The technology of injectable facial fillers has revolutionized the face of cosmetic surgery practices and the faces of cosmetic surgery patients. In recent years, not only has the number of procedures increased dramatically, but the choice of fillers available to patients has also increased significantly.
Injectable Filler Uses
Injectable fillers are used primarily for wrinkle correction. Some wrinkles are the result of habitual muscle contraction, and these wrinkles are generally correct either with a brow lift, similar surgery, or with the use of Botox injections. Other wrinkles are the result of loss of skin tone and the loss or displacement of subcutaneous fat in the face. These wrinkles can be corrected either with facelifts or with injectable fillers.
Injectable fillers can also be used for facial augmentation instead of facial implants. They are commonly used in lip augmentation, and less commonly used for chin and cheek augmentation.
The first cosmetic filler used on a large scale was collagen. Collagen injections were used to correct age-related wrinkles and folds and plump lips, but it has a relatively short lifespan. At best, patients could hope to get four months of good results out of collagen injections. In addition, many collagens were animal-derived, which could cause allergic reactions in many patients.
The combination of collagen's great promise and its significant shortcomings led many companies to attempt to develop new injections that overcame the shortcomings to give patients safe, consistent, and long-lasting results. These days there are many new, technologically-advanced alternatives have been developed. Now the only problem is how to choose among the options. By understanding the advantages and disadvantages of each filler, you can make the right decision for your needs.
Hyaluronic Acid-Based Fillers
Hyaluronic acid is a natural compound produced by the body. It is found in the eye and the spinal fluid in addition to the skin. Early versions of hyaluronic acid-based fillers were derived from rooster combs and cow eyes, but modern versions are what is known as non-animal-based hyaluronic acid (NAHA). NAHA is actually derived from the protein capsules that streptococcus bacteria build around themselves. Restylane and Juvéderm are the most popular forms of NAHA fillers. Though they function in basically the same fashion, important distinctions between them and their related compounds (Perlane and Juvéderm ultra, for example) can make a big difference in how they are used and how effective they are.
The main difference between Restylane and Juvéderm is that Juvéderm is manufactured as a smooth gel, whereas Restylane has a granular texture. Juvéderm's smoother texture causes less irritation at the injection site and can produce better cosmetic results in some applications, such as lip augmentation. Although sometimes Restylane causes swelling at the injection site for two or three days, swelling following a Juvéderm injection is generally less than 24 hours, and some people see no swelling whatsoever.
Restylane, however, is intentionally manufactured with a granular texture for a reason (and its relative Perlane have an even more granular texture).The texture of Restylane and Perlane makes them more resistant to decomposition, leading to a greater likelihood of longer results, especially in very dynamic areas, such as the nasolabial folds. In addition, the granular texture gives the fillers greater lifting power, and Perlane's larger texture makes it suitable for injection into some of the deeper fat pockets where age-specific fat losses often occur.
Composite fillers are composed of two parts: a carrier gel and microspheres. The carrier gel is primarily a delivery system, and though it can provide some immediate wrinkle correct, it is quickly digested by the body. The microspheres, however, are made of a more resistant material. Calcium hydroxyl apatite (CHA) in Radiesse and polymethylmethacrylate (PMMA) in Artefill.
The sphere material in Radiesse, CHA has long been used as a bone filler, so it is highly compatible with the body. Because it is resistant to absorption, it provides long-lasting results as the body fills in around the microspheres with its own collagen. The improvement over NAHA fillers is significant. Juvéderm results can last for three to nine months while Restylane/Perlane results last for six months to a year, but clinical studies have shown that over 80 % of Radiesse patients receive more than one year of full wrinkle correction.
ArteFill seeks to take the concept behind Radiesse another step further. Since the PMMA is a biocompatible but completely artificial material, it is never absorbed by the body. The theory is that this should lead to permanent wrinkle correction. ArteFill has been approved by the FDA for use in the US for only a few years, and therefore large-scale data on the length of correction a person can expect. But individual patients have seen wrinkle correction that lasts for seven years or more.
If you are interested in having non-surgical wrinkle correction, schedule an injectable filler consultation with a local plastic surgeon.
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