The ABC's Of Injectable Fillers:From Artecoll to Zyplast - everything you need to know!

Many doctors recommend that their patients try a temporary filler for their first few treatments, just to make sure it is providing them the results they want

There are many trends in cosmetic enhancements: everything from bodylifts to the short-scar facelift has had a surge in popularity that has patients asking their doctors about the potential of such a procedure. But none can be more significant than the use of dermal fillers to soften wrinkles and make lips look full and fresh. These fillers are popular for several reasons: they're non invasive, they provide dramatic, natural results, and they are more cost-effective than a full facelift.

But which one's right for you? There are a few questions you have to ask yourself and your doctor:

Do I want a permanent filler or something temporary?

What areas of my face do I want enhanced?

What is my budget for these procedures?

What are the risks involved?

Patients should go into any consultation with their eyes wide open. There can be side effects, like bruising and swelling, so you definitely don't want to get work done the day of a big event. Occasionally there can be infection from the injection, or in the case of some permanent fillers, small bumps called granulomas. (These can usually be treated by a shot of cortisone). The permanent fillers usually have a slightly lumpier feel to them, though this usually isn't visible to the naked eye, while the temporary fillers can have a varying lifespan-usually anywhere from 3 months to a year.

Many doctors recommend that their patients try a temporary filler for their first few treatments, just to make sure it is providing them the results they want. If they are satisfied, they may want to opt for a permanent filler, so they don't have to keep coming back.

According to Dr. Jerry Moysa of the Plastic & Cosmetic Laser Surgical Centre in Calgary, Alberta-who have their own Injectable Clinic-injectable fillers work exceptionally well if the patients are screened carefully. "Doctors have to make sure the product is being used for the right reasons. The right product has to be used for the right application."

Continues Dr. Sammy Sliwin of Toronto's Forest Hill Institute of Aesthetic Plastic Surgery. "You like to give patients choices. The more they understand about the options, the happier they are with the results." Sliwin has been amazed by the growth of injectables in the last few years. "We now set aside specific hours just for patients who are coming in for fillers."

So what are your options? Following is a menu of the most exciting, popular and enduring fillers that are available:

Artecoll

Comprised of Plexigas beads in collagen, Artecoll is a "permanent" filler that is expected to last at least 5 years or more. "I don't like to use Artecoll in the lips, but I think it is excellent for the nasolabial folds," says Moysa. "It's also great for acne scars." Tracey Hotta, a registered nurse who works out of the Cosmetic Surgery Institute in Toronto, also likes Artecoll and feels it has been given a bad rap. "When Artecoll first came on the scene, it was being injected the same way as collagen, but it's not the same type of product. It requires smaller amounts and has to be injected deeper to get the best results." She doesn't recommend it for shallow areas like the forehead. An allergy test is required before treatment.

Autologen

A long-lasting filler that is made from skin and collagen harvested from your own body. Usually requires 2 to 3 treatments, but is not permanent.

CosmoDerm/CosmoPlast

A collagen-based filler from human skin grown in a laboratory-no allergy test required. CosmoPlast is excellent for lips, while CosmoDerm works on fine lines. "This fillers are great if you don't want a lot of swelling," says Hotta. "They also have lidocaine in them, so patients like them because they are less painful than other fillers." The products usually lasts 3 to 6 months. "But even though the product doesn't last as long, it really looks great, especially in the lips," says Sliwin. CosmoPlast is also being used in combination with other fillers to create a more luscious-looking lip.

DermaLive/DermaDeep

One of the newer fillers, DermaLive and DermaDeep are a combination of hyaluronic acid and acrylic hydrogel, which are minute particles; collagen builds around the particles, giving the fillers their volume. DermaLive is used for augmenting lips and smoothing out deep wrinkles. DermaDeep is very effective on nasolabial folds and for chin and cheek augmentation.

Dermalogen

For nasolabial folds, frown lines (glabullar folds) and other problems areas like acne scars, this filler is made from a human tissue matrix modified in a lab. Usually lasts from three to three and seven months.

Fat Injections

"I love fat," Sliwin says. "It's a great filling material-very popular with my patients. It is soft and can add lots of volume. I use it in the cheek area, the chin and under the eye. It doesn't work as well in the lips as it moves around too much." In this procedure, intact fat cells with connective tissue are removed from one part of the body and injected in the areas needed. Not all the fat usually takes, however, and sometimes most of it is reabsorbed by the body.

Hylaform

This is an animal-based hyaluronic acid that is used to fill out wrinkles, fine lines, acne scars and enhance lips. It's effects usually last 3 to 6 months.

Juvederm

Juvederm is nonallergenic hyaluronic acid derived from a non-animal source. It comes in three versions: Juvederm 18 for fine lines and crow's feet, Juvederm 24 for forehead and cheek wrinkles, and Juvederm 30 to fill lips, sculpture cheeks and fill deep nasolabial folds. Results can last 9 monthe to 1 year.

Perlane

"I think this is an excellent product for treating the deeper nasolabial folds," says Moysa. Perlane is a non-animal based hyaluronic acid that is part of the Restylane family. It is used for plumping up wrinkles, frown lines and marionette lines. Results usually last a year or more.

Restylane/Restylane Fine Lines

A popular lip enhancement filler, Restylane is a finer hyaluronic filler than Perlane and usually lasts 6 months to a year. Restylane Fine Lines is often used with Restylane to fill out tiny creases around the lips.

Reviderm

This filler consists of biodegradable micron-sized beads in a hyaluronic base. Usually two injections are required, the second one coming six weeks after the first, giving time for tissue to form around the beads. Results usually last 6 to 9 months.

ZyDerm/ZyPlast

Once the most popular filler of them all, this collagen filler is fading from prominence. Not only do you require an allergy test because it is an animal-based product, results usually don't last much longer than 3 or 4 months. However, Hotta still has clients who request them because they have used them for so long with such good results. ZyDerm is great for fine lines while ZyPlast works especially well on the lips.

What's New

Everytime it seems like the last possible frontier in cosmetic enhancements has been reached, something new comes along. Restylane will be introducing a new filler this year-pending Health Canada approval-called Restylane Sub-Q. This product is designed specifically for contouring and shaping the cheeks and chinnot for use on lips and wrinkles-and will be an alternative to fat grafting.

What lies in the future? Many doctors feel that patients are opting more for permanent fillers. "It's very expensive to keep coming back every six months," says Sliwin. "The ideal would be a product that stimulated collagen and that was permanent. But I just can't see that happening."

 

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