Cosmetic injections like botox and collagen


Fillers: Injectable fillers are the large group of substances used to correct contour defects and are used primarily on the face to enhance lips, fill hollows, and soften the appearance of wrinkles. They can be categorized in different ways: permanent versus semipermanent versus temporary; space occupiers versus bioactivators that both fill space and stimulate the development of natural collagen; biological (derived from living tissue) versus nonbiological.

Whereas resurfacing procedures seek (among other goals) to even out skin topography by lowering the surface, fillers plump up low areas. Fillers may also be used in conjunction with skin excision procedures (for example, facelifts) and Botox. Fillers are intended to provide subtle corrections. Regardless of the filler chosen, repeat injection sessions are usually required, both to fine-tune the result and to re-create the effect as the filler is absorbed.

Like Botox, most injectable fillers have a temporary effect, some having no more lasting power than hair color or waxing. Longerlasting injectables have the major disadvantage of creating a displeasing result that may not be correctable. Thus there has been a trend away from permanent fillers like liquid silicone and toward temporary and semipermanent fillers. Still, neither providers nor patients has been entirely happy with the short life span of the most commonly injected fillers.

Filler injections are performed in an office setting. Some products can cause allergic reactions and require pretesting, but most products used today do not carry this risk. Local or topical anesthesia is often used. Multiple needle insertions may be required, and some discomfort should be expected. Afterward, some swelling, redness, and lumpiness are common. Final results may not be evident for months, yet correction may not last much longer. New fillers come on the market regularly as others fall out of favor. The following is a partial list of fillers used currently and in the recent past, including brand names where applicable:

Collagen: Collagen is a vital protein that is naturally present in skin, tendons, ligaments, and other supporting body tissues. It helps these structures maintain rigidity, but its volume and quality deteriorate with age. For many years collagen was the most popular substance used for filling soft tissue defects. It generally creates minimal inflammation with minimal posttreatment morbidity. Depending on the product, one or more injections may be necessary for acceptable correction. All injected collagen is eventually absorbed, so for most products, treatments must be repeated every three to six months to maintain the desired effect.

Bovine collagen (Zyderm, Zyplast): Cow tissue–derived collagen has been used as a filler since the 1980s. Collagen manufactured from animal tissue can cause allergic reactions in susceptible individuals, and pretesting is recommended.

Bioengineered human collagen (Cosmoderm, Cosmoplast, Cymetra, Alloderm, Dermalogen, Autologen, Fascian): Human collagen is manufactured from donated skin, grown in laboratories, or can be made from the patient’s own tissue. Human collagen does not cause allergic reactions and does not require pretesting.

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