Dermal Fillers

Dermal fillers are injectable products that are designed to either smooth wrinkles or improve facial contours. Depending on the particular product, it can be injected any where from the middle part of the skin called the middle dermis, to the deep part of the skin or deep dermis. These products can also be injected just below the skin, an area known as the subcutaneous tissue, which is a fatty layer. Their ability to smooth skin or improve facial contours and the longevity of their results depends on each product and it’s formulation.

There are only two general products that are considered dermal fillers: collagen based products and hyaluronic acid (HA) based products. As of November of 2010, all FDA approved collagen products will have reached their expiration date, and no more product is being produced, leaving essentially only HA products available in the US for dermal filling.

Hyaluronic acid is a naturally occurring substance found in our own skin and tissues. In its natural state it is made of very long chains of sugar molecules that attracts water molecules and provides support to the cells in the body. In the purification and processing of this material, these long chains are chemically bonded, called cross-linking. This gives it even more stable physical characteristics, and slows the resorption of the product once it’s been injected into the skin and subcutaneous tissue. Products that are more cross-linked are thicker more viscous gels with stiffer physical characteristics, and are therefore better at filling large facial contours by virtue of their structural support. They are more durable and are less apt to be broken down or resorbed. Less cross-linked products are less viscous and can permeate the more shallow part of the dermis, making it better suited for shallow injections to treat fine lines.

Restylane Fine Lines and Juvaderm Ultra are the most popular products available in the US for treatment of fine lines that occur around the mouth, chin, jaw line, between the eyes, and forehead. They are approximately equivalent in concentration of hyaluronic acid and percentage of cross-linked HA, and they perform and last in a similar fashion. They can be easily molded after injection and are the best product for the ‘tear trough’ grooves between the lower lid and the nose.

Restylane, Perlane, and Juvaderm Ultra Plus are the more cross-linked product with higher concentrations of HA. They are thicker gels requiring care in placement in the deeper skin or below the skin, because they do not easily become integrated around the collagen of the dermis, and merely push it away, forming a bluish spot. These products are approximately equivalent in concentration with Juvaderm Ultra Plus having the highest percentage of cross-linked product. These products are designed to create changes to facial contours like the laugh lines or naso-labial folds, the marionette lines or oral-mandibular grooves, and for volumizing the cheek regions. They are also the product of choice for lip augmentation.

|| Back to Top ||