One of the most obvious and troubling signs of aging are the lines and wrinkles that often occur on the skin of the face. The appearance of these distressing lines is a result of growing older. As we age the skin slows down the production of two proteins called collagen and elastin, which provide fullness to the skin. Other factors such as sun exposure, diet, smoking and gravity can speed up the aging process, making the wrinkles even more prominent.
Although there are a number of surgical procedures that can be used to treat these lines such as chemical peels and laser skin resurfacing, many people look for options that have an immediate result with minimal down time. Soft tissue fillers cannot completely correct facial lines, but in many cases provide an excellent non-surgical option to improve the appearance of wrinkles. The most commonly treated wrinkles are those around the nose and mouth known as the nasolabial lines and marionette lines. Soft tissue fillers are also an excellent option for those looking to have more full and youthful appearing lips.
The results of your injections will vary for each individual as will the length of time it will last. Some patients have reported their treatment lasting a year or longer, while others report a duration of only three-to-six months. Therefore, repeated injections may be necessary. We will discuss with you how to maintain your results with repeated treatments.
There are many FDA-approved soft tissue fillers that can be used to give a more youthful appearance to the skin.
Collagen (Cosmoderm™, Cosmoplast™)
Collagen products are one of the original soft tissue fillers used over 20 years ago. Collagen gives structure to the skin and is used to add volume to lips and fill in fine lines. Introduced nearly 20 years ago, the first collagen used was bovine collagen. This type of collagen is no longer used because some patients can be allergic to it and allergy testing needs to be done before a patient can be injected. We rarely use collagen these days, however, in certain situations it is a cost effective treatment for fine lines. If used, cosmetic surgeons use human-derived collagen (eg. Cosmoderm™, Cosmoplast™) which does not require allergy testing. The downside of collagen injections is that they do not last very long. Most people only see results for a couple of months before needing to be reinjected. Most surgeons prefer using hylauronic acid fillers, which last longer.
Hyaluronic acid (Captique™, Hylaform®, Restylane®, Juvederm™, and Juvederm Ultra Plus™)
Hyaluronic acid is a natural component of human skin and is the framework in which skin cells live. There are several hyaluronic acid products available: Captique™, Hylaform®, Restylane®, Juvederm™, and Juvederm Ultra Plus™. Each has various characteristics that we will take into account when choosing a filler. All hyaluronic acid products bind water and give the skin volume. These fillers can be used to fill hollow areas of the face, including the cheeks and lips. One of the main advantages of hyaluronic acid gel is that it does not pose an allergy risk for patients and there is no risk of transmitting animal diseases by injection. Since a skin test for allergies is not required with hyaluronic acid gel, patients can be treated on their first visit to our office. The results of hyaluronic acid last approximately four to six months. One of the newer hyaluronic acid fillers, Juvederm™, has received FDA approval for a persistence of 1 year. This does not mean that the effects last a year, but there is still material present at one year. Typically patients will need to add to the filler after 6 months. The Hyaluronic acid fillers work wonderfully in the lips and in deep creases on the face.
Poly-L-lactic acid (Sculptra™)
Poly-L-lactic acid (Sculptra™) is a biodegradable synthetic filler used to replace lost facial fat, giving the face a more youthful appearance. It is currently only FDA approved for treating facial fat loss in patients with HIV. Use on healthy individuals is considered off-label use at present.
Calcium hydroxyapatite (Radiesse®)
Calcium hydroxyapatite (Radiesse®) is a new biocompatible, FDA approved filler for deep nasolabial lines. Small calcium microspheres are injected under the skin with a fine needle. The body tends to form collagen around the calcium providing a long lasting result. Many people report the effects lasting up to one year.
This filler is a great treatment for nasolabial lines. Depending on the severity of your lines, more than one syringe may be needed. Radiesse® is not suited to be injected in the lips because it is too firm and does not feel natural.
Some more permanent solutions are available such as gortex implants or fat transplantation. Other permanent fillers are available, however, the FDA considers them off label use.
Soft Tissue Implants
Advanta gortex implants offer a longer-lasting option for diminishing deep facial grooves and folds, particularly around the mouth, nose, and lips. The material is inserted under the skin as strips, threads, or hollow tubes that serve as a permanent filler. These substances also can form the foundation into which other injectable fillers may be added. Like any implant, problems can occur such as infection, implant shape distortion and extrusion. We will review the risks, benefits and alternative treatments at your consultation.
Tulsa Surgical Arts - 7322 91st Street, Tulsa, OK 74133 - 918-392-7900
