About Wrinkle Filler Materials Like Collagen

The world of injectable fillers really changed in the first half of 2007 with the introduction of a number of new products.

Injectable fillers work by literally “filling-up” a crease, wrinkle, or depressed area. You can think of them as caulking for your skin. For the last few years I have considered Restylane to be the all around best product but Juvederm, Perlane, Radiesse, Artefill, and Sculptra have all been introduced and compete with Restylane.

Restylane, Juvederm, and Perlane belong to a class of products called hyaluronic acids. The hyaluronic acid in these products is nearly identical to the hyaluronic acid already found in all human beings. The advantage here is that your body shouldn’t reject it. All of these products are manufactured; they are not derived from animal or human tissues. The advantage of Juvederm and Perlane is that they may last longer than Restylane, perhaps in excess of one year. Of course there is a great deal of variability based on where you put the product as well as from person to person. My experience is that when used on areas of the face that do not move much and injected closer to the surface of the skin, Restylane can last well over a year. I have not used Juvederm and Perlane long enough to comment on longevity. All of these products have versatility because they are colorless and rarely result in visible lumps or discoloration. You can just about put them anywhere in the face. If you have a problem with any of these products, there is another product that can be injected into the area causing the hyaluronic acid to dissolve in a few hours.

Radiesse is used more for filling valleys and depressed areas rather than crease filling. It is a thicker product looking a little like toothpaste. It is made of Calcium Hydroxylapatite, which is also naturally found in human tissues. Radiesse is not new in that it was FDA approved several years ago, but it did just receive FDA clearance for use as a cosmetic filler. I have been using it for more than 3 years “off-label” cosmetically and have confidence in the product. The product is manufactured, not harvested from animal tissues. I really like using Radiesse for filling depressed areas. It is great in the smile lines and filling deep grooves under the eyes. It is not as effective with fine lines. It typically lasts over a year. In addition to those areas, Radiesse can be used as an augmentation product to create higher cheekbones, stronger chins, and fuller cheeks. One interesting thing about Radiesse is that it causes your body to form collagen around the particles of Radiesse resulting in further improvement developing in the first few weeks after injection.

Artefill is different than the other fillers in that it is touted as being permanent. The material is a combination of Polymethylmethacrylate (PMMA) and collagen. PMMA has been used as a surgical implant material for decades for reconstructing bone defects. The human body is not capable of dissolving PMMA. In Artefill, PMMA has been converted to a very fine, powder-like material, that is mixed with collagen for injection. Interestingly, the PMMA is not what actually fills your lines, but rather your body’s response to the PMMA. PMMA particles stimulate your body to form capsules of collagen around each microscopic granule. A few weeks after injection, the filling effect is complete. The collagen that is mixed in with the product is meant to estimate how much your body will produce. As the injected collagen dissolves, your body is replacing it with its own collagen. Because the collagen in the product is made from cows, an allergy test is required prior to use of the product. For now, I am only using this in the smile lines.

All said, there are a lot of options when it comes to filler materials. Which one to use is a decision that is best made after a consultation. Besides the options I have mentioned here, there are still more products available, any one of which may be best for you.