Dermal Fillers: Moving Beyond Collagen and Silicone
There are numerous anatomical and physiological changes that result in the appearance of aging. With time, we lose volume in our skin, fatty tissue below the skin, as well as muscle and bone. Coupled with the effects of gravity, hormonal changes and chronic sun exposure, these changes can result in an aged appearance with resulting deep and superficial skin wrinkles. In developing a plan for optimal facial rejuvenation, it is useful to consider the face as analogous to a balloon that slowly deflates with time. One of the pillars of any plan for facial rejuvenation is therefore replacement of this lost volume. Whereas we once had only silicone and collagen to inject, we now have at our disposal an array of dermal fillers that can be selected to achieve your aesthetic goals. With experience and a trained eye, your dermatologist can help identify the most appropriate filler(s) for making you look like a more youthful, rested version of you . There are currently four different categories of dermal fillers:
Hyaluronic acid (Juvederm, Voluma, Volbella, Restylane, Belotero)
Hyaluronic acid (e.g., Juvederm, Restylane, Belotero) is the most commonly used type of filler worldwide, with millions of injections being performed yearly within the U.S. alone. Its popularity stems from its versatility, safety, and reversibility. Because HA is found naturally in the human body and is therefore usually very well tolerated. HA can also be dissolved by injection of an enzyme called hyaluronidase, which has implications for safety and the ability to fine-tune or reverse results, if desired. The HA products range in viscosity, making appropriate selection of the appropriate filler for a particular anatomical site of upmost importance.
Calcium hydroxylapatite (Radiesse)
Calcium hydroxylapatite (i.e., Radiesse) is also found naturally in the body, where it contributes to the structure of bone and teeth. Radiesse is a more viscous and volumizing filler that can be useful for rejuvenation in larger areas with significant volume loss such as the temples and backs of the hands. An additional benefit of Radiesse is that it can last slightly longer than some of the HA fillers. It is, however, irreversible and less safe for certain areas with thinner tissue, such as the lips and under the eyes.
PMMA (i.e., Bellafill) is a long lasting filler FDA approved for use in the nasolabial folds (“smile lines”) and for acne scars. In studies this filler has shown to last up to 5 years, and there are individual reports of it lasting up to 10 years. Individuals wanting Bellafill injections need a skin test prior, so as to maximize the likelihood of a favorable outcome.
Poly-l-lactic acid (Sculptra)
Sculptra is a milk sugar derivative that can be used in larger volumes for global facial rejuvenation. This particular filler, significantly more than the others, stimulates the body to produce more collagen within the skin, resulting in volumization and some skin tightening. It can take months to see the full result, which typically requires a series of injections. This is sometimes an optimal filler for younger patients who want to look globally rejuvenated, but do not have as many specific problem areas.
Please feel free to schedule an appointment with either of our cosmetically trained providers to learn more about dermal fillers. We look forward to working with you to develop a treatment plan that will provide the results you desire.
For more information about dermal fillers, call Santa Barbara Skin Care today to schedule your consultation at either of our convenient office locations