Twenty years ago, the only solution for removing the classic signs of aging like wrinkles, sagging skin, under eye hollows, and thin lips was going under the knife or hardcore chemical peels and laser. But today, a range of facial fillers can be injected to smooth out those facial lines, enhance lips, treat nasolabial folds, and remove furrows between the brows, taking years off the face to bring back that youthful look. What makes injecting facial fillers so attractive? Facial Fillers also known as “dermal fillers” or “injectables” offer a cosmetic treatment that is minimally invasive with little or no recovery time. Injecting fillers has become the most popular way to solve anti-aging problems in a non-surgical manner. With so many types of dermal fillers available today, choosing the right one can be overwhelming. The following sections provide useful information about some of the most widely used fillers.
What are the Main Ingredients That Constitute These Facial Fillers?
Most of the commonly used fillers are derived from Collagen or Hyaluronic acid. Collagen is a naturally occurring protein in mammals that is used to create injectable fillers that are either bovine-derived, porcine or human-derived. Bovine-derived collagen is extracted from the tissue of cows that have been raised in consistently monitored, disease-free environment. The Allergan, Inc. Zyderm® and Zyplast® product is produced from highly purified collagen collected from a closed herd of cattle. As there is a 3-8 percent chance of an allergic reaction to bovine collagen, an allergy test is required prior to undergoing treatment with this filler. The source of human-derived collagen products varies. However, the most popular of these products, Cosmoplast® and Cosmoderm® from Allergan, Inc., is sources from cultured human fibroblast cells that have been maintain in tissue culture for 10 years. These cells are the source of other human derived products used to treated burn victims and have an excellent safety record. A pre-treatment allergy test is not necessary with the human derived collagen products. Evolence® is the latest collagen product produced from porcine collagen with a useful life in the face of about a year. The longevity of collagen injections depend on patient’s lifestyle, physical characteristics, and the part of the body treated. Collagen is observed to disappear faster in areas that are directly affected by muscle movement. Only a professional doctor can help you to determine the right period required for retreatment to maintain the results.
Hyaluronic acid is a type of polysaccharide called a glycosaminoglycan. Also known as hyaluronan or hyaluronate, hyaluronic acid occurs naturally in the human body and is central to regulating cell growth and renewal. Hyaluronic acid is non-immunogenic, which means the body doesn’t consider it as a foreign substance, thus minimizing the chance of an allergic reaction. While allergies to these products do occur, allergy testing is not recommended do the low incidence of allergies to these products. Dermal fillers that contain hyaluronic acid offer a soft natural look and also have great longevity. Hyaluronic acid fillers have an added advantage in that they can be manipulated even long after a treatment using the enzyme hyaluronidase. The results are like have surgery but the magic wand was an office procedure and a treatment comfortably placed with tiny injections.
The Most Popular Facial Fillers
Restylane ®
Known as one of the most effective and popular fillers, Restylane dermal gel composed of hyaluronic acid. The non-animal biodegradable filler adds volume to the skin treating under eye hollow and dark circles. It smooths facial folds and wrinkles in areas surrounding the eyes and mouth. The effects of this filler easily last for a year or more depending on factors like age and skin type, and the initial treatment volume.
Juvederm ™
This injectable gel is the first FDA-approved hyaluronic acid dermal filler which restores your skin’s volume and addresses moderate to severe the facial folds, like “smile lines” or nasolabial folds. This filler is made up of cross-linked hyaluronic acid and effects last for an average of 6 months. Other hyaluronic acid fillers are granular in nature, but the smooth consistency of Juvederm ™ allows the injection to be administered with relative ease. Due to the enhanced ability of this product to flow in the face, it is best to discuss with your treating physician where this product will work best.
Perlane®
Another hyaluronic acid based filler – Perlane, with larger molecules and large concentration of hyaluronic acid, making it more effective to treat deeper wrinkles and larger folds. Though it is only FDA approved to last up to 12 months, it has found to be longer-lasting than Restylane ®. This product is the best of the hyaluronic volumizers for deeper lines or more active points of facial movement.
Botox ®
This facial injectable is made from Botulinum Toxin Type A and designed to eliminate facial wrinkles. It commonly treats areas like frown lines between the eyebrows, “crow’s feet,” and creases on the forehead. It primarily addresses the periocular region and its effects last up to 6 months. While Botox is not a filler, it is often used in combination with fillers to achieve results that previously could only be accomplished with surgery.
Zyplast® and Zyderm®
The first collagen based fillers approved by the FDA are made of purified bovine-derived collagen and are used to enhance facial contour and reduce fine lines and deep wrinkles. Zyderm® subtly smooths crow’s feet or fine lines around the lips. Zyplast® is used to treat deeper folds such as brow wrinkles or frown lines, and provides volume and contouring to your face. The longevity of this product is limited compared to the new hyaluronic acid fillers. The product contains local anesthetic making quite comfortable for lip edge treatment. Prior testing is needed to screen for potential allergies before actual treatment.
Radiesse ®
Formerly known as Radiance, Radiesse is made of calcium-based microspheres, the same component of bones and teeth. The filler stimulates the body to produce new collagen around the microspheres, which makes it last longer. It is utilized to correct moderate to severe wrinkles and contour the facial features. Radiesse® filler is the first FDA-approved one-year dermal filler that restores and corrects the signs of facial lipoatrophy in patients with HIV. Initially the manufacture claimed longevity of 5 to 8 years, however, clinical experience suggests that this product lasts 12-18 months when used as a facial filler.
ArteFill®
ArteFill® which is known as Artecoll® outside of United States is a dermal filler that offers longer lasting results than other cosmetic filler injections. It is made of polymethylmethacrylate (PMMA) microspheres that are suspended in bovine collagen and is mainly used to treat static facial lines, enlarge lips, fill in facial imperfections, and diminish nasolabial folds. It not only acts as a dermal filler, but its microspheres also stimulate the body to produce its own collagen. As the injected collagen slowly degrades naturally, the newly produced collagen replaces it. This leads to long-lasting, almost permanent results. Due to a tendency to form lumps, the product is not recommended for lip or lower eyelid treatment.
Silicone oil
Silicone oil has only one FDA approved indication for use in the repair of complex retinal detachments. This material finds its way into off label use as a medical grade facial filler. However, silicone oil has a number of side effects. Consequently it is not advisable to use liquid silicone for facial filler. Silicone oil is occasionally used by non-medical injectors for illegally black market treatment. Often the silicone oil used is not medical grade but rather industrial silicone oil, which was never intended for the human body. There have been deaths from these types of illegal treatments.
Benefits and Risks Involved in Injecting Facial Fillers
The biggest advantage of these fillers is that they do not require any invasive surgery and require little recovery time. While the results of fillers do not last forever, their longevity is sufficient to offer a practical alternative to surgery. In many case, the result of filler service can be better than what can be accomplished with actual surgery. Periodic top off allows the effects of service to be maintained. Side effects like bruising, swelling, lumpy firmness, and tenderness are seen in 5% of treatments. The incidence of allergic reaction varies with the products used and should be discussed with the treating physician.
Before undergoing an anti-aging treatment, it is important to consult a well-qualified and a board certified cosmetic surgeon, to help you to understand which FDA-approved filler is the best for you.
October 20, 2009
Facial Fillers: A Solution to Non-Surgical Cosmetic Treatment
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