If taking a close look at your face in the mirror is not the positive experience it once was, you are not alone. Years of smiling and frowning, damage from the sun, pollution and other environmental factors, and the natural loss of fullness in the cheeks, take their toll on all of us. If you are not ready for a surgical solution, don’t despair. New injectables, designed to help turn back the hands of time and restore the volume of youth, are widening the options available for men and women who are looking for a way to accomplish subtle but effective changes to reverse the effects of aging.
After years of attacking the advance of facial lines and wrinkles with fillers on an individual basis, one line at a time, experts have discovered that the loss of facial volume has as much or more to do with the look of aging than the little creases that appear around the eyes, mouth, and forehead. That depletion of volume results from the gradual loss of fat, muscle, and bone that comes with aging. Everything begins to droop because the support structure isn’t there anymore. Most facial volume loss occurs after age 40, although some people start noticing this change in their late 30s. When this happens, areas of the face that were once full get depressed and are made more prominent by shadowing or darkening – leaving the face looking older. The new generation of cosmetic procedures that give the face a lift without surgery involve the injection of one or more dermal fillers to replenish volume, restructure the face, and counteract the power of gravity.
In addition to the widely recognized botulinum toxin (BOTOX®), more recently FDA approved (Dysport®), and the incobotulinum toxin (Xeomin®), which are all viable options to fill and relax fine lines and wrinkles, a number of other fillers have been approved by the U.S. Food and Drug Administration (FDA), expanding the options available for facial rejuvenation. These include: hyaluronic acid (Restylane®, Perlane®, Juvederm®, and Belatero®); poly-L-lactic acid (Sculptra®); calcium hydroxyl apatite (Radiesse®); and a hyaluronic acid (Voluma®). While a single injection of one of these fillers may still be appropriate and sufficient in many cases, the American Academy of Dermatology reports that a combination of procedures often yields more natural and longer-lasting results.
Know your injectables.
With such a wide variety of options for facial rejuvenation, only your physician can determine which filler or combination of fillers is appropriate for you. Want to know more about your options? The following is a brief overview of some FDA approved injectable fillers.
BOTOX®, Dysport® and Xeomin® are FDA-approved for the treatment of facial lines and wrinkles for up to six months. These injectables are made from a highly purified protein that, when administered by a trained physician, can smooth out wrinkles around the eyes, furrows between the eyebrows and forehead, “smile lines” around the mouth, lines on the neck and droopy eyelids caused by sagging excess skin. BOTOX®, Dysport® and Xeomin® work by relaxing the surrounding muscles in the face, which not only helps to correct wrinkles and fine lines, but may prevent them from deepening further.
Perlane® is produced by the same company that makes Restylane® and is essentially the same product as Restylane®. Perlane® has larger gel particles and thicker consistency than Restylane® for a deeper injection for more severe facial lines and wrinkles.
Restylane® is an effective facial filler used to smooth facial wrinkles and enhance and restore volume to facial areas like the lips and cheeks; it has been FDA-approved for lip enhancement in adults over 21. Restylane® can last 6-12 months depending on what area of the face is being treated. No skin test is required with Restylane® because it is produced from hyaluronic acid (found naturally in the skin) so there is little chance of an allergic reaction.
Juvéderm® is a facial filler composed of hyaluronic acid that is approved by the FDA to last up to one year. Juvéderm® sets itself apart from other facial fillers with Hylacross™ technology, which is made of smoother properties and a less granular consistency. Juvéderm® is commonly used to correct moderate to severe facial wrinkles. Juvéderm® can improve facial lines between the nose and mouth (smile lines), the creases of the cheek, and small wrinkles on, above, and below the edges of the lips. Juvéderm® contains the local anesthetic lidocaine to avoid patient discomfort. Juvéderm® products are FDA approved for patients over the age of 21.
Juvéderm® Voluma™ XC, the newest FDA-approved filler from Allergan®, addresses all three areas of the cheek to provide a youthful lift that subtly but effectively rejuvenates the face. The filler consists of hyaluronic acid and lidocaine, a local anesthetic, to minimize patient discomfort. While other facial fillers are administered to other areas of the face such as the nose and mouth, Voluma™ specifically lifts all areas of the cheeks for facial renewal results lasting up to two years. Juvéderm® products are FDA approved for patients over the age of 21.
Sculptra® is a synthetic material made up of poly-L-lactic acid and is approved by the FDA for restoring lost facial volume, also known as lipotrophy. Because Sculptra® has had such a strong rate of success in helping to provide a more youthful appearance in patients who have lost facial fat over time. Sculptra® normally requires multiple injections to achieve desired results, can last up to two years and does not require any allergy tests.
Radiesse® facial filler is an FDA-approved wrinkle treatment comprised of calcium based microspheres. Radiesse® is different than most facial fillers because in addition to correcting facial lines, it stimulates the body’s natural production of collagen. Collagen is a protein of connective tissue in our bodies that supports our internal organs. Because collagen diminishes with age, Radiesse® helps reverse the effects of aging. Radiesse® is biocompatible, so no allergy tests are necessary prior to your procedure.
Belotero Balance® is an FDA-approved dermal filler that smoothes moderate to severe wrinkles and restores lost volume on the face. This facial filler is especially effective for fine superficial lines and under the eyes. Belotero Balance® quickly integrates into the patient’s skin to create more natural results. It is also the least likely hyaluronic filler to be seen under the skin when placed superficially. For most patients results last for about six months after one treatment.
Before you undergo any injectable cosmetic treatment
As with any procedure that involves the introduction of a foreign substance into the body, injectable fillers can carry risks and have side effects, such as allergic reactions, the formation of bumps under the skin and even skin discoloration. It is recommended that wrinkle fillers be injected by a board-certified dermatologist, plastic surgeon or other specially trained medical professional. It is crucial to discuss the pros and cons of your options and know what to expect during and after the procedure prior to making decisions regarding any cosmetic treatment.
Sources include: The American Academy of Dermatology and The American Society of Plastic Surgeons.