Fillers and Skin Rejuvenation
According to dermatologists, facial wrinkles result from the loss of three essential skin components: collagen, elastin, and hyaluronic acid. Injectable skin fillers address this problem by replacing one or more of these substances in areas where loss has occurred. In the past few years a whole new generation of fillers has been developed for skin rejuvenation and facial enhancement, and several of these substances have been approved by the FDA. Treatments with these fillers offer immediate, lasting improvement with no down time (the proverbial “lunchtime lift”).
Since the introduction of injectable bovine (cow) collagen in 1976, skin fillers have been used for cosmetic applications such as filling in wrinkles and enlarging lips. While it has been extremely popular, bovine collagen poses some problems and risks. Because it is an animal-derived product, collagen can cause allergic reactions in some patients and also could potentially carry animal-borne diseases. (All patients must undergo an allergy test before having their first collagen injection.) A major drawback of bovine collagen injections is that the results are short-lived (generally three to six months at most).
In 2002 the FDA approved the use of human bioengineered collagen (collagen derived from human cells) for treating facial wrinkles and acne scarring, and for reshaping lips. Human-derived collagen offers an improvement over bovine collagen because it doesn’t pose allergy risks, but the results are equally as temporary.
The most promising of the new fillers are hyaluronic acid products (brand names are Restylane® and Hylaform®). Hyaluronic acid is the term used to describe a group of naturally-occurring sugars that provide a framework for the skin by holding together collagen and elastin. When hyaluronic acid gel is injected into the skin, it binds with water and creates enough volume to fill out large depressions (such as the deep wrinkles that often form between the nostrils and the corners of the mouth).
Since it is not derived from animals, hyaluronic acid gel poses no risk of allergy or animal-related diseases. Patients do not have to undergo an allergy test and therefore can receive treatment on their first visit to the doctor. Another advantage of hyaluronic acid gel is that (compared to collagen) less volume is required to fill deep wrinkles and reshape lips. The results are still temporary, but the effects last substantially longer than those of collagen injections. The typical recommendation is that hyaluronic acid treatment for wrinkles should be repeated in about six to twelve months (the effects of lip enhancement last about six months).
Patients considering treatment with any skin filler should ask the following questions:
- How long are the results expected to last?
- What are the potential risks and side effects?
- Has the FDA approved this filler for this type of use? If so, for how long has it been used?
- How much experience does this doctor have with using this filler?
As the demand for injectable skin fillers increases, research in this area is growing. In the coming years, expect to see treatment options expand.
If you are considering a facial procedure, please consult an expert cosmetic surgeon such as Dr. Greenberg, M.D., of Orlando, Florida.