Wrinkle Fillers
Volume Replacement |
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Collagens
Hyaluronic Acid
Radiesse
Sculptra
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Wrinkle fillers (Dermal
fillers) can consist of human fat, human collagen, bovine collagen,
hyaluronic acid (found naturally in the body's connective tissue),
synthetic substances or combinations of those materials.
The older, short-acting fillers are made of natural products such as
collagen and fat that are quickly absorbed by the body. The new
long-acting fillers mostly rely on synthetic materials for that extra
durability. Each product has a different "location" preference and
duration.
Some are
best used in deep wrinkles, some in shallow lines, and some for plumping
or restoring volume. Choosing the one that works best for your needs and
desires calls for physician experience and the availability of choices.
Collagen
products available in the U.S. include Bovine (from cows) and
Human-tissue engineered - grown in a lab under strict FDA standards.
Collagen products from both sources typically last 3 to 4 months. The latest collagen, Evolence, which comes from porcine cources, has a duration of 6 months or longer.
Hyaluronic
Acid products are nearly
identical to the natural hyaluronic acid found in the body. Unlike
bovine collagen, there is no need for pre-testing. Currently the two HA
fillers that Dr. Pilest prefers are Juvederm and Restylane. Both last
from 6 to 9 months.
What is Hyaluronic Acid?
Hyaluronic acid is a naturally
occurring sugar. It is found in the human body in the skin, cartilage,
joints and the eye. In skin tissue, hyaluronic acid fills the space
between collagen and elastin fibers. The role of hyaluronic acid in
skin is to deliver nutrients, hydrate the skin by holding in water,
and to act as a cushioning agent.
How is
Hyaluronic Acid made?
Perlane,Restylane and Juvederm are sterile, clear, colorless dermal (skin) filler gels
made of chemically modified hyaluronic acid. Hyaluronic acid is a
naturally occurring substance found in the fluids surrounding cells
and tissues. It is chemically, physically and biologically similar in
the tissues of all species. Made from highly purified natural
hyaluronic acid the gel is gradually absorbed by your body through
natural mechanisms.
Radiesse
Radiesse consists of smooth particles of calcium that, after injection,
also form a scaffold that is slowly filled with human collagen. Studies
show it lasts for a year to 18 months, although the spheres may last as
long as five years before breaking down.
The
component of Radiesse calcium hydroxylapatite (CaHA) microspheres, has
been used over the years in for vocal cord insufficiency, tissue marking
and for oral defects.
Sculptra
Sculptra, which is approved for lipoatrophy, facial wasting, consists of a synthetic substance called polylactic acid that has long been used in medical products such as
dissolvable stitches. It adds volume to skin and lasts about two years.
Sculptra is designed to replace volume. It can be
used with other filler products. Sculptra is rapidly becoming a very
popular product and has enjoyed years of success in Europe under the
name NewFill.
Why would I need volume replacement?
Over time, your skin loses its full, firm, youthful appearance. This is
the result of a natural aging process: your skin is damaged, becomes
thinner, or loses its natural elasticity. As a result, it becomes loose
and starts to wrinkle. Fat tissue, which also helps to fill out your
face, is lost, causing skin to sag and further wrinkle. This reduction
in skin volume can make your face look thin and narrow, possibly making
you appear older than you are. Sculptra can help your skin regain a firm
and youthful appearance by restoring skin volume you may have naturally
lost.
How do I choose
the best dermal filler?
Dr. Pilest has over
28 years of experience in corrective and cosmetic dermatology. He will
discuss with you the various fillers, what they will accomplish and the
potential advantages and disadvantages of each. Often two or more
products may be required to achieve best results.A denser firmer dermal filler may be used as a base with the more fluid fillers used to complete the correction closer to the skin's top surface.
What else can I do to prevent wrinkles?
Diet and exercise are more important than you think when it comes to youthful-looking skin. Plenty of water, fresh fruits, time each day spent "moving" to increase capillary strength and bring oxygen to the skin cells - and of course proper rest. The right kind of pillow can also make a difference. If you wake up with "sleep wrinkles" on your face, consider special pillows such as the Face Saver Pillow.
Overview
Filler:
Human collagen; brands include CosmoDerm, CosmoPlast,
Cymetra.
What it is: Purified natural substance from human
tissue.
Duration: Two to six months.
Bottom line: Safe but fades fast; no allergy test
required.
Filler: Bovine collagen; brands include
Zyderm and Zyplast.
What it is: Purified collagen from cows.
Duration: Two to six months.
Bottom line: Requires allergy test before treatment;
fades fast.
Filler: Porcine collagen; brands include
Evolence .
What it is: Purified collagen from pig tendons.
Duration: Six months or longer.
Bottom line: No allergy test.
Filler: Hyaluronic acid; brands include
Restylane, Juvederm, Perlane and Prevelle Silk.
What it is: Synthetic versions of a natural
substance found in the body's joints.
Duration: Depending on the product formulation, from
six to 12 months. Prevelle has a lesser duration.
Bottom line: More expensive than collagen but lasts
longer; safe; rare allergic reactions.
Filler: Calcium hydroxy-lapatite microspheres;
brand name Radiesse.
What it is: Synthetic, biocompatible substance.
Duration: 12 to 18 months.
Bottom line: Longer-lasting but not permanent; can
cause lumpiness if improperly injected or injected in unsuitable areas
such as the lips..
Filler: Synthetic polylactic acid in
microspheres; brand name Sculptra. It's approved for other
purposes but also used off-label for replacing lost facial volume from
fat loss that comes from aging.
What it is: Synthetic, biocompatible substance.
Duration: Two years.
Bottom line: Longer-lasting but not permanent. A volume
replacement stimulator - not a wrinkle filler.
Filler: Polymethyl-methacrylate microspheres
suspended in bovine collagen; brand name ArteFill.
What it is: Synthetic, biocompatible substance injected
with bovine collagen carrier.
Duration: Five years or more.
Bottom line: Considered permanent; requires allergy
test; treatment success dependant upon injection technique. Unskilled injections may result in unremovable lumps or nodules. Currently unavailable
2008 © Total Dermatology is one of Southern California's top laser dermatology centers offering
laser treatments for
sundamage,
pigmentation,
acne and acne scars
and
Fraxel CO2 laser for 3 in 1 skin rejuvenation. A Nonsurgical Nose Job is possible with simple injections of Radiesse.
Dr. Pilest, a Board Certified dermatologist and one of Orange County's most
popular cosmetic dermatology specialists, offers patients in Orange County a wide variety of
wrinkle fillers such as
Restylane,
Juvederm,
Cosmoderm and Cosmoplast,
Radiesse (also known as Radiance), and
Sculptra. Dr. Pilest treats patients from the Newport Beach, Irvine, Laguna Beach, Laguna Hills,
Tustin, Mission Viejo and Orange County area as well as cities throughout California, the United States and abroad.
He is recognized as a master level injection specialist and is a national
teaching faculty member for Bioform Medical. Dr. Pilest is well known for his
expert treatments in managing
Rosacea,
acne, and
hyperpigmentation.
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