Dermal Fillers Classification
- collagen injection
- hyaluronic acid based fillers
- calcium-based microsphere hydroxylapatite
- fat injection
- butulium Toxin A (Botox injection)
Dermal Fillers are gels consisting proteins (collagen) or other dermal nutrient (hyaluronic acid) injected into the skin and absorbed by the skin to plump up and help to restore volume loss as well as reduce wrinkle. Fillers began initially with collagen (skin connective tissue structural fibrous protein) and progressed to hyaluronic acid (skin moisturizer nutrient). Both are natural substance produced by the body that give the skin support, creating a plump appearance. Collagen injections have been used for decades to replenish the skin’s volume and help preserve a youthful appearance. It’s a safe, non-surgical treatment that can smooth out facial line and wrinkles, even scars. The first generation fillers typically lasted between four to six weeks – sometimes longer; sometimes less. The new generation of collagens appears to be longer lasting. Fillers come in a range of consistencies and are injected using very fine needles into or under the skin where the wrinkles and sagging are found. Generally, the thicker fillers will be used for the deepest wrinkles and folds and will be injected more deeply into the tissue of your face. The procedure typically will take around 30 minutes to an hour.
The next-generation filler market is exploding with new products. These include the innovative collagen based filler, hyaluronic acid based filler, and more recently the calcium-based substance called hydroxylapatite (hydroxyapatite) filler. Artefill, the latest FDA-approved facial filler, has the potential to remain in the face for years. It combines purified collagen and polymethacrylate.
Some of the newest and most exciting injectable hyaluronic acid based wrinkle treatments are Restylane®, Perlane®, and JUVÉDERM®. The products work by adding immediate volume in the skin or deep under the skin, smoothing wrinkles from underneath. They also attract and bind to moisture molecules under the skin’s surface for a hydrating effect. All are FDA-approved. Restylane SubQ is the thickest gel filler which is used to replace lost fat in gaunt cheeks and is injected just under the muscle in the cheek. Restylane Hydrafill are used to fill out medium to fine lines and wrinkles. Restylane Lipp is a lip filler for restoring plumpness to thinned lips. Perlane is a product for deeper wrinkles. Restylane generally costs in the range $400-600 per session and is one of the more expensive but most effective dermal fillers on the market.
JUVÉDERM has additional FDA clearance for use with all skin types and colors, making it an ideal choice for many African-American and Hispanic patients. Juvederm comes in different particle sizes as small, medium or large particle size which enable flexibility in selection to fit a particular area. Clinical trials suggest it may last up to six to eight months. Hyaluronic acid based fillers can be removed by the use with an enzyme – hyaluronidase to correct problems or unwanted results.
Radiesse® is a calcium-microsphere based hydroxylapatite (hydroxyapatite) dermal filler. The calcium “microspheres” are suspended in a smooth gel that can be injected with very little discomfort. Radiesse is most often used to augment the bridge of the nose and jaw line for non-surgical cosmetic improvement and for chin and cheek augmentation too. One of the major advantages of Radiesse is the long-lasting (1-5 years) results it offers.
Fat injections use your own tissues where fat cells were collected from one area of your body, usually the buttocks or abdomen, and were transferred to the target site. These injections can be used to fill in wrinkles and lines, create contours in the face, enhance lips, and smooth scars. Fat injections tend to be long lasting but may not be permanent. They can be repeated as necessary as above fillers.
Dermal Fillers – Restylane vs. Juvederm
According to the experts, Restylane and Juvederm rank well with one another. Is one better than the other? No. The choice of which product to use is better left to the professionals and greatly depends on the task at hand. Both dermal fillers are hyaluronc acid products that effectively fill in facial lines and wrinkles.
Restylane (Medicis) is a gel-like product that is thicker than Juvederm (Allergan) and may treat deeper lines more efficiently. Restylane is used for creating a fuller face because of its ability to plump the skin. Once ‘molded’ it tends to stay in place and not travel into other areas.
Juvederm, on the other hand, is a more syrup-like substance and produces smoother lines without too much manipulation, and as a result, may be better around the lips and mouth area. Juvederm produces less bruising. Both last for just under a year and can correct most of the issues around an aging face.
List of FDA approved and to be approved Dermal Filler:
Human collagen based dermal filler: Brands include CosmoDerm, CosmoPlast, Cymetra.
Bovine collagen based dermal filler: Brands include Zyderm and Zyplast.
Polymethyl- methacrylate microspheres suspended in bovine collagen dermal filler: Brand name ArteFill.
Hyaluronic acid based dermal filler: Brands include Restylane, Juvederm, Hylaform.
Calcium hydroxyl- lapatite microspheres dermal filler: Brand name Radiesse.
Synthetic polylactic acid in microspheres dermal filler: Brand name Sculptra. It’s approved for other purposes but also used off-label for wrinkles.