As aesthetic clinicians, we are constantly balancing three things: patient safety, product performance, and long-term outcomes. With the recent FDA approval of Evolysse Smooth and Evolysse Form, it’s time to take a step back and examine how these newcomers compare to the established titans in our injectables toolkit—Juvederm, Restylane, RHA Collection, and Belotero.
Let’s explore the differences not just in marketing, but in molecular behavior, clinical application, rheology, and patient outcomes. And importantly, we’ll ask: Where do Evolysse fillers genuinely belong in your practice?
Overview: Understanding the Field
Here’s a snapshot of the HA fillers currently approved by the FDA for aesthetic use:
| Brand | Manufacturer | Technology Platform | FDA Indications |
|---|---|---|---|
| Juvederm (Ultra, Voluma, etc.) | AbbVie (Allergan) | Vycross, Hylacross | Lips, midface, chin, nasolabial folds, etc. |
| Restylane (Lyft, Kysse, etc.) | Galderma | NASHA, XpresHAn | Lips, cheeks, wrinkles, tear trough, hands |
| RHA Collection | Revance (Teoxane) | Resilient Hyaluronic Acid | Dynamic wrinkles and folds |
| Belotero Balance | Merz | Cohesive Polydensified Matrix (CPM) | Superficial lines, tear trough |
| Evolysse (Smooth, Form) | Evolus / Symatese | Cold-X™ | Nasolabial folds, midface volume |
What Makes Evolysse Different?
The Cold-X™ crosslinking technology is at the heart of Evolysse’s identity. According to the manufacturer, it enables better preservation of native HA properties while reducing degradation of polymer chains during production. From a clinical standpoint, that may mean:
- Less swelling immediately post-injection
- Improved tissue integration
- Lower extrusion force, which translates into smoother injection experience
- Balanced elastic and viscous properties, depending on the product (Smooth vs. Form)
Let’s break that down by product and compare directly.
Evolysse Smooth vs. Competitors
Indication: Moderate to severe nasolabial folds and superficial rhytids
Plane of Injection: Mid to superficial dermis
Main Competitors: Juvederm Ultra, Restylane Refyne, RHA 2, Belotero Balance
| Property | Evolysse Smooth | Juvederm Ultra | Refyne | RHA 2 | Belotero |
|---|---|---|---|---|---|
| Crosslinking Tech | Cold-X™ | Hylacross | XpresHAn | RHA (resilient) | CPM |
| G’ (Elasticity) | Moderate | High | Low-Moderate | Moderate | Low |
| Cohesivity | Balanced | High | Moderate | Moderate | High |
| Spreadability | High | Low | High | High | Very High |
| Integration Quality | Smooth, natural | Volumizing, more “set” | Dynamic areas | Dynamic areas | Ideal for superficial lines |
| Notable Advantage | Less swelling, subtle contouring | Strong volumizing | Flexibility | Movement compatibility | Tear trough-ready |
Clinical Insight:
Smooth appears most similar to Refyne in its balance of structure and softness, but with easier extrusion and possibly less edema post-treatment. Its spreadability and tissue integration lend themselves well to patients seeking soft, natural correction with minimal downtime.
Evolysse Form vs. Competitors
Indication: Midface volume loss, deep folds, chin and jawline contour
Plane of Injection: Deep dermis or subcutaneous
Main Competitors: Juvederm Voluma, Restylane Lyft, RHA 4
| Property | Evolysse Form | Voluma | Lyft | RHA 4 |
|---|---|---|---|---|
| Crosslinking Tech | Cold-X™ | Vycross | NASHA | RHA |
| G’ (Elasticity) | High | Very High | High | Moderate-High |
| Cohesivity | High | Moderate | High | Moderate |
| Lift Capacity | Strong | Very Strong | Strong | Good |
| Swelling Profile | Low | Moderate to high | Moderate | Low |
| Notable Advantage | Precision and control | Strong projection | Cost-effective volume | Dynamic midface use |
Clinical Insight:
Form offers a refined option for deep volumizing with less hydrophilic swelling. In patients with thinner tissues or high visibility areas (e.g., tear trough-adjacent midface), this can be a significant advantage over Voluma or Lyft.
Duration of Effect
Both Evolysse Smooth and Form demonstrated clinical efficacy up to 12 months in their respective FDA trials. This puts them on par with most competitors, especially in nasolabial fold correction.
| Filler | Average Duration |
|---|---|
| Evolysse Smooth | ~12 months |
| Evolysse Form | ~12 months |
| Juvederm Ultra | 9–12 months |
| Voluma | Up to 24 months |
| Refyne / Defyne | 12–18 months |
| RHA Collection | 12–15 months |
| Belotero Balance | ~6 months |
Safety and Adverse Event Profile
All the currently FDA-approved HA fillers carry similar risk profiles—bruising, swelling, lumpiness, and, rarely, vascular occlusion. Evolysse’s manufacturing suggests lower swelling and a smoother injection force, but vigilance and cannula/needle technique remain critical.
Cost and Economics
Evolysse has entered the market with aggressive pricing and introductory offers, especially for practices already using Jeuveau. Compared to Juvederm and Restylane lines, this may offer a lower cost per syringe, giving injectors more flexibility in package pricing without compromising quality.
When Would I Use Evolysse?
Here’s where Evolysse might be your go-to:
- Evolysse Smooth: Superficial fine lines, subtle NLFs, “first-time” filler patients wanting soft entry-level correction
- Evolysse Form: Patients with moderate volume loss who are worried about puffiness or swelling from traditional volumizers
If you’re familiar with RHA 2/3 or Refyne/Defyne and appreciate the newer generation of soft, resilient fillers, you’ll likely find the Evolysse line intuitive to use.
Final Thoughts: A Welcome Addition, Not a Displacement
While no filler is objectively “better” than another, Evolysse Smooth and Form do fill important clinical niches, particularly for patients sensitive to swelling, or those seeking extremely natural integration. Their low extrusion force, Cold-X™ formulation, and clean tissue integration make them a strong addition for practices prioritizing refined, tailored outcomes.
If you’re looking to round out your injectable offerings with a low-swelling, high-control option, Evolysse may be a worthwhile addition to your toolbox.
Would you like a comparison injection protocol guide across these fillers? Or a risk mitigation training around vascular compromise across platforms? Let me know. I always believe education reduces risk—and empowers both injector and patient. Join Cosmetic Medical Training and take your Botox training certification and Evolysse Training today!
