*Guest Post by Kevin*
Since Botox was first approved by the FDA in 2002, there has been a proliferation of facial injection products that help keep us looking young. These products fall broadly into two classes – neurotoxins and dermal fillers.
Neurotoxins include Botox and two competitors, Dysport and Xeomin. These products relax the frown lines between the eyes, the crow’s feet on the sides of the eyes and the horizontal wrinkles above the brow. They smooth away fine lines and wrinkles by relaxing the muscles that cause them. The results will typically last 3-4 months.
Dermal fillers are a second category of injection products and they work very differently than neurotoxins. Whereas neurotoxins work to smooth wrinkles away by relaxing facial muscles around the eyes, dermal fillers replace fatty tissue and collagen that have been lost to the ageing process.
Everything You Ever Wanted to Know about Dermal Fillers
Not sure which is right for you? Here are some of the top dermal fillers available on the market.
Hyaluronic Acid Based Dermal Fillers
There are several types of dermal fillers, but many of the current products FDA approved in the US are what are called “Hyaluronic Acid” based products. Hyaluronic acid is a lubricating gel-like compound that’s found most commonly in our joints. It is hydrophilic, which means it has the ability to absorb water.
Synthetic Hyaluronic acid can absorb up to 1000 times its weight in water. This property means that when it is injected into the skin, it provides volume and a plumping effect.
Calcium Microsphere Based Dermal Filler
Radiesse is a long-lasting dermal filler that is in a class by itself currently. It is not made up of Hyaluronic acid, but rather tiny calcium microspheres. These calcium spheres are so small that they are invisible to the naked eye and also fit easily through the injection syringe.
Compared with Hyaluronic acid based dermal fillers, Radiesse is thicker and longer lasting.
Poly-L-Lactic Acid Based Dermal Filler
Sculptra is also unique in that no other dermal filler on the market uses the same material or method of action. Sculptra is a long lasting (up to 2 years) injection product that works very differently than other dermal fillers.
Instead of creating immediate volume, Sculptra uses the body’s natural healing response to stimulate the production of your own collagen. Because you stimulate your own collagen after Sculptra injections, the best results will be seen 6-9 months after starting injections.
Which Dermal Filler is Right for Me?
Our patients often want a single answer for which dermal filler is right for them. While this may seem to be a simple question, there are many factors that affect the answer. The choice of dermal filler depends on the area of the face injected.
For example, in thin skin areas such as the lips and under eyes, normally injector’s reach for Hyaluronic acid based fillers. The reason is that this class of gel is quite smooth and the risk of using thicker, longer lasting fillers in these areas is lumpiness.
The patient’s desired duration (how long injections last) also factor into product choice. If a patient wants maximum duration, fillers such as Radiesse, Sculptra or even Bellafill are often used. Longer lasting fillers are typically more expensive and cost is another important factor in the decision.
A patient’s budget also helps us determine which products to use as the Hyaluronic acid based fillers are generally cheaper than Radiesse, Sculptra or Bellafill.
Are There Side Effects for Dermal Fillers?
Each class of dermal filler carries different risks. Hyaluronic acid based dermal fillers are very safe because they can be easily reversed with an enzyme called Hyaluronidase. If there is a problem or concern, injecting Vitrase or another Hyaluronidase based enzyme will dissolve the filler. These properties make Hyaluronic acid based fillers the safest class.
Radiesse, Sculptra and Bellafill all carry a risk of causing granulomas. Granulomas are a hard nodule under the surface of the skin that result when the body views the dermal filler as a foreign object and surrounds it in an allergic type response. Bruising and swelling are also very common after dermal filler injections.
About the Author: Kevin DiCerbo is the Director of Celibre Medical. He has been working side by side with Dr. Kaplan since 2004 and has managed Celibre Medical since its inception. He is a certified medical laser safety office (CMLSO) and uses his knowledge of laser physics to help patients understand laser treatments. He also oversees the day to day administrative activities at the two offices. He has a BS in Engineering from Cornell University and an MBA from UCLA.