Collagen has been used for more than 20 years as a soft-tissue filler. It can be derived from cows (bovine-based collagen) or humans. Collagen injections last up to six months. Some people are allergic to bovine collagen, so a skin test should be performed before the injection is given. According to the American Society for Aesthetic Plastic Surgery, 160,252 injections of collagen were performed in 2006. Average cost for the procedure is $397.
Material for fat injections is generally taken from another part of the body (called autologous fat injections). The fat is usually obtained from the abdomen, thighs or buttocks, processed and then injected under the skin on the face. Since the fat is taken from the patient’s own body, there is no risk of allergic reaction. In addition, patients receive a “mini-liposuction” in the donor area. The length of time that fat injections last varies widely, from several months to years. Last year, 96,570 autologous fat injections were performed in the U.S. Average cost is $1450.
Hyaluronic acid is a man-made version of a natural component of connective tissue. It is available under several product names (Hylaform®, Restylane® and Juvederm™). An injection lasts from four to 12 months. More than 1.59 million injections of hyaluronic acid were given last year. Average cost per procedure is $532.
Calcium hydroxyl-lapatite is a synthetic version of the same material found in bones and teeth. It is sold in the U.S. under the names Radiesse® and Radiance®. It’s one of the longest lasting semi-permanent fillers, lasting for two years or more. About 77,067 injections were performed in 2006 at an average cost of $856.
Poly-L-lactic acid is a synthetic material used to make dissolvable sutures and soft tissue implants. It’s sold under the name Sculptra® and is approved for correction of facial fat loss in HIV patients. Some physicians are using it off-label as a cosmetic filler for wrinkles. Injections last about two years. Last year, 44,696 injections of Sculptra were given in the U.S.
ArteFill is the first permanent injectable filler to be approved in the U.S. It contains 20 percent tiny, round polymethyl-methacrylate particles (a material used to make medical implants) and 80 percent bovine collagen. ArteFill also contains a small amount of lidocaine anesthetic. A skin test must be performed prior to the injection to ensure the patient is not allergic to the collagen or lidocaine.
Injectable fillers are popular treatments. However, Simon Ourian, M.D., a Cosmetic Surgeon with Epione Medical Corporation says they are still a medical procedure and so, should be approached with caution. He says some fillers are better than others for thinner areas of skin, like around the eyes. Others are better for use around the mouth. Ourian says patients should seek advice from a physician who has had plenty of experience with injectables. Ask to see before and after pictures. Also be aware that swelling and bruising may be possible for a few days after the injection.
People who are uncertain about what to expect may be better off with one of the less permanent injectables. If the patient is happy with the results, a longer-lasting injectable may be chosen for re-treatment. The American Society of Plastic Surgeons cautions that injectables aren’t for everyone. The treatment may not be sufficient for deep wrinkles. In those cases, injectables may be used in conjunction with other types of cosmetic procedures.