Facial wrinkles and creases begin to appear as the underlying collagen and elastin fibers begin to break down and wear out. While this breakdown is part of the natural aging process, the effects of gravity, sun exposure and years of muscle movements such as smiling, chewing and squinting make a significant contribution.

Injectable bovine collagen and synthetic fillers are the most frequently used materials for filling facial wrinkles and frown lines, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face fill out deep facial wrinkles, creases and furrows. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser treatment, or a recontouring procedure, such as a facelift.

WHAT ARE MY OPTIONS?

There are many different types of fillers available today. Your Plastic Surgeon will discuss your choices with you and help you decide which product is best suited to your needs.

Collagen is a naturally occurring protein that provides support to various parts of the human body: the skin, the joints, the bones and the ligaments. Injectable collagen, patented by the Collagen Corporation under the trade names Zyderm and Zyplast, is derived from purified bovine collagen. The purification process creates a product similar to human collagen. Collagen is used primarily to fill wrinkles, lines and scars on the face.

Restylane, Perlane and Hylaform contain synthetic, bio-degradable hyaluronic acid in the form of crystal clear gel and have been used in Europe for years. In contrast to other bio-degradable fillers, they are not extracted from animals, have no risk of allergic reaction and are perfectly safe to use instantly without pre-testing. They are injected into the skin to lift the wrinkle or fold. Once in your skin, they create volume, resulting in a healthy and vital appearance. When injected into the lip they can restore a more natural and/or sensuous look.

Fibril is a gelatin powder compound that's mixed with a patient's own blood and is injected to plump up the skin, similar to injectable collagen.
Radiesse, formerly known as Radiance, has proven to be a safe and effective alternative for those patients wishing to avoid the potential side effects of bovine and solid implant materials. It is long lasting and does not require a skin test because it is the same mineral component found in our bones and teeth.

AlloDerm is a dermal graft/implant material made from donated skin and processed by the LifeCell Corporation. With AlloDerm, the epidermis, or top layer of skin cells, and the cells in the dermis are removed from the donor tissue. All that remains is a collagen framework that provides strength to the skin. AlloDerm contains no cells that can cause rejection or inflammation. Once the AlloDerm graft or implant material is in place, it gradually becomes a natural part of your body.

WHO ARE THE BEST CANDIDATES FOR INJECTABLE FILLERS?

While collagen can smooth out wrinkles, injectable collagen isn't for everyone. Some patients are allergic to bovine collagen or may develop an allergic reaction over time. If you are considering collagen injections to correct the early signs of aging, you will need to have a simple skin test prior to your treatment. Synthetic dermal fillers and collagen are also expensive, especially when required in larger quantities. They also get completely absorbed in six to nine months requiring repeated re-injections.

Injectable fillers are usually not sufficient for severe surface wrinkles on the face, such as multiple vertical "lipstick lines" that sometimes form around the mouth. Instead, you may benefit from resurfacing technique, such as chemical peel, dermabrasion or laser treatments. Rather than filling in facial lines, resurfacing methods strip away the outer layers of the skin to produce a smoother appearance.
Deep folds in the face or brow caused by overactive muscles or by loose skin may be more effectively treated with cosmetic surgery, such as a facelift or brow lift. Injectable fillers alone cannot change facial contour the way surgery can.

WHAT TO EXPECT FROM TREATMENT
The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body. You should not expect the same long-lasting results that may be gained from cosmetic surgery. When injectables are administered by a qualified plastic surgeon, complications are infrequent and usually minor in nature.