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A wide variety of temporary and permanent fillers are now available. They can be used to restore youthful facial contours by eliminating frown or smile lines, crows feet and scars and they can be used to augment specific facial features such as lips, chin, and cheeks.
Over time, these products have become safer, easier to use and more accessible to the patient. The number of products also allows physicians to treat a broad scope of problems in various ways, leading to much greater flexibility in treatment and optimum results.
The temporary fillers include collagen, hyaluronic acid, calcium hydroxylapatite and poly-L-lactic acid. With all fillers, short-term redness, swelling and tenderness at the injection sites can occur.
- Collagen has been used for over twenty years as a filler and is the gold standard that all other fillers are compared to. Collagen can be obtained from cow hide or from manufactured human skin. A skin test with the cow derived collagen is required prior to the treatment to determine whether the patient is allergic to the implant. The effect of collagen usually lasts two to four months and can be used to treat lines and wrinkles in the lower half of the face as well as lip enhancement.
- Hyaluronic acid is also available from an animal (rooster comb) or a non-animal source. Allergy testing is not required prior to using the animal derived product but there may be a low incidence of allergic reactions. HA is often used for lip enhancement but can also be used for filling facial lines and contouring. The animal derived HA usually lasts between three and six months and the other slightly longer.
- Calcium hydroxylapatite not only replaces volume to folds and wrinkles but also stimulates the body to produce new collagen. As a result, this product can last more than a year. Poly-L-lactic acid is used primarily to sculpt or repair facial defects and is not recommended for lip augmentation or treatment of superficial lines and/or wrinkles. Skin testing is not required for either calcium hydroxylapatite or poly-L-lactic acid.
Semi-permanent to permanent implants such as fat injections, and physical implants can be effective for deeper lines, furrows and folds as well as lip and cheek enhancement. Placement of these can be more complex and time consuming but relatively safe.
Filler technology is rapidly expanding and there are many more cosmetic options on the horizon. This is an exciting time in the field of cosmetic rejuvenation!