Are You Curious About Dermal Fillers?

Dermal fillers are not new - we have been plumping our skin for over 120 years! Many people have recently read ads or seen commercials about dermal fillers but are uncertain about their use, effectiveness, or price. Let's look at how fillers have been used to enhance the appearance of our skin and try to answer some common questions to help you decide whether to investigate dermal fillers further.

Dermal fillers, also known as soft tissue augmentation, are used to restore volume loss in our skin due to injury or aging. By filling in the hollows and plumping up sagging skin, the appearance of wrinkles or skin folds is diminished or erased. Permanent dermal implants and fillers made from Gore-Tex or polymer beads (such as Artefill) are not included in this discussion because one of the advantages of modern dermal fillers is that they are absorbed by our body after some period of time. The need for repeated treatments does add expense but it allows future treatments to blend with the new appearance of our skin and guarantees that decisions made for the current style do not turn into permanent regrets (think about tattoos).

Dermal fillers were used as early as the 1890's. Doctors would take fat from a patient's arm and inject it into their face. Fat is still a popular substance used by some practitioners today who may move fatty tissue from an area of the body where it is not required to another area where it is desired. Early in the last century, injections of paraffin wax were tried but the results were often disastrous in both appearance and health effects. In the 1940's, highly refined injectable silicone emerged as a potential dermal filler with excellent cosmetic results. However, it was banned as a cosmetic agent after adverse effects and migration of the silicone were observed.

Starting forty years ago, technology advances contributed to a cascade of new dermal fillers. In the 1970's, an injectable collagen derived from cowhide was developed and received FDA approval. It was the industry standard for many years until the development of human derived collagen fillers. The emergence of liposuction in the late 1970's resulted in fat again becoming a popular dermal filler. A patient's own collagen was processed from the harvested fat and injected. In the 1980's, new techniques utilizing human serum were found to stimulate collagen synthesis but concerns with the AIDS epidemic and other blood diseases resulted in these human serum collagens being removed from the market.

More recent advances have centered on compounds that work naturally or harmoniously in the human body. Hyaluronic acid is a polysaccharide naturally found in our skin that strongly binds to water. When injected, hyaluronic acid fills the hollow area below skin folds, hydrates the skin, and provides a very soft and natural feel. Calcium hydroxylapatite gel replaces missing volume, then integrates into the skin, stimulates the production of new collagen, and provides a scaffold for the growth of that collagen. Poly-L-lactic acid, the synthetic material used in dissolvable stitches, has been adapted to fill volume and provide a structure for the development of new collagen. These new advances have surpassed collagen injections as the most commonly used dermal fillers.

The flexibility of modern dermal fillers means that they are not just used to fill the nasolabial folds around our nose. We can improve or eliminate smile lines, wrinkles at the corner of the mouth, marionette lines around the chin, folds above the chin, tear troughs, frown lines, pre-jowls, and lip lines. They are also great for enhancing lips, cheeks, chins, earlobes, and filling depressed scars.

Many dermal fillers are similar to each other but have specific uses, last different amounts of time, contain different amounts of filler, and have different costs:

• Hyaluronic acid fillers such as Restylane, Juvederm Ultra, Elevess, and Perlane are designed to correct moderate skin folds. A single syringe normally lasts 6 to 12 months and costs $500 to $700 in the Tucson area.
• Thinner hyaluronic acid fillers such as Prevelle are designed to correct small wrinkles. A single syringe normally lasts 3 to 9 months and costs $300 to $500.
• Hyaluronic acid fillers such as Juvederm Ultra Plus have a higher proportion of crossed linked hyaluronic acid, which gives it an exceptionally smooth texture and allows it to last up to three months longer. This makes it the filler of choice for lip enhancement and it costs $500 to $600 per syringe.
• The calcium hydroxylapatite filler Radiesse lasts up to 1½ years and corrects moderate to severe skin folds. Because of the additional structure that it provides to the skin, it is widely used in the back of the hands to restore a more youthful appearance. It comes in a larger capacity syringe that normally costs $500 to $800.
• The poly-L-lactic acid filler Sculptra is administered by qualified physicians in three sessions over several months and gradually provides correction lasting up to two years. One treatment area normally costs $800 to $1000.
• Collagen injections derived from animal or human tissue such as Cosmoderm, Cosmoplast, and Zyderm normally last 2 to 6 months. These are used more rarely and vary in price.

Many people are unsure about the difference between dermal fillers and neuromodulators like Botox Cosmetic and Dysport. Not all wrinkles and skin folds are the same. Some are caused by the loss of collagen or tissue below the wrinkle and are best treated with dermal fillers. Others are caused by muscles that never completely relax and force the skin above them together like an accordion. Neuromodulators do not fill wrinkles but they relax the muscular contractions that cause wrinkling. Many people need treatment with both dermal fillers and neuromodulators and are ecstatic with the results.

Budget is often a major issue because, until you speak with a trained injector, you don't know which or how much dermal filler is needed. Establishing realistic expectations and developing a plan to achieve your goal within your budget is essential during the initial consultation. Address all your desires, including the exact location, amount, and expected duration of the correction. Some areas may allow smaller amounts of filler to be placed over a period of time. However, obtaining less correction than recommended will almost certainly produce disappointing results and some desired corrections may only be achievable by surgery, if at all.

Most professional injectors apply topical anesthetic or ice before the filler is injected. For additional comfort, many fillers also have an anesthetic such as Lidocaine premixed into them. After dermal filler injections, people may experience bruising, redness, irritation, swelling, itching, tenderness, and a feeling of tightness in the injected area. Bruising is common so plan ahead for special occasions.

Dermal fillers are among the fastest growing segment of cosmetic corrections and aesthetic enhancements. In today's economy, they are far less costly than the once traditional face lift with many people returning to work the same day. Dermal fillers are safe, FDA approved, effective, and the results are immediate. For information about all the dermal fillers offered at Skin Care By Design, click Dermal Fillers.

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