Fillers and Injectables: an Overview
In the past few years, a growing number of new products aimed at wrinkle management have been approved for use by the FDA, expanding your treatment options but also making it more important than ever to be well informed. With growing technology it is important to make sure you are getting a safe product from a qualified physician who understands facial anatomy as well as the side effects of the products. There are two major categories of injectable substances, muscle paralytics, the most popular of which is Botox, and collagen replacement products, of which there are a growing number available. Botox is a formulation of botulinum toxin A which is a protein that causes temporary muscle paralysis. It has been used safely for 15 years and has recently been approved by the FDA for use in smoothing wrinkles. Botox is carefully injected through a tiny needle into specific muscle groups, most commonly along the forehead, between the eyebrows, and around the eyes. Over a period of about 3-5 days, the muscles are inactivated and the wrinkles are dramatically reduced and often eliminated. The effect lasts anywhere from 4-6 months, after which time the muscle makes a full recovery. Although rare, occasional side effects are bruising in the area and droopiness of the eyelids. By preventing the brow furrows from forming, permanent deep wrinkles are prevented and a more youthful, relaxed look is maintained over the years. Collagen replacement products are the second major category of injectables. There has been exciting growth in this area in recent years with the introduction of several new products which are both safer and longer lasting than standard collagen-based injectables. Restylane and Hylaform, both hyaluronic acid-based products, were approved by the FDA in November of 2003 and are used as soft tissue fillers in the reduction of wrinkles. Hyaluronic acid is a naturally occurring component of joint fluid and connective tissue. It adds volume to the skin, minimizing fine wrinkles and lines. The most common areas treated are the lines around the nose and mouth, the wrinkles between the brows and on the forehead, and occasionally along depressed scars. The results are immediate although there is commonly some mild redness and swelling which lasts several days. The effects are longer lasting than collagen and vary from person to person, ranging from four months up to a year. For many patients, the newer hyaluronic acid-based products have become favored over the collagen-based products such as Zyplast, Cymetra, and Cosmoplast. Although many of these collagen products are still in use, their popularity is decreasing in favor of the longer lasting effects of the hyaluronic acid alternatives. Another injectable filler that has been used in Europe but has not been approved for use in the United States is Radiance, a product derived from calcium hydroxyapatite which is a substance found in bone and teeth. Its appeal lies in the fact that is lasts between two and four years, but the downside is that it can cause firm areas under the skin and in rare cases it may even transform into bone. Sculptra is another semi-permanent product which currently has FDA approval for patients suffering from HIV facial lipoatrophy. So when you look in the mirror and see those furrows and wrinkles that add unwanted years to your face and make you look perpetually stressed, it is nice to know that there are an ever growing number of non-surgical options available. But with the growing number of choices and availability it is important to know what you are getting and to make sure it is delivered in a safe environment by a qualified physician.
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