ShareThisBy MARIE KUECHEL and ROBERT SINGER
newbeauty.com
Tuesday, September 11, 2007
The idea of fewer office visits and more longevity is attractive to some, but many doctors eschew permanent fillers because they are just that: permanent. As the face continues to change over time, these injectables remain where injected, and may not complement your appearance as you age.
The history
While long-lasting injectable fillers may seem like a good idea in theory, they remain the most controversial. The first permanent filler was silicone, but the Food and Drug Administration has never approved it for cosmetic use. Among the reported drawbacks: risk of granulomas (small nodules that can be felt beneath the skin) and migration (when the filler moves away from the injection site). All current available permanent fillers run these risks. But it's important to differentiate between permanent injectables and long-lasting fillers. The only FDA-approved permanent injectable is Artefill, which some doctors are using to correct wrinkles, acne scars and other deep depressions. Artefill works by encouraging your skin to produce more collagen, so while there is some instant correction, your real results will develop over time.
How they work
Long-lasting or semi-permanent fillers such as FDA-approved Radiesse and Sculptra (approved for treatment of facial fat loss in HIV positive individuals, and used off-label in healthy individuals) have been embraced by many dermatologists and plastic surgeons for their ability to stimulate collagen production. These are useful when you need a lot of volume. They essentially act like injectable scaffolding that prompts the body to produce collagen around it. These products help build volume (as opposed to filling) for results that last over a year. Many doctors find Sculptra to be especially useful for hollow cheeks or temples and to lift up the jaws and cheeks. Radiesse is another product that can be used in the nasolabial creases and marionette lines. It's great for thicker-skinned people who can tolerate a thicker product.
Coming soon?
Although long-lasting and permanent fillers haven't seen the explosive growth enjoyed by temporary dermal fillers like Restylane, many are seeing success in Europe and Canada and the manufacturers have their sights set on the United States.
-- Aquamid: Currently in clinical trials, this long-lasting filler is essentially water cross-linked to polyacrylamide, and this product works strictly by filling, rather than stimulating the body's own collagen production.
-- Bio-Alcamid: Another permanent filler comprised of water and a synthetic polymer, Bio-Alcamid lasts indefinitely, but can be extracted without surgery if necessary. Although this product has been available in more than 20 countries since 2000, U.S. trials have yet to start.
-- DermaLive and DermaDeep: Available outside the United States in two formulations to treat different degrees of wrinkles and folds, these products are comprised of an acrylic gel in a hyaluronic acid base. Touted as a semi-permanent filler, two to three treatments can enhance the cheekbones and fill deep nasolabial folds and scars.
Marie Kuechel is an editor at New Beauty, a semi-annual magazine about cosmetic enhancement. Robert Singer is a medical doctor. Reach them at editors (at)newbeauty.com. For more columns visit www.scrippsnews.com
