Now more than ever, people are seeking ways to stretch their dollars further. This is especially true in the realm of cosmetic surgery. While facelift, browlift and necklift procedures remain the gold standard for facial rejuvenation, many non-surgical options are now available for some patients. Among these options, dermal fillers have excelled in terms of cost efficacy and patient satisfaction. But with so many products on the market, it is often difficult for patients to determine which to choose. Furthermore, certain patients are ideal for fillers while others may benefit from different procedures.
Dermal fillers are some of the most exhaustively studied substances in medical use today. They have been used for decades and are very safe. Dermal fillers can be made from a variety of substances. Some of the very first fillers were made from collagen, which is a substance found in every part of our bodies. Initially, collagen derived from cows (Zyplast and Zyderm) was used, but problems related to patient allergy and the short duration led to the development of newer agents. Engineered human collagen (cosmoderm and Cosmoplast) showed decreased allergic reaction and longer period of effect, but at a price. The bioengineering of this substance is expensive. In general, newer, non-collagen products have replaced these in most practices.
The most commonly used injectable fillers today contain either hyaluronic acid (Restylane, Perlane, Juvaderm), polylactic acid (Sculptra), or calcium hydroxylapatite(Radiesse). Hyaluronic acid binds to water and has a volumizing effect beneath the skin. Because it is found throughout our bodies, the risk for allergic reaction is minimal and it is extremely safe. Polylactic acid differs from other fillers because it is thought to stimulate the cells in our skin to produce more collagen. Calcium hydroxylapatite fillers are the newest addition to our menu of options. These fillers contain small particles of a bone-like substance in a gel carrier and may have the longest period of efficacy.
Fillers are injected to correct depressed facial scars, to fill deep wrinkles, to volumize various parts of the face including the lips, and in some cases, to create the effect of a lift in the face. Among the most common reasons patients seek treatment is to correct deep lines in the face. The most commonly treated places are the nasolabial folds (lines extending from the nose to the jaw on both sides), Marionette lines (the ‘parentheses’ lines on either side of the mouth) and the lips for augmentation.
Dermal fillers are excellent options for the treatment of specific areas in the face. The overall degree of facial aging, the indications for alternative treatments, the risks and expectations are thoroughly discussed by your cosmetic surgeon. Be sure to seek advice from a board certified plastic surgeon who plans on performing these injections him or herself. See the table below for more information on the longevity, indications and differences between the fillers commonly used in my practice.
Although cost varies depending on the type of filler used, talk with the office staff about our discount office days for even more cost savings.