Wrinkle Fillers

Facial cos metic surgery can produce dramatic results. A facelift can turn back the clock many years.

Even so, we can still be le ft with fi ne lines, folds, or wrinkles that aren't always eliminated with a facelift It is standard practice today for facial cosmetic surgeons to use other procedures to complement the surgery. So ft -tissue fillers, often referred to as "wrinkle fillers," fill in wrinkles and grooves or creases, blending them into the rest of your skin.

What Are Fillers?

Fillers are the materials used to plump up wrinkles or folds in the skin. They come in two forms: injections and implants. Filler injections are typically used for nasolabial folds, forehead lines, crow's feet, smile lines, frown lines, and the fine wrinkles around the lips. Filler implant material is frequently used to fill creases in the cheeks, to improve wrinkled lips, or to fill in nasolabial folds. Fillers may be either temporary or permanent.

Types of Temporary Fillers

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Fillers are considered temporary when the material used is eventually reabsorbed by the body. Temporary fillers can also provide an ideal way to try out a wrinkle-filling or tissue-lifting technique before considering a more permanent method. Fillers are popular because they are quick and involve virtually no downtime.They are delivered by injection.

Collagen

Collagen injections are effective for the correction of fine smile or frown lines, nasolabial folds, delicate lines at the corners of the eyes or around the lips, and acne scars. Collagen is a natural protein, a substance that forms part of the supporting structure under the skin. However, our own supplies of collagen naturally diminish with age. Using collagen for cosmetic purposes was first introduced in the United States nearly twenty years ago. During that time, most collagen fillers were derived from purified bovine (cow) collagen.

	Collagen injections are used here to soften nasolabial folds.

In March 2003, the FDA approved the first human-source collagen products, made from purified human collagen under controlled laboratory conditions. Marketed as CosmoDerm ™ and CosmoPlast, ™ these products are expected to gain popularity because they eliminate the concern over allergic reactions to bovine collagen.

Both forms of collagen are temporary fillers. The treatments last from three to six months.

Hyaluronic Acid

Our bodies produce hyaluronic acid, a structural part of the skin that creates volume and shape and acts as a lubricant and shock absorber, but our natural supplies diminish with age. Synthetic gels, marketed under the names Restylane, ™ Perlane, ™ and Hylaform ™ are very similar to natural hyaluronic acid. (Restylane and Perlane are the same product; Perlane is more highly concentrated.)

How do they work? The substance stimulates one's own natural skin cells to float upward to the surface of the skin. As a result, creases and grooves are filled in more naturally.This makes these injections particularly useful for treating nasolabial folds, lip lines, smile lines, and drooping corners of the mouth. They are also used to fill fine to moderate wrinkles as well as scars.The results last for about six to twelve months.

Autologous Fat

	Two strands of implant material are threaded under the skin to soften the nasolabial folds.

Injections of your own autologous body fat can be used to reduce deeper facial wrinkles or fill in the hollows that have gradually appeared. These fat deposits can be drawn from the buttocks, thighs, or abdomen and are quickly processed into injectable form in the doctor's office. Sometimes the fat is extracted during a mini-liposuction procedure or taken from a simple incision in an area such as the back of the knee. Because this is your body's own tissue, there is no risk of allergy or rejection.

In some people, the results last only a month or two; in others, they last years. Note that sometimes the area injected with the fat may become lumpy as the fat is reabsorbed by the body.

Fascia

Another treatment derived from your own or donor tissue, this filler consists of tiny pieces of the fascia, the firm, white collagen-rich layer that covers the muscles, just underneath body fat. Fascia is commonly harvested from the muscle above the ear through a small incision above the hairline. Originally small pieces were used only in surgery to fill deep scars, but it is now possible to process fascia into an injectable substance used to augment lips and smooth wrinkles. Like autologous fat, fascia lata is sometimes used as an alternative for people who show an allergic response to bovine collagen. Results should last three to six months.

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