General Information on Injectables & Fillers
Generally performed as outpatient
procedures, cosmetic filler injections are extremely safe and effective for
filling in wrinkles and scars, removing frown lines or rejuvenating sagging
skin.
The key is making sure you get the
proper filler for your specific needs―and that you have reasonable
expectations.
Some fillers are primarily used
for shallow surface flaws while others are injected deeper under the skin to
fill in more substantial folds or depressions. Some fillers can also be used to
increase the fullness of the lips or cheeks.
The newer dermal fillers on the
market even assist in stimulating creating new collagen growth to prevent
future flaws.
Whatever the procedure, there’s a
product out there for it these days, although the most common areas treated are
still smile lines around the nose and mouth, fine lines above the mouth, frown
lines between the eyes, and acne scars.
Dermal Fillers
The materials used in dermal
fillers vary from basic human fat and animal-based collagens to hyaluronic acid
and enhanced microsphere-added hydroxylapatite.
Different materials induce
different reactions within the body, so the amount of time the injections last,
potential side effects, recovery times and how often you’ll have to return for
treatments will also vary.
Dermal fillers also come in a
variety of thicknesses and brand names, with some more suited for certain parts
of the face or body than others. In general, dermal fillers fall into three
categories:
•
Fat/Collagen Fillers
•
Hyaluronic Acid Fillers
•
Hydroxylapatite microsphere-enhanced fillers
As a rule, the thicker the filler,
the deeper it’s injected under the skin and the larger the folds it is meant to
fill.
There are also two general
classifications for the duration of dermal fillers, temporary or permanent.
For the sake of this page though,
we’ll stick to the temporary facial fillers which require repeated injections
(some less than others) to maintain.
Botox and Dysport
For those interested in Botox (and
its counterpart Dysport), it’s important to note these are not technically
“fillers” but more muscle paralyzers or “wrinkle-freezers.”
“Wrinkle-freezers” are made up of
primarily of Botulinum Toxin A, a substance that essentially paralyzes the
muscles around the injection point to decrease the amount of current wrinkles
and prevent further wrinkles.
Botox is the best known of the two
having been around longer, and is primarily used between the eyebrows or on the
crow’s feet around the eyes.
Dysport is Botox’s newest
competitor, only recently approved by the FDA. Like Botox, it has botulinum
toxin A as its primary ingredient.
The main difference is Dysport
takes affect a little bit quicker (1-2 days instead of 3-7), is slightly
cheaper overall and spreads out a little bit further than Botox.
Both last about the same time -
three to four months.
For more on Botox and Dysport, visit
our Botox page here.
If
you have any questions about Botox injections or would like a free consultation
with a Botox specialist in your area, fill in the form on the right-hand side
of this page and one of our experts will contact you!
Facial Fillers
Fat Transfers
Fat transfers were one of the
first dermal filler techniques and have been used for well over 100 years to
fill in various forms of facial lines and folds.
Today, though, fat transfer is not
as common for the face as newer products have superseded it in terms of
duration and quality.
Successful fat transfer is also
very dependent on the technique of the surgeon to ensure as many fat cells
survive as possible, making results for many people very inconsistent.
Still, in certain cases fat
transfer from other parts of the body can be used to fill in some facial lines
and folds and add fullness.
Fat injections had been commonly
used to rejuvenate the lips, for bags under the eyes, to lessen the lines
around the mouth or fill out the cheeks or chin.
Collagen
Fillers
Collagen Fillers come in two basic
forms, bovine and human. They fell out
of favor with the introduction of the hyaluronic acid fillers. Few plastic surgeons use these fillers today
since there are better options available.
Bovine (cow) collagen was one of
the first forms of collagen to be used for dermal fillers. Bovine collagen is a
naturally occurring protein that is found in the skin, bones and muscles of
cows.
This collagen is so similar to
human collagen it can be used fairly seamlessly (although with some treatment
beforehand naturally) to fill in fine lines and correct scars.
Zyderm and Zyplast are the most
common brand names for bovine collagen fillers.
Zyderm I is used for the treatment
of fine lines and lesser scars, while Zyderm II is meant for longer, deeper
scars. Zyplast is used to get longer-lasting results for more damaged skin.
Since bovine collagen is a
protein, it will break down in the body over time. Generally, the results last
from 3-6 months. Once the collagen fades, the treatment can be repeated.
There are a few instances of
allergic reactions to bovine collagen injections. Those reactions can include
redness at the injection site, hives, and chest pain.
During the consultation process,
your doctor will recommend you do a skin test to see if you are allergic before
proceeding with a bovine collagen injection.
Human Collagen
Created from real human collagen,
this filler is a normal part of all skin and is naturally absorbed by the human
body.
Human collagen is best used for
fine wrinkles, especially those found around the mouth, and it typically lasts
3 – 4 months. For continued effects, repeated treatments are necessary. The
effects are immediate in onset however.
Like Bovine collagen, these fillers are not used as frequently as the
hyaluronic acid fillers.
Cosmoplast, Cosmoderm, Cymetra,
Fascian and Autologen are the most common human collagen products on the
market.
Hyaluronic
Acid Fillers
Hyaluronic acid is part of the
connective tissue of all human skin and several dermal fillers have been
developed over the years with hyaluronic acid as their base.
These fillers also stimulate
collagen production in the skin, allowing for better, longer-lasting results
and a longer period of time between injections.
Hyaluronic acid fillers are
excellent for plumping up lines and wrinkles because they attract water and are
ideal in correcting nasolabial folds, thin lips, wrinkles (especially above the
lips), reducing under-eye circles and filling out the chin or cheeks.
The most common brand names for
hyaluronic acid fillers are Juvederm, Perlane and Restylane.
Restylane and
Juvederm
Both Restylane and Juvederm are
popular hyaluronic acid fillers. The difference between the two is the
consistency of the gel, and preference depends on both the patient and the
doctor.
Perlane
Perlane is a
"mid-dermal" hyaluronic acid filler product. As a sister product to
Restylane, Perlane is designed for more pronounced facial folds and wrinkles
such as those on the sides of the mouth.
The duration of effect averages
between 6 – 9 months for Restylane and Juvederm and 9-12 months for Perlane and
Juvederm Ultra.
For continued effect, repeated
treatments are also necessary with Perlane.
Macrolane
Another hyaluronic acid derivative
used mainly for breast augmentation procedures is called Macrolane. Because it
also absorbs into the body like other fillers, Macrolane is an alternative to
chemical implants.
Hydroxylapatite
microspheres
Radiesse
Marketed under the brand name
Radiesse, calcium hydroxylapatite is physically larger in particle size than
other dermal fillers.
Basically, tiny calcium-based
microspheres form a “scaffold” to support and stimulate the growth of collagen.
Over time, the microspheres gradually break down and are safely and naturally
absorbed by the body.
Radiesse does more than
temporarily fill-in facial folds and wrinkles and can be used to restore facial
volume for a more youthful look.
Radiesse also works to stimulate
new collagen production while adding volume and lift. It’s best used for
moderate to severe wrinkles, nasolabial lines, facial fat loss and volume loss
in the cheeks.
Duration of effect is usually
12-15 months in most patients.
If
you are considering facial fillers and injections, please visit the website of
double board-certified plastic surgeon Dr. Jonathan Berman for more information.
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