Wrinkle Injections: What are the Options?

Wrinkles are caused by loss of vital components in the lower level of the skin called the dermis.

There is no way to topically replace the building blocks of the dermis (collagen, elastin, and hyaluronic acid). There are, however, quite a few products - known collectively as dermal fillers - that dermatologists can inject into the dermis to temporarily restore your skin's volume and minimize the appearance of wrinkles, lines, and scars.

Are you shocked to learn that the first precursor of today's procedures was performed in 1893, when a doctor first took fat from a patient's arm and injected it into facial defects?

Dermal fillers are becoming more accessible, affordable, and natural-looking every day. Let's consider a few of the most popular fillers on the market (and keep in mind that many doctors use these products in combination to achieve the desired results):

  • Hylaform: the hyaluronic acid filler with the lowest concentration of hyaluronic acid.
    • Pros: The soft consistency of this filler makes it particularly appropriate for use in the lips and large areas like the cheeks.
    • Cons: All the hyaluronic acid fillers are associated with more post-treatment redness and bruising than collagen fillers. The effects of Hylaform last about three months, the least of the hyaluronic acid fillers.
       
  • Restylane: the best known and most popular of the hyaluronic acid fillers.
    • Pros: Restylane is the stiffest hyaluronic acid filler and therefore particularly effective in treating deep wrinkles. Results typically last about six-nine months, making it one of the longest-lasting fillers.
    • Cons: All the hyaluronic acid fillers are associated with more post-treatment redness and bruising than collagen fillers. The stiffness of Restylane makes it less suitable for soft areas like lips and can lead to bumpiness if it isn't used by an experienced doctor.
       
  • Juvederm: one of the newest fillers on the market, approved by the FDA in late 2006.
    • Pros: The high amount of hyaluronic acid in this product makes it suitable for deeper facial folds (like the nasolabial folds around the sides of the mouth). Results last about six months - in some cases, even up to a year.
    • Cons: All the hyaluronic acid fillers are associated with more post-treatment redness and bruising than collagen fillers. Patients report stinging and pain during the injections.
       
  • CosmoPlast and CosmoDerm: These fillers are made from bio-engineered human collagen. (There are dermal fillers on the market made from bovine-derived collagen - in fact, that's all that was available when collagen injections were first approved in the '80s.) CosmoPlast is the stiffer of the two, which makes it better suited to areas like the bridge of the nose and the corners of the mouth.
    • Pros: Unlike bovine-derived collagen, bio-engineered collagen does not require allergy testing in advance. Collagen fillers are associated with less pain, bruising, and redness than hyaluronic acid fillers.
    • Cons: Collagen fillers are the most expensive on the market, and results typically last only about four months.

Perlane was just approved by the FDA and will be on the market soon. Others fillers are coming as well so stay tuned for updates.

Wishing you great skin!

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Dr. Baumann is author of the best-selling book, " The Skin Type Solution." To learn more about her revolutionary skin typing system, visit her Web site, SkinTypeSolutions.com

All of Dr. Baumann's recommended skin care products are available online, and a portion of proceeds goes to The Dermatology Foundation.
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