.Good – excellent volume enhancement was noted almost immediately after the HA injections, improving patient-reported quality of life aspects.

Our conclusion based on the data is that all four are effective and safe. Anecdotally, a patient’s response to the specific filler can be specific to that individual. The duration of the filler varies from one individual to the next. The duration also varies depending on the area injected.

Syringe Size

Another common question is: How many syringes do I need? 

Different fillers come in different sizes. The price from the manufacturer also varies depending on the size of the syringe. All dermal fillers are one-time use by ONE patient. They should not be shared or stored for later use. Some medspas sell “half syringes”, which should cause consumers to take pause to consider the sterility of your “half syringe.”  

Here are the various syringe sizes based on the filler type.  

HYALURONIC ACID DERMAL FILLERSYRINGE SIZE
JUVEDERM ULTRA1mL
JUVEDERM ULTRA PLUS1mL
JUVEDERM VOLUMA1mL
JUVEDERM VOLBELLA0.55mL & 1mL
JUVEDERM VOLLURE1mL
BELOTERO1mL
VERSA1.2mL
VERSA LIPS1.2mL
RESTYLANE-L0.5mL & 1mL
RESTYLANE LYFT1mL
RESTYLANE SILK1mL
RESTYLANE DEFYNE1mL
RESTYLANE REFYNE1mL
RESTYLANE KYSSE1mL

Revanesse Versa and Lips+ contain the most amount of HA filler within a syringe (1.2mL per syringe).

Hyaluronic Acid Concentration

Different fillers have different concentrations which affect the duration, elasticity, and softness of the filler. Here are the various concentration amounts based on the filler type.

HYALURONIC ACID DERMAL FILLERHYALURONIC ACID CONCENTRATION
JUVEDERM ULTRA24mg/mL
JUVEDERM ULTRA PLUS24mg/mL
JUVEDERM VOLUMA20mg/mL
JUVEDERM VOLBELLA15mg/mL
JUVEDERM VOLLURE17.5mg/mL
BELOTERO22.5mg/mL
VERSA25mg/mL
VERSA LIPS25mg/mL
RESTYLANE-L20mg/mL
RESTYLANE LYFT20mg/mL
RESTYLANE SILK20mg/mL
RESTYLANE DEFYNE20mg/mL
RESTYLANE REFYNE20mg/mL
RESTYLANE KYSSE20mg/mL

Revanesse Versa and Lips+ contain the highest amount of HA concentration within a syringe.

Why Choose Versa, Hyaluronic Acid Dermal Fillers Over Restylane, Juvederm, and Belotero?

All four HA dermal fillers are generally accepted to have similar efficacy and safety. Due to the various sizes of filler beads, some larger bead fillers have a longer duration of effect in the face. 

We decided to participate in the Versa Challenge, because Versa has an additional layer of purity in its manufacturing which reduces complication, and has similar efficacy and safety compared to other HA dermal fillers. Finally, the Versa Challenge offer of $299 for a 1.2mL syringe provides patients a great opportunity to try a different hyaluronic acid dermal filler.

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