The use of injectable facial fillers is one of the fastest growing areas in the field of cosmetic surgery. Many advances in have been made in the last 5 years that have led to safer, more predictable and longer lasting fillers.
As one ages, the face loses volume. This creates more prominent wrinkles and skin folds while features become less distinct. Dynamic wrinkles caused by facial movement such as smiling and frowning appear. Injectables were designed to subtly reduce these signs of aging.
Injectables include two basic classes: fillers, to restore lost volume, and botulinum toxin injections, to lessen the appearance of wrinkles with smiling, frowning, concentrating and looking surprised. Most fillers work by filling the lip or wrinkle with volume and are gradually digested by the body. While botulinum toxin injections work by weaken the underlying muscles to decrease their overlying dynamic movement.
FDA approved injectable fillers include Collagen, Hyaluronic Acid Fillers, Fillers with microscopic beads and Poly Lactic Acid.
For those wishing to avoid the injection of any foreign material, lipotransfer, the harvesting and reinjection of your own fat, may be an option.
Hyaluronic acid fillers:
These were the first of the new fillers to be FDA approved. Hyaluronic acid is a naturally occurring carbohydrate which occurs in skin. It is a clear gel with a thick consistency. Since skin testing is not required, injections may be done on the same day as the initial consultation. Manufacturers have manipulated particle size (thickness) and crosslinked molecules to offer both normal and longer duration products.
Restylane and Juviderm are examples of normal duration products that are injected in more superficial lines and have easier flow characteristics.
Restylane is a cosmetic dermal filler made of non-animal based hyaluronic acid. It was FDA-approved in 2003 for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds, the lines between the nose and mouth. Upon being injected beneath the skin’s surface, the gel adds natural volume and lift to smooth wrinkles and folds. Restylane integrates into dermal tissue then attracts and binds to water molecules to help maintain volume. Restylane is gradually degraded by the body’s own mechanism and disappears without any residue. Results can be seen immediately following treatment and last six months, or even longer.
Perlane and Juviderm Ultra Plus are examples of longer duration products are usually injected into deeper lines and folds.
The newest advance has been the addition of local anesthetic, Lidocaine, to the filler to reduce discomfort upon injection.
Fillers with Microscopic Beads: This class includes Radiesse. Radiesse contains calcium based microspheres suspended in a water based gel. Since skin testing is not required treatment may be received on the same day as consultation.
Poly Lactic Acid Fillers: Sculptra is substance known as L-Poly Lactic Acid which is similar to the material used to make a type of suture that is used to close lacerations. This material does not require allergy testing. Following injection the body produces new collagen in the area injected. The reaction is not immediate but increases over the next 3-4 weeks after injection.
Note: The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation with your cosmetic surgeon. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.