Injections and Fillers

One of the most popular forms of treatment for reducing the appearance of fine lines and wrinkles and create smoother, younger skin is injections. In an office-based procedure, the physician uses fine needles to insert a filler into the skin to add volume, replace collagen and/or stimulate natural collagen and new skin cell growth. A host of different types of fillers are available. You will need to talk to your doctor about the advantages and disadvantages of each for your desired results, the area being treated and how deeply the problem occurs in the layers of the skin.

Types of Fillers
New discoveries continue to surface for different types of fillers. The most commonly used categories and products are summarized below.

Botulinum Toxins are derived from the bacteria that causes botulism. These products work by immobilizing the muscles that cause lines and wrinkles. Type A products include Botox® and Dysport®. They require injections 2 to 4 times a year. Type B products, such as Myobloc®, tend to be longer lasting. Some people are naturally resistant to botulinum toxins and cannot use these products.

Bovine Collagen is just what it sounds like: collagen derived from cows. Specifically, it is made from skin, bone and cartilage extracted from cow tissue. Zyderm® and Zyplast® are commonly used bovine collagen fillers. Generally, these products are injected beneath wrinkles, such as crow's feet, frown lines and facial folds, to replace the natural collagen. Bovine collagen treatments are temporary, lasting generally between 3 and 12 months. In some cases, individuals may be allergic to these products.

Calcium Hydroxylapatite is a newer substance derived from human bones and teeth. It is made into an injectable paste that is frequently used to fill lips and larger wrinkles and folds. Radiance® is the most recognized product in this category. Because it is a human substance, there is no rejection and results may last between 2 and 5 years.

Hyaluronic Acid is a naturally occurring part of the substance of the body that helps cushion and lubricate the skin. Products in this category - including Restylane®, Hylaform® and Sculptra® - plump and smooth the skin. They generally last between 3 and 12 months.

Human Collagen is one of the safest fillers and comes in different forms. Autologen is collagen that is removed from the patient in a different part of the body and then injected into the desired site. Collagen derived from the replicated cells of infants is the formulation for CosmoDerm® and CosmoPlast®, fillers used for deep lines and wrinkles. Human Tissue Matrix and Dermalogen are fillers created from collagen derived from deceased humans. All these products offer the advantage of being natural to humans, so there is no possibility of an allergic reaction. However, human collagen products are absorbed into the body, which generally makes them shorter lasting than other fillers or treatments.

Fat is another natural human substance used as a filler and injected into the skin to fill out wrinkles. However, fat injections are slightly more invasive since both a donor and treatment site are involved. However, fat injections are still conducted on an outpatient basis with either a topical or light local anesthetic. Using a needle, the physician removes fat from another part of the body, most commonly the abdomen or buttocks. The fat is cleaned and prepared and then injected into the desired site on the face. Patient may experience some swelling or bruising following the procedure, which dissipates in days. In some cases, the injected fat may not settle evenly, which could cause some lumpiness.

Synthetic fillers use man-made materials to plump the skin and/or stimulate the growth of new skin cells and collagen. Artecoll® was one of the first fillers used for cosmetic injections. It is made up of tiny synthetic beads floating in collagen. Once the collagen is absorbed by the body, the synthetic beads signal the body to produce more collagen and new skin cells naturally. However, because it is synthetic, some individuals experience a rejection or allergic reaction to the substance.

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