Dermal Fillers for Wrinkle Removal

Dermal fillers are being used more and more to help reverse the changes associated with aging. Because the goal is to return the dermis to its original youthful state, dermal fillers can give a more natural appearance than surgical face lifts.

There are 3 causes of wrinkles. The force of gravity, sun damage, and volume loss. Reduced collagen is what causes the volume loss and injectable fillers address that issue. Dermal fillers are being used to reduce or eliminate wrinkles, raise scar depressions, enhance lips, and replace soft-tissue volume loss. In 2007 about 1.36 million women and 84,000 men received wrinkle- fillers in the US.

How Do These Injectables Work?

All injectable fillers are placed carefully in the skin's second layer, the dermis. This is the layer which supports the skin surface, and as we age it starts to lose some of its collagen and elastin. Collagen is a fibrous protein which intertwines in the dermis with elastin, another fibrous protein, to form a supportive matrix. As the body produces less collagen, the matrix forms little gaps and weakens, causing the skin's top layer to subside and look wrinkled. Until recently, the most frequently used material for filling facial wrinkles and frown lines was injectable collagen. However, collagen injections aren’t for everyone. A very small percentage of patients are allergic to bovine collagen.

Commonly Used Dermal Fillers

* Restylane and Perlane from Medicis contain hyaluronic acid in the form of a crystal-clear gel. Hyaluronic acid occurs naturally in the body and therefore it also dissolves naturally with time and is integrated into the body’s tissues. These products have the same 20 mg/cc strength of hyaluronic acid; they just vary in gel particle size. This variability makes for tailoring of injections according to the size and depth of the wrinkles ranging from lip enhancement to hand injections.

Following the injections, normal activities can be resumed immediately and discomfort is minimal. The treatment site may have a little swelling, which lasts a few hours. There might be some slight bruising which can be covered with make-up. If the lips are treated, initial swelling and tenderness may occur within the first several days, but subsides after two or three days. Depending on the area treated, correction can last up to six months or longer. Lip enhancement created by Perlane has up to twice the longevity of standard collagen implant treatments.

* Radiesse from Bioform Medical is a synthetic filler, thoroughly tested and FDA-approved and needing no allergy testing. It stimulates your skin to produce more of its own collagen. It is a gel containing tiny calcium-based microspheres and when these are injected into the deep dermis, the skin responds by forming a collagen membrane around each of them. For many patients, the benefits of treatment with Radiesse dermal filler may last up a year or more.

* Juvéderm from Allergen is a smooth consistency gel made of hyaluronic acid a naturally occurring substance in your skin that helps to add volume and hydration. The injection process takes only about 15 minutes and results are immediate. Plus, there's minimal recovery or downtime. Juvéderm is indicated for injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds).

There are some risks.

In November 2008 the FDA announced that it plans to review the labeling of some wrinkle-filler products, also known as dermal fillers, because it has received 930 reports of serious problems associated with the products during the past 6 years.

Problems are rare but include life-threatening events such as severe allergic reactions and anaphylactic shock, and more commonly facial palsy and disfigurement. Many reports involved minor swelling. The FDA would't name the products cited in the reports.