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Teosyal RHA fillers are Teoxane‘s resilient hyaluronic acid range. Teoxane markets them as the first HA fillers FDA approved for dynamic wrinkles and folds. A Teosyal RHA filler suits tissue that moves all day. Grade selection turns on injection plane, fold severity and regulatory status. This guide covers RHA 1, 2, 3, 4 and Kiss with trial data, technique, safety and stocking.
The Story Behind Teoxane RHA Filler
Valérie Taupin founded Teoxane in Geneva in 2003. The RHA 2, 3 and 4 gels earned CE marking in October 2014 and launched as Teosyal RHA in 2015. The FDA approved RHA 2, RHA 3 and RHA 4 in October 2017. RHA 3 added lip augmentation in October 2023. Teoxane reports 40 million syringes sold worldwide as of 2025, and its fillers reach more than 80 countries. Europe sells the range as Teosyal RHA, and Revance sells it as RHA in the US.
How Teosyal RHA Technology Works
RHA stands for resilient hyaluronic acid. Teoxane’s process limits HA chain breakdown during manufacturing, so the gel keeps long chains in an entangled network. The pivotal RHA 4 paper reports a cross-linking degree of 2 to 4%, against 5 to 10% for most monophasic gels.
The three FDA grades share 23 mg/g of HA from bacterial fermentation, BDDE cross-linking, a pH 7.3 buffer and 0.3% lidocaine. The grades differ in cross-linking, from RHA 2 (least) to RHA 4 (most).
5 Teosyal RHA Fillers and Where Practitioners Use Them
Each Teoxane RHA filler has its own plane, label and evidence base.
Teosyal RHA 1
RHA 1 targets superficial and fine lines in thin skin, where a heavier gel can show. Teoxane lists at least 12 months. It has no FDA approval and no US pivotal data, so confirm your local regulations before you stock it.
Discount structure
- 1 - 4 packs - $152.00 each
- 5 - 9 packs - $147.44 each
- 10 - 19 packs - $144.40 each
- 20 - 29 packs - $139.84 each
- 30+ packs - $136.80 each
Teosyal RHA 2
RHA 2 is the least cross-linked FDA grade. The label calls for mid-to-deep dermal injection for moderate to severe dynamic wrinkles and folds. Each syringe ships with 30G ½ inch needles. In the pivotal split-face study, 83.6% of treated folds improved by at least one WSRS grade at 24 weeks. Teoxane lists 12 to 18 months.
Discount structure
- 1 - 4 packs - $178.00 each
- 5 - 9 packs - $172.66 each
- 10 - 19 packs - $169.10 each
- 20 - 29 packs - $163.76 each
- 30+ packs - $160.20 each
Teosyal RHA 3
RHA 3 uses the same mid-to-deep dermal plane as RHA 2 with a firmer gel. It ships with 27G ½ inch needles. At 24 weeks, 91.9% of treated folds improved by at least one WSRS grade. Practitioners also use it for marionette lines and cheek and jaw volume. Its lip augmentation approval covers the upper and lower lips, vermilion borders and oral commissures. Our page lists 12 to 15 months, and some patients reach 18.
Discount structure
- 1 - 4 packs - $191.00 each
- 5 - 9 packs - $185.27 each
- 10 - 19 packs - $181.45 each
- 20 - 29 packs - $175.72 each
- 30+ packs - $171.90 each
Teosyal RHA 4
RHA 4 is the most cross-linked grade, labeled for deep dermis to superficial subcutaneous injection. It builds volume in the cheeks and midface. In the pivotal study, 97.7% of treated folds improved by at least one grade at 24 weeks. The 2025 FDA midface approval covers RHA 4 with mepivacaine, not the lidocaine syringe we list. Teoxane lists 15 to 18 months.
Discount structure
- 1 - 4 packs - $206.00 each
- 5 - 9 packs - $199.82 each
- 10 - 19 packs - $195.70 each
- 20 - 29 packs - $189.52 each
- 30+ packs - $185.40 each
Teosyal RHA Kiss
RHA Kiss Lidocaine (2 x 0.7ml) is the lip syringe. Its soft gel has 19 mg/mL of HA and matches the rheology of RHA 2. Place it in the mucosa for volume and contour, or in the mid-dermis for perioral lines.
Discount structure
- 1 - 4 packs - $135.00 each
- 5 - 9 packs - $130.95 each
- 10 - 19 packs - $128.25 each
- 20 - 29 packs - $124.20 each
- 30+ packs - $121.50 each
Teosyal PureSense Kiss (2 x 1.0ml) is a separate PureSense product with 24 mg/mL of HA. Our page lists 9 to 12 months. Neither Kiss product has FDA approval in the US.
Discount structure
- 1 - 4 packs - $176.00 each
- 5 - 9 packs - $170.72 each
- 10 - 19 packs - $167.20 each
- 20 - 29 packs - $161.92 each
- 30+ packs - $158.40 each
Matching Grade, Depth and Technique
Choose the plane first. RHA 2 and RHA 3 belong in the mid-to-deep dermis. RHA 4 goes in the deep dermis to superficial subcutaneous tissue. Step up from RHA 2 to RHA 3 as the fold deepens. Use RHA 4 when volume loss drives the problem.
The FDA studies left technique to the investigator and capped treatment at 3.0 mL per fold per session. In the RHA 4 trial, injectors used linear threading, serial puncture and fan techniques. Mean total volume per fold was 1.79 mL.
A Teoxane-funded split-face trial compared a 25G, 2 inch cannula with a 27G ½ inch needle for RHA 4 in the nasolabial fold. At 12 weeks the cannula was non-inferior, and each side had 47 of 50 responders.
Teosyal RHA vs Other HA Fillers
The strongest published comparison pits RHA 4 against Restylane Lyft in a split-face trial. In the FDA summary, RHA 4 improved WSRS by 0.18 grades more than its control at week 24. The one-grade responder rate was 97.7% against 89.6%. The paper found no significant difference at the two-grade level, so read it as non-inferior with a modest edge.
A study of 18 popular HA fillers found that G prime comparisons hold up best within one product family. Test a grade on a few patients in a moving area before you shift inventory.
Safety, Contraindications and Patient Counseling
Patient selection starts with the label. The FDA summary for RHA 2, 3 and 4 lists four contraindications. A routine intake history will catch all of them:
- A history of anaphylaxis or multiple severe allergies
- Allergy to the trace gram positive bacterial proteins in the gel
- Hypersensitivity to amide anesthetics such as lidocaine
- Bleeding disorders
Screen for all four before the first injection. Common reactions were lumps, firmness, swelling and tenderness, and most had resolved by day 14 in the RHA 4 study. Post-marketing reports outside the US also list inflammatory reaction, vascular complication, implant migration and necrosis. RHA is HA based, so hyaluronidase dissolves it. Keep it and a vascular occlusion protocol on hand.
In the FDA lip study, about 78% of patients showed visible effects at 12 weeks and 61% at 36 weeks. At one year, 48% did. Quote lip and fold durations separately.
2026 Teosyal RHA Cost for Clinics
Teosyal cost depends on the grade and how many packs you order. Cosmo Direct Supply sells to businesses only, with a $300 minimum subtotal. Per-pack prices fall 3% at 5 packs, 5% at 10, 8% at 20 and 10% at 30. The table lists the price per pack at the 1 to 4 pack tier:
|
Product Name |
Price |
|---|---|
|
$152.00 |
|
|
$178.00 |
|
|
$191.00 |
|
|
$206.00 |
|
|
$135.00 |
|
|
$176.00 |
At that tier, cost per mL runs from about $76 for RHA 1 to $103 for RHA 4. A US practice can start with RHA 2, RHA 3 and RHA 4, then add RHA 1 or Kiss as demand grows. Record the lot number and expiry date of every syringe you inject, and buy only from suppliers that document sourcing. Prices can change, so check each product page.
Putting Teosyal RHA to Work in Your Practice
The Teosyal RHA range spans RHA 1 for fine lines to RHA 4 for deep volume, with Kiss for the lips. The strongest data sits behind RHA 2, 3 and 4 in nasolabial folds, so match each grade to its labeled plane. Practices that buy Teosyal online from Cosmo Direct Supply can cover folds, lips and cheeks from one brand.
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Which Teosyal RHA fillers are most popular?
RHA 2, RHA 3 and RHA 4 are the grades with FDA approval, so US practices tend to start there. Kiss is the main lip option, and RHA 1 covers fine lines.
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What makes Teosyal different from other HA fillers?
Teoxane's process allows a lower cross-linking degree than most monophasic gels. The FDA labeling for RHA 2, 3 and 4 also names dynamic wrinkles and folds directly.
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Are Teosyal RHA fillers FDA approved?
The FDA approved RHA 2, 3 and 4 for moderate to severe dynamic wrinkles and folds in adults aged 22 and older. RHA 3 also has lip augmentation approval, and RHA 4 with mepivacaine has midface approval. RHA 1 and both Kiss products have no FDA approval in the US.
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Where can I buy Teosyal RHA fillers wholesale?
Licensed practitioners and clinics can buy Teosyal RHA fillers wholesale from Cosmo Direct Supply and be confident in the product's authenticity and quality. Volume pricing applies on every product page, with discounts on bulk order.
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Between RHA filler vs Juvederm, which should a clinic stock?
Most clinics stock both. RHA targets dynamic wrinkles and folds, and the published head-to-head data covers RHA 4 against Restylane Lyft, where RHA 4 was non-inferior with a modest edge. Test a grade on your own patients before you shift inventory.
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