Injectable Facial Fillers - An Introduction

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					Injectable Facial Fillers - An Introduction
As one gets older, the effects of age, heredity, the sun, gravity and
lifestyle take their toll on the skin of the face and body. The face
being the most exposed part of the body is the part where the skin
changes are most obvious, and that part is what everybody worries about
first in an effort to keep looking young.
Face changes are obvious. There is increased development of wrinkles and
folds as the underlying subcutaneous tissue thins out and there is loss
of volume and fullness. Another reason for the formation of creases and
folds in the skin of the face is the continual or frequent usage of the
muscles of expression in the skin. Initially the usage of these muscles
cause the formation of dynamic wrinkles which disappear when the muscles
of that particular part of the face relax. Thus we get what are popularly
known as frown lines or glabellar lines (between the eyebrows), forehead
lines (horizontal lines on the forehead on looking up, also called
surprise lines) and crows' feet (the lines radiating out from the corners
of the eyes).
Ultimately these dynamic wrinkles become more permanent and remain even
when we relax the muscles of expression. Think of a piece of paper that
is folded and opened repeatedly. In the end the initial mild fold becomes
permanent and prominent.
The upper face is not the only part of the face affected by age and the
other factors mentioned above. Moving downwards we see the nasolabial
folds, the deep grooves running from the sides of the nose to the corners
of the mouth. Beyond that, running from the corners of the mouth in
almost the same direction as the nasolabial folds, are the marionette
lines, so-called because these lines make the person look like a puppet.
The solution to these problems is a simple, relatively inexpensive and
safe injection of a gel-like substance known popularly as a facial filler
or skin filler into the underlying area of the skin. Injection of this
volume under the skin will cause the skin to balloon up and recover its
lost fullness, at the same time causing the overlying wrinkles or folds
in the skin to become shallower to the point they even disappear. These
fillers are useful not only to remove folds and creases, but there is
also a use for them to augment volume on the face as well as other parts
of the body. Thus we can change the shape of the nose for those who are
somewhat flat-nosed, augment the cheeks in those who have hollow cheeks,
enlarge the lips for those who want sexier, bigger lips, or even enlarge
the chin of those whose chins are smaller than desired. Fashion trends
change, and fillers can be used to enlarge those body parts which are
desired fashion of the day. Moving down the body, one can enlarge the
breasts with fillers, or enlarge the buttocks to enhance perceived
Ideally the substance injected should be safe to the human body and not
cause any side effects, be as close in chemical composition as the
naturally occurring substances in the skin as possible, and be able to
last. Technically a lot of formulations have been introduced in recent
years that try to approximate this ideal state of affairs.
They are:
Hyaluronic Acid. Hyaluronic acid is a natural component of the dermis of
the skin.
It forms the extracellular matrix and gives the skin its volume and
turgidity. Because hyaluronic acid is a naturally occurring substance in
the human body, fillers made from this material do not excite any
allergic reaction and are considered perfectly safe. The hyaluronic acid
may be modified in certain brands so that it lasts longer in the body
before being absorbed. Examples of popular hyaluronic acid fillers are
Juvederm (also popularly referred to as Juvaderm or Juviderm), and
Restylane (also known as Restalyne or Restalyn). Hyaluronic acid fillers
can last from a couple of months to 6 months (Restalyne) to 1 year
Collagen. A major component of the extracellular matrix, it is
responsible for skin strengthand elasticity. Collagen fillers are usually
derived from bovine sources and may give rise to allergic reactions. Thus
allergy testing is usually recommended if one uses collagen fillers.
Examples of collagen fillers of bovine origin are Zyderm and Zyplast.
Another type of collagen filler derived from human skin is less
allergenic. Examples of these are Cosmoderm and Cosmoplast. How long do
collagen fillers last? About 3 - 6 months.
Hydroxylapatite. This is a non-toxic, biocompatible mineral found
naturally in human teeth and bones. Small microspheres of hydroxylapatite
suspended in a gel-like medium, such as Radiesse, are used as fillers for
moderate to deep wrinkles and facial folds and cheek augmentation. How
long does Radiesse last? About 12 - 18 months.
Human Fat. This forms the most natural of fillers, as this is derived
from the patient's own body fat. This fat is usually harvested by
liposuction from the buttock fat or abdominal fat, washed, and reinjected
into wrinkles and folds. Liposuction, however has its own risks. How long
do fat injections last? This depends on the technic of harvesting of the
fat cells (less traumatic harvesting and less disruption of the live fat
cells allows for a longer-lasting result), and the area of injection (
the effect lasts longer in areas where there is less movement such as the
back of hands and the cheeks, and shorter in areas where there is
constant movement such as the lips and mouth areas). Averaging at least 3
PMMA (Polymethylmethacrylate). Popularly used for buttock augmentation
(Brazilian butt), polymethylmethacrylate is non-absorbable and is
considered a permanent filler. Artefill is a filler composed of PMMA
microspheres mixed with bovine collagen. How long does Artefill last?
Generally lifelong.
Poly-L-lactic Acid. Currently indicated for the correction of facial fat
loss in people with HIV. The brand is known as Sculptra. Effects last for
about 2 years. These are the major types of facial fillers in common use
by esthetic practitioners. It is recommended that you seek the advice of
your trusted experienced esthetic doctor before you decide to embark on
any filler injection to get the best results.
Interested in reading useful articles about esthetic procedures to
further enhance your looks?
You are welcome to visit
Tony Wong is an established medical practitioner with an ongoing esthetic
medical practice.