Cosmetic Fillers, Dermal Fillers for Wrinkles, Scar Treatment | Collagen, Juvederm, Restylane, Captique, Radiesse, Sculptra, Perlane, Artefill, Hyaluronic Acid

Cosmetic Fillers

Cosmetic fillers and dermal fillers are growing in popularity for skin augmentation, as an anti aging treatment for skin care, that can help fill in wrinkles, lines and even scars. There are different types of fillers or injectables, some made with collagen and others with man-made materials or hyaluronic acid.

If your skin has deep wrinkles or lines, or very depressed acne scars, dermal fillers and cosmetic augmentation can help with facial rejuvenation. With augmentation, either fat from the person's body, collagen or a cosmetic filler is injected under the skin to plump things up. This helps smooth out wrinkles and other skin imperfections.

Cosmetic wrinkle fillers such as Juvederm or Restylane injections are placed or injected directly into wrinkles or depressed scar areas. Injectable facial fillers can be used to reduce wrinkles and for:

• smile lines and frown lines (those parenthesis lines from the nose to the mouth, called nasolabial folds or marionette lines) - facial fillers can smooth out these lines
• sagging cheekbones - longer-lasting dermal fillers can be used in this area as an anti aging treatment for skin care
• upper or lower lips - cosmetic lip fillers can plump up lips, what is known as lip enhancement
• glabellar lines between the eyebrows, also called the 11's (because they look like the number 11) - wrinkle fillers or facial injectables can be used to fill in the lines in this area
• acne or other scarring - dermal fillers can also help in this condition

Dermal fillers can help with facial rejuvenation and can reduce wrinkles. But cosmetic fillers and dermal fillers won't make skin more taut. For that, you would need something other than wrinkle fillers. For example, other types of cosmetic surgery would be used, such as face lift or other facial plastic surgery.

Collagen injections - Bovine collagen is one of the original fillers. It can be used for wrinkles, lip enhancement or augmentation and scars. Examples include Zyderm® and Zyplast®. Synthetic forms of human collagen is used like bovine collagen, for wrinkles, lip enhancement and scars. Examples of collagen treatments include Cosmoderm ® and Cosmoplast ®. Collagen injection results can last 2-6 months. A recently approved collagen filler is Evolence ®, which is made from pig skin. Results of Evolence are said to last six months. Collagen injections can cost about $500-$800 per syringe.

Hyaluronic acid - This is a newer wrinkle filler agent. Hyaluronic acid is a lubricating gel that attracts water to the site which can also plump up and fill in the wrinkles. Results can last 3-8 months. Examples include:

• Juvederm or Juvéderm ® - Juvederm is made of hyaluronic acid. Juvéderm filler was developed by the company that makes Botox Following injection with Juvéderm by a good plastic surgeon or licensed clinician, you may notice an improvement in your wrinkles for several months. Juvederm can cost from $500-$800 per syringe.

• Restylane ® injections - Restylane filler is also a hyaluronic acid compound. The hyaluronic acid in Restylane is from non-animal sources. Restylane is made by the company which makes Perlane. The hyaluronic acid particles in Restylane dermal filler are smaller. Restylane is injected directly into the wrinkles. Done correctly, by a licensed practitioner or cosmetic surgeon, the texture and appearance of the skin can stay smoother for several months. Restylane can cost from $500-$800 per syringe.
• Perlane ® injections - Perlane is also a hyaluronic acid compound. Perlane is made by the same company that makes Restylane. Both have been approved as wrinkle fillers. The difference between these cosmetic fillers is that the hyaluronic acid gel particles in Perlane are larger. The company says this lets Perlane reach deeper into the skin. The Perlane procedure should only be done by a board-certified plastic surgeon or licensed practitioner. The effects can last several months. Perlane can cost from $500-$800 per syringe.
• Captique - Captique is also a hyaluronic acid compound. Like the other cosmetic fillers, it is injected directly into wrinkles. It is important that you use a licensed practitioner or qualified cosmetic surgeon for Captique injections.
• Prevelle - Prevelle is a hyaluronic acid filler used for wrinkles and smile lines. It is used for fine lines to moderate lines.
• Puragen - Puragen is also a hyaluronic acid filler. It is used for deeper wrinkles and facial lines. Puragen is made with a different technology that proponents say results in longer-lasting results.

Radiesse ® or Radiance® - Radiesse is a wrinkle-filler or volumizer made up of calcium-based microspheres that are suspended in a gel that is injected into the skin to fill in wrinkles. Results can last over a year, making Radiesse one of the longer-lasting cosmetic fillers. Because Radiesse results do last so long, it is important that you use a qualified plastic surgeon for best results. It is generally not advised for thin skin or near the eyes. Radiesse can cost from $1000-$1600 per syringe.

Sculptra ® or NewFill - this is a volume enhancer - poly L-lactic acid. PLLA is synthetic polymer from the alpha-hydroxy-acid family. It can fill in sunken cheeks. Injections of Sculptra or NewFill are given over a period of months, and results can last over a year. This makes Sculptra and NewFill among the longer-lasting wrinkle fillers. Because Sculptra has such long-lasting results, it is essential that you use a qualified plastic surgeon for best results. Sculptra can cost from $900-$1600 per syringe.

ArteFill ® - ArteFill combines a made man product of polymer beads (PMMA microspheres) with bovine collagen to smooth out wrinkles. When done by a good cosmetic surgeon, ArteFill is considered the longest lasting of all the cosmetic fillers, although patients may need supplemental filler treatments as their skin changes over time. ArteFill costs $1200 to $1700 per syringe. You should be tested for allergies before considering ArteFill. It is also not advised for thin skin or near the eyes.

Fat transfer - Fat transfer is exactly that - fat is transplanted from one part of your body to another, for example fat from your buttock or thigh could be transferred for augmentation to your face or hands. The fat is usually obtained from the butt, thighs, or stomach in a process similar to liposuction. As an alternative to man-made cosmetic fillers, fat transfer can fill in creases and wrinkles on the skin. In larger amounts, fat transfer can also fill in depressions in the skin caused by surgical scars or acne. Fat can also be used to augment and contour the lips, cheeks, jaw, brows and under the eyes. As with any cosmetic procedure, make sure you check the credentials of your surgeon or practitioner.

Absorbable injectable cosmetic wrinkle fillers - such as Juvéderm, Restylane and Radiesse - are approved by the Food and Drug Administration (FDA) for correcting soft tissue contour defects, for example wrinkles and facial lines, as well as nasolabial folds which appear around the mouth and nose. Non-absorbable injectable cosmetic wrinkle fillers - ArteFill - is FDA approved for correcting facial tissue around the mouth.

What do cosmetic fillers cost

The cost of cosmetic or dermal fillers varies, depending on the type of filler being used. Collagen can range from $200-$400 per syringe. Other fillers such as Restylane, Sculptra, Captique, Perlane, Radiesse, ArteFill and Perlane can cost from $400-$1000 per syringe. You may require more than one syringe for treatment, as well as multiple treatments.

You may need more than one injection to achieve the effect you want. Success depends on the general condition of your skin, the type of filler used and the skill of your cosmetic doctor. Potential reactions to cosmetic fillers include swelling, redness, pain, itching, discoloration and tenderness. There can also be swelling at the implant site. Infection, itching, and raised bumps in the skin are additional risks. Serious things such as disfigurement, allergic reaction and shock can also occur.

Fillers can be combined with other types of body sculpting techniques and anti-aging treatments, such as Botox injections for wrinkles, frown lines, smile lines and crow's feet. Cosmetic laser treatments may also be used, for example for acne scars or for for skin resurfacing. Thermage, which uses deep heat is another option used by some people.

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Updated March 2009

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