Cosmetic Surgery

Skin Fillers for Wrinkles

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Skin fillers fill wrinkles with either manufactured products or materials from the patient's own body. The surgeon will discuss which option is best.

What to expect

Collagen injection
Collagen is a fibrous protein found in skin, bones and connective tissues. Collagen helps give skin its texture and elasticity. Aging, sun damage and smoking break down the collagen layer and contribute to the development of wrinkles.

Collagen may come from several sources, including cow (bovine) skin, the patient's own skin, or skin of a deceased donor. Collagen is injected into the skin to treat certain acne and other scars on the face and to fill furrows on the forehead, cheeks and lips. It can stay in the facial skin for up to six months or, in rare cases, as long as a year. Collagen is ultimately absorbed by the skin and its effects disappear. Collagen must be reinjected every three to six months to sustain the appearance of fullness. To get the longest lasting results, the surgeon may slightly overfill with each injection.

Purified bovine collagen, derived from cow skin, is the most common skin filler and has been used to treat skin defects since the early 1970s. It is approved by the Food and Drug Administration. However, in rare cases, patients may have an allergic reaction to it. Before receiving an injection of bovine collagen, patients will have their skin tested to determine if they are allergic. Collagen can also be derived from the patient's own skin, grown in a laboratory or obtained from deceased donors.

Collagen injection is a relatively safe procedure. Because skin is more sensitive than fat, more pain is associated with a collagen injection than with Botox™, which is injected under the skin and into the muscle.

Hyaluronic acid
Hyaluronic acid products manufactured or derived from rooster combs, are injected to decrease fine lines, creases and depressions and to restore skin volume and fullness.

One product, Restylane™, has been used by cosmetic surgeons since 1996. It is a non-animal-based product, eliminating the risk of allergic reaction. It is effectively used to diminish moderate to severe facial wrinkles, such as the nasolabial folds between the nose and the corner of the mouth. Prior to a treatment with Restylane™, you will be instructed not to use aspirin, nonsteroidal and anti-inflammatory medications, herbal supplements or high doses of vitamin E for three weeks; these products may increase bleeding or bruising at the injection site.

A topical anesthetic is used prior to injecting the skin. Results of the treatment usually last at least six months, and may be combined with Botox™.

Hydroxyapetite
Radiesse™ is considered a semi-permanent filler for deeper skin wrinkles and creases. However, it is not intended for high movement areas such as the lips. Radiesse™ injections may last one to three years.

Fat transplantation
Fat may be harvested from certain areas of your body, often the lower abdomen, through liposuction and then placed in a syringe and injected through small incisions into the cheek, tear trough, temple or forehead. Like bovine collagen, the effects are unpredictable and may be temporary. Your surgeon may choose to over-inject fat to extend the results of the procedure. The care taken when fat is harvested, filtered, prepared and injected is crucial and helps yield more lasting results.

To get the results you desire will likely require more than one session of injections, as well as overfilling of the site to compensate for the body's reabsorption of the fat. Bruising usually diminishes within three weeks.

Risks

Risks associated with treating facial wrinkles include, but are not limited to:

• Allergic reaction to collagen injections. Signs include rash, hives, swelling or flulike symptoms.
• Infection
• Surface or contour irregularities are associated with skin augmentation procedures.

Skin filler procedures are performed by specialists in Dermatology and Facial Plastic and Reconstructive Surgery (Otorhinolarnygology.