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Another method for wrinkle reduction is the use Dermal or Soft Tissue Fillers such as Collagen (Cosmplast, Cosmoderm) and Hyaluronic acid (Restylane, Perlane). As we age, starting the age of 35 we lose about 1% of dermal Collagen and ground substance such as Hyaluronans- substances responsible for supporting the structure and contours of the upper layer of the skin. Chronic sun damage and aging weaken the natural collagen framework and the skin loses its elasticity. Deep marks and scars are also manifestations of damaged to the underlying collagen structure by skin lesions such as acne, chickenpox and by skin injury. Wrinkles are the result of years of repetitive facial expressions coupled with the effects aging or sun damage when collagen and ground substances are slowly depleted or damaged. Aging or sun damaged skin is not as resilient hence when you stop smiling or frowning the facial lines do not disappear (static wrinkles). Collagen replacement or use of soft tissue fillers can provide a quick fix to smooth out the static wrinkles and lines; enhance fullness to the lips; fill in scars and deep marks and provide fullness to undesired hollow areas of the face. The look of a dermal filler is natural and softens wrinkles, furrows and scars we developed as we age.
What Areas and Conditions can be Treated with Soft Tissue Fillers?
Specific areas that can be treated are Worry lines on the forehead, Vertical Lip Lines (above the lips), Marrionette Lines (vertical lines on the corners of the mouth), Crow’s feet; Deep smile lines or Nasolabial folds, Acne or other Facial scars. Also used to enhance fullness of the lips.
What are the different Soft Tissue Fillers?
There is a cornocopia of filler materials now available and more are in development or awaiting FDA approval. Many of these substances have been used in Europe, Canada and South America for years. In 1977 the first bovine collagen injection (Zyderm® I was on the market and by 1981, the FDA granted approval. Two other versions of bovine collagen followed soon after (Zyderm® II, Zyplast®) In March 2003, human collagen Cosmoplast and Cosmoderm was approved by the FDA for use in the US. These products eliminate the need to do skin testing as was done on older bovine derived versions.
Hyalorunic Acid (Restylane, Perlane, Hylaform) exists naturally in all living organisms. Hyaluronic acid plays a crucial role in providing volume to the skin, shape to the eyes and elasticity of the joints of the human body. The skin houses the vast majority (57%) of the hyalorunic acid. As we get older the skin cells lose their ability to produce hyaluronic acid. The ability of hyaluronic acid to hold on to water makes it an ideal filler such that even while the filler is being naturally degraded, what remains of the filler holds on to water and maintains it shape longer until eventually completely degraded.
Soft Tissue Fillers are classified into temporary, semi permanent, permanent fillers or implants. Below is a short list of fillers; many are not yet FDA approved.
*Currently FDA approved Fillers
Temporary fillers (last 2-12 months)
Zyderm, Zyplast, Cosmoderm*, Cosmoplast*, Restylane*, Perlane*, Hylaform*, Juvederm*, Cymetra, Sculptra*/New Fill, Facian and Autologen
Semi - permanent fillers (last 1-5 years)
Radiesse*, Alloderm and Fat grafting
Permanent fillers and Implants ( permanent although some are removeable)
Artecoll (Artefill), Aquamid, Isolagen, Silikon 1000, Silskin. Permanent implants include Soft form, Softform-RC, Ultrasoft, Gortex and Advanta
What are treatments like?
Soft tissue fillers are injected into the treated areas after a local or topical anesthetic is applied. Nerve blocks may be used for lip enhancement procedure. There is temporary redness and swelling that can last for 12-24 hours and occasional bruising lasting for few days to a week. The results are immediate. Just like natural collagen, non permanent fillers will eventually lose their form and broken down by the body’s natural processes.