Cosmetic Dermal Fillers - A Facelift Without Surgery?

Dermal fillers have received a lot of media coverage lately, appearing everywhere from CNN to local news stations. They are being billed as the “new facelift” because they are an alternative to traditional plastic surgery. But what exactly are these procedures? How do they work and what risks do they bring? Let’s take a closer look at dermal fillers.What’s In a Name?Dermal fillers get their name because they are used to fill certain areas of the skin (dermis) for cosmetic purposes. Essentially, they are substances that are injected into the skin — typically the facial area — to smooth out wrinkles and to give the face a fuller, more youthful appearance. In medical circles, this procedure is also referred to as “facial volumization,” which refers to the goal of adding volume to the patient’s face.Commonly Used ProductsYou’ve probably heard of collagen lip injections. Collagen is one of several dermal fillers used for the purposes mentioned above. While it is commonly associated with lip enhancement, it can also be used on the face in general. We actually have a natural layer of collagen in between our skin and the tissue it covers. As we age, however, collagen levels decrease and it leads to the “sunken” look of the face. Cosmetic surgeons can inject collagen products (taken from either a cow or a human donor) in order to add volume to the patient’s face. Hence the term “facial volumization.” Restylane(r) and Radiesse(r) are other products that are now commonly used in the United States. The ‘r’ in parentheses is for registered trademark, by the way. Unlike collagen, which is a naturally occurring substance, both Restylane and Radiesse are trademarked products. Let’s look at each one in more detail.* Radiesse is also a dermal filler used for cosmetic reasons. The product is designed to smooth out facial wrinkles and give the face a fuller, more youthful appearance. It is manufactured by BioForm Medical, Inc. The FDA approved Radiesse for use within the United States in December 2006. Since then, it has become increasingly popular as a skin fill product. Like most dermal fillers, the effects of Radiesse are temporary and said to last for up to six months.* Restylane is manufactured by Q-Med. The FDA approved this product for use within the United States back in 2003. The primary ingredient in Restylane is hyaluronic acid. It’s also a temporary treatment for reducing wrinkles, typically used around the nose and mouth.Considerations and Further ResearchWhile they may not produce the longer-lasting effects of a full facelift, dermal fillers have certain obvious advantages. For one thing, they are non-surgical treatments with very little downtime (compared to a facelift). With that being said, there are potential risks associated with these and other “skin filler” products. So if you are considering a cosmetic dermal filler procedure, you owe it to yourself to conduct a lot of research before making a final decision. Start by researching and comparing the different products that are available these days. Seek out unbiased information, as much as possible. Visit the FDA’s website and read the notes about each product’s approval. Later, if and when you choose a specialist to perform your procedure, be sure to ask plenty of questions about it. Ask how long the physician has been using the product, and what kind of success they (and their patients) have experienced. Take your time, read up on the subject as much as possible, and make a smart decision.

Dermal fillers make up the most significant part of the cosmetic injectables market across the United States. Every year, technical and efficacy advancements are made that benefit the consumer. Restylane® is one in the line of fillers that have received FDA approval, assuring it has been thoroughly tested and found safe and effective.

Restylane® is a very good and popular dermal filler, chosen by many patients throughout the world. Next to Botox®, Restylane® is the second-most-common injectable used in the United States. It works by plumping up creases under the skin, making it particularly well suited for use on the lower face. Restylane results tend to last up to 6 months, which is longer than some other fillers.

If you have lines on your face or around your lips that you want to diminish, you may be a candidate for Restylane®. It’s a great choice if you want to have fuller or more defined lips, and it’s also an excellent option to fill in deeper facial lines like nasolabial folds (those pesky crevices between your nose and the corners of your mouth).

Restylane is made of hyaluronic acid, which is a natural substance that already exists in our bodies. Hyaluronic acid is water loving and keeps its shape by utilizing the moisture in your own body. It’s that ability to bind to water that helps provide longer lasting results, commonly lasting for about six months.

There are not many side effects related to this product although some redness and slight swelling usually occur. For example, Restylane injected in the lips tends to plump them up a lot in the first few days before settling into the targeted fullness. If your intention is to have fuller lips to enhance your attractiveness for some specific event, you should get your treatment done at least four or five days ahead of time.

Like other fillers on the market, Restylane is administered by injection. Since the product can produce discomfort when injected, most doctors use a numbing cream or inject Lidocaine before injecting Restylane.

A board certified dermatologist and/or plastic surgeon will be highly experienced in the use of Restylane, thus minimizing risk and assuring satisfaction with the outcome. Such physicians have a detailed knowledge of facial anatomy and their intensive training allows them to understand the many nuances of where and how much to inject for the desired result.

Note: The specific risks and the suitability of Restylane® Cosmetic for a given individual can be determined only at the time of consultation with a physician. All procedures have some degree of risk. The information provided here is not a substitute for a consultation.

What is it?

Restylane is the first dermal filler made of clear biodegradable non-animal stabilized hyaluronic acid (NASHA). Hyaluronic acid is a lubricating and protective gel that is naturally produced in every living organism.

NASHA is a stabilized substance that is not derived from any animal sources. Therefore, it does not transmit any diseases between species, or cause allergic reactions in patients with food allergies.

Restylane does not require any allergy or skin testing prior to treatments. It is the only dermal filler of its kind that has gained approval by the FDA (Food and Drug Administration) for the reduction of severe facial lines and wrinkles, mainly around the nose and mouth.

How is it used?

Restylane is injected subcutaneously (beneath the skin) as a clear gel that adds a natural filler into the skin. This process smoothes wrinkles and folds in the surface of the skin. It is also used to contour and restore skin volume.

The NASHA gel integrates with skin tissues, attracting and binding water molecules to itself. The result is smoother, fuller skin surfaces.

The hyaluronic acid is then gradually broken down by the body and will disappear without leaving any residue behind. Results are immediate and can last as long as six months or more.

In most patients one injection is sufficient to bring about the desired results. In about one third of patients, more than one injection is needed.

Side Effects

The most common side effects reported by patients who have had Restylane injections are:

· Redness

· Swelling

· Bruising

· Tenderness

· Pain

· Itching

These symptoms have been temporary and mild to moderate in severity.

Restylane should not be used for breast augmentation or implantation into muscles, tendons, ligaments or bones. It also should not be implanted into blood vessels because blood flow obstruction may occur.

Restylane should not be used in patients who have:

· Severe allergies

· Allergies involving hypersensitivity to drugs or proteins

· Gram-positive bacterial protein allergies

Your cosmetic procedure

There are many cosmetic products on the market today. It is your job to research them as thoroughly as you can to find out if they are safe and effective. Here are some things for you to consider:

· Have they been approved by the FDA?

· Which ones does your plastic surgeon recommend?

· Which ones does your regular physician know are safe?

Any procedure you are considering should be explained to you in detail so that you can make an educated decision.

If you intend to undergo any cosmetic procedure, surgical or non-surgical, it is important to consult with a skilled and qualified plastic surgeon. During your initial consultation, ask a lot of questions. Be sure you understand all of the elements involved in your elected procedure.

Your doctor will also ask a lot of questions. You will need to answer truthfully and completely. He will need to know your medical history, overall health, age, reasons for wanting the procedure and your expectations for the outcome.

Softening deep acne scars resulting from severe bouts of cystic or nodular lesions requires a well thought out cosmetic corrective plan. And according to reports in Dermatologic Surgery, popularized scar removal options like laser resurfacing may not satisfactorily smooth away deep acne scars. Yet, patients can readily witness scar depth reductions in indented acne scaring using aesthetic therapies such as dermal fillers.

Silicon based dermal fillers

In a 30-year perspective study of using dermal fillers to correct acne scars, doctors Jay Barnett and Channing Barnett deemed medical-grade liquid silicone the only filler substance that permanently and precisely corrects acne scars. During their investigation, the researchers reviewed the lives of five patients with a history of acne scarring. Each patient showed improvements from injections of liquid silicone at the initial treatment session and at 10-, 15-, and 30-year follow-up sessions.

Hyaluronic acid dermal fillers

Even though silicon based dermal fillers work, heavily marketed fillers made of hyaluronic acid also present a potential deep acne scarring corrective. While the results from dermal fillers can prove pleasantly dramatic, in the case of hyaluronic acid, the enhancements may only last six months. Moreover, most Food and Drug Administration approved dermal fillers like Perlane have only been tested on and prescribed for correction of nasal labial folds, not acne scars that can arise on multiple areas of the face.

Calcium-based dermal fillers

In a study published in the Journal of Cosmetic and Laser Therapy, investigators tested a dermal filler composed of calcium hydroxylapatite to treat acne scars. Researchers used the filler to correct both round or saucerized acne scars, and deep acne scars with a sharp triangular shaped called “ice-pick” scars. After administering the dermal filler to ten patients with various types of acne scarring, the investigators found that only saucerized acne scars responded well to the treatment. Scar improvements lasted up to twelve months in some volunteers.

How to select a dermal filler

While dermal fillers offer dazzling results, they aren’t cheap. And typically, the longer the filler lasts, the more expensive the treatment. Dermal injections can run from $300 to $2000 for treated area so plan to spend smartly. Moreover, a dermal injection is only as aesthetically beautiful as the professional delivering the shot.

When seeking a dermal injection, seek a professional possessing experience with correcting deep acne scars with dermal fillers. Finally, when using a dermal injection, make certain that you have your acne outbreaks under control because dermal injections are contraindicated for facial areas experiencing pain or inflammation, including pimples.

Sources:

Barnett, Jay %26 Channing Barnett. Treatment of Acne Scars with Liquid Silicone Injections: 30-Year Perspective. Dermatologic Surgery, November 2005; vol 31, no 4, pp 1542-1549.

Food and Drug Administration. Perlane Injectable Gel – P040024s006 Labeling. May 2, 2007. http://www.fda.gov/cdrh/pdf4/p040024s006c.pdf

Goldberg, David; Snehal Amin %26 Mussarrat Hussein. Acne scar correction using calcium hydroxylapatite in a carrier-based gel. Journal of Cosmetic and Laser Therapy, September 2006; vol 8, no 3, pp. 134-136.

Woo, S; J Park %26 %26 Y Kye. Resurfacing of Different Types of Facial Acne Scar With Short-Pulsed, Variable-Pulsed, and Dual-Mode Er:YAG Laser. Dermatologic Surgery, April 2004; vol 30, no 4, pp 488-493.