Question*

Dermal Fillers

Collagen, Zyderm, Fat, Cosmoderm, Restylane, Juvederm, Captiuqe,
Radiesse, Sculptra ArteFill.

Dermal fillers are natural or synthetic substances that are injected in the deep layer of skin (dermis) in order to filling in wrinkles, crevasses, or scars.

Fat Grafting or Injection
Fat injection was one of the earliest techniques used for augmenting skin and soft tissue. Fat is harvested from another area of the body, cleaned, filtered, and then injected in very small amounts in the dermis or subcutaneous tissue. Although some of this fat reabsorbs with time, most of it does remains. The survivability of the injected fat graft depends on the location, amount, and technique of injection. In general fat injection is used to augment the soft tissues in all areas of the body, including under the eyes, lips, cheeks, scars, as well as to fill in dents or depressions in other areas of the body.

Collagen Replacement Therapy
Collagen is the most abundant protein in the nature. Our skin, bone, teeth, hair, muscle, and blood vessels are made out of collagen. Therefore, collagen is a very safe choice for soft tissue or skin augmentation. Zyderm and Zyplast are made of bovine collagen, which is derived from cow skin. Both are injected with a smallneedle, and are packaged with Lidocaine, which anesthetises the area treated. Zyderm is used most successfully to treat shallow, distensible scars. Zyplast has more collagen, and is used for filling larger defects. It is also used for lip augmentation. Both require allergy tests before their use. The results of Collagen last 3-4 months, and collagen injection needs to be repeated for maintenance

CosmoDerm and Cosmoplast are made of human collagen – produced with dermal fibroblasts harvested from bioengineered human skin cells. Neither requires a skin test prior to their use. Cosmoderm is best suited for superficial wrinkles and acne scars. Cosmoplast is more effective for the treatment of deeper wrinkles, scars and for enhancing the vermillion border of the lips.

Hyaluronic Acid Dermal Fillers
Hyaluronic Acid Dermal Fillers are a generation of dermal fillers that last twice as long as collagen (approximately 8 months). Hyaluronic acid is a natural component of the human skin that forms the skeletal framework of a healthy and youthful skin. Aging, sun damage, and smoking diminishes the amount and quality of the Hyaluronic acid skin framework, thus contributing to the formation of wrinkles and loss of skin elasticity. There are a variety of Hyaluronic acid based dermal fillers available including Restylane, Juvederm, and Captique.

Restylane, used in more than three million treatments worldwide, is approved in the United States for the correction of very deep wrinkles, such as Nasolabial Folds, Crows Feet, Frown lines, and acne scars. Restylane is also being used for lip augmentation as well as filling of the hollow around the eyes.

Juvederm which is another form of Hyaluronic acid corrects conditions including fine lines and Crows Feet, Forehead and Cheek Wrinkles, and fill lips, sculpture cheeks and fill deep Nasolabial Folds.

Radiesse
Radiesse is a long lasting filler composed of smooth calcium hydroxylapatite particles similar to the compounds found in bones and teeth, and suspended in a gel. Once injected, Radiesse stimulates buildup of new collagen, and the results are estimated to last about two years. Radiesse is injected in small amounts deep under the skin to fill creases, lines and wrinkles, to soften Nasolabial folds and facial lines, add fullness to the skin and fill in scars.

ArteFill® (Artecoll®)
ArteFill® (Artecoll®) is the first so-called "permanent dermal filler" currently being considered for use by the FDA. ArteFill is made of polymethylmethacrylate (PMMA) micro-spheres (miniature beads) that are suspended in bovine collagen. When an ArteFill injection is given, the solution not only acts as a dermal filler, but its micro-spheres also stimulate the body to produce its own collagen. As the injected collagen slowly degrades naturally, the newly produced collagen replaces it. This gives ArteFill® long-lasting, almost permanent results. The greatest difference between ArteFill® (Artecoll®) and other dermal fillers is durability of results. Studies have shown that patients who received an ArteFill® (Artecoll®) injection showed an improvement in the nasolabial folds five years after treatment. There has not been extensive clinical experience with this product in the United States yet.