Less Invasive > Dermal and Subdermal Fillers
Injection of a dermal filler beneath a scar, deep wrinkle, or facial depression makes most people very happy. There are several fillers to choose from, but none are perfect. The perfect filler would be painless, free of allergy, long lasting, and inexpensive. The drug companies know this, and they are working hard to find the golden egg.
Dermal fillers are intended to be injected into the second layer of the skin but many are placed deeper into the subdermal space as well. The earliest preparations were of collagen, which suffered from significant rates of allergy and short duration of effect.
A big advance came with the introduction of the synthetic hyaluronic acid fillers. Restylane ® was approved by the FDA in 2003 and quickly became the filler of choice. Perlane ® is identical but consists of larger gel particles and so can be used to correct deeper folds.
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Juvederm ® was approved in 2006. It may last a tiny bit longer than Restylane but is, basically, quite similar.
Other longer lasting fillers exist but are not as easy to use in the thin skin in some areas of the face. Sculptra ® (not a true filler) relies on stimulation of collagen formation for its effect.
Radiesse ® can last for several years. Made of a calcium compound, it is injected beneath the dermis and can show if placed too superficially.
The latest entry into the U.S. market is Evolence ® , a new type of all-natural collagen filler derived from pig tendons. The risk of allergy is remote and it is said to last up to one year.
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