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Injectable filler materials
can be used to fill contour depressions and fine lines as well as modifying
facial shape. Typical contour depressions include the nasolabial folds and
marionette lines. Lipstick bleed lines and crow's feet are examples of
fine lines. Lip and cheek augmentation are typical shape changes, which
can be produced with injectable fillers. Some injectable fillers are
useful for one of the above categories and not others. The average
durability varies with different injectables. All injectables carry risks
of tissue reaction, infection, asymmetry, nodularity, and others.
Fortunately, with currently approved injectables these risks are uncommon.
A consultation can help determine the most appropriate modality to treat your
concerns. Alternatives to injectables include various surgical treatments
such as autogenous fat transplantation (fat injection), and placement of
Alloderm (freeze dried skin) and polytetrafluoroethylene (Softform, Gortex) as
well as solid cheek and chin implants. Various injectable materials are on the market in the United
States. In addition, many that are not approved for treatment in the
United States are in widespread use. Some materials are being used for an
application different from that for which they are approved -which is a
widespread and legal part of the practice of medicine.
Dr. Bass cautions that the effects of these materials in cosmetic
applications is unknown . Patient’s
should be extremely concerned about placing unapproved materials in their faces,
especially materials that are permanent, or non-biological.
See the News
section for Dr. Bass' SnapReview on the subject of new injectables.
Injectable Fillers Injectable Fillers are also recommended for wrinkles, crow's feet, and lipstick bleed lines
Restylane Restylane is a safe and natural cosmetic dermal filler that restores volume and fullness to the skin to correct facial wrinkles and folds, such as nasolabial folds. Restylane is FDA approved for use as a cosmetic filler. This material is made from hyaluronate which is the predominate matrix material in our skin and connective tissues. This is a very biocompatible material with little tissue reaction. Because no anesthesia is mixed in with the material, nerve blocks must be used to allow comfortable injection. The injection technique is significantly different from that used for collagen. This material is commonly used for lipstick bleed lines, crow’s feet, lip augmentation and fill of nasolabial folds and marionette lines. Average durability is generally considered to be 6 months.
Radiesse
Radiesse
is a new long lasting injectable contouring agent which is FDA approved for
cosmetic correction of facial contours such as nasolabial folds. This
provides 1-1.5 year durability for
correction of depressions like nasolabial folds and marionette lines
but is not used for fine lines like lipstick bleed lines or crow's feet.
Other areas of preferred application include cheek and chin contouring, nasal
contouring, as well as correction of early aging changes in the pre-jowl
sulcus before facialplasty is necessary.
The material is made of hydroxylapatite which is the mineral matrix
occurring naturally in the body although the Radiesse material is made
synthetically and is therefore sterile and not from an animal source.
Fat Injection Fat
injection, which is medically known as autogenous fat transplantation, utilizes
your own fat, which is harvested with a needle and syringe to provide contour
correction on the face and body. This is a minor procedure which
requires recovery. Advantages
include the use of your body’s own cells rather than a foreign material as
well as the long duration (1-3 years or more) of the cells which survive in the
new location. Disadvantages include
the recovery associated with the treatment and the variability in the amount of
injected fat which does survive, often necessitating re-treatment one or more
times over a year or two.
Collagen Collagen is one of the oldest injectables in widespread use in the
United States. This is formulated from bovine collagen sold under the
brand names Zyderm and Zyplast. More recently synthetically formed human
collagen (not from human donors) has been FDA approved under the brand names
Cosmoplast and Cosmoderm. Advantages include ease of injection, local
anesthesia in the collagen making injection less uncomfortable, and good shape
control. Collagen can be used for contour depressions, depressed scars, fine
lines, and lip augmentation. Disadvantages include the need for skin
testing with bovine collagen, which delays the beginning of therapy and
relatively short durability. While the durability of collagen, or any
injectable, will vary from patient to patient, Dr. Bass advises patients that
they can likely expect no more than 3 months of correction.
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Manhattan: 568 Park Avenue at 63rd Street - 212.593.2600 Great Neck: 833 Northern Boulevard, Suite 110 - 516.773.3705
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