Last week, I briefly discussed some of the more popular hyaluronic acid (HA) fillers, including Juvéderm®, Restylane®, and Perlane®. What I didn’t include were non-HA dermal fillers, which can be synthetically created in a lab or created from your body’s own cells. Like hyaluronic acid fillers, other types of dermal fillers are great for replacing lost volume in the face that appears as we age. As with other procedures, individual needs may vary, so this is just a brief summary of other fillers; consult your board-certified dermatologist for more specific information for your own situation.
Sculptra® Aesthetic
Sculptra® uses poly-L-lactic acid, a biodegradable synthetic polymer from the alpha hydroxy acid (AHA) family. Because your body views it as a foreign substance, injections of PLA will create a tissue response in your body that will produce more collagen to reinforce the structure of your skin. This is a more gradual solution; effects are not immediate, and your appearance typically returns to baseline within two days after your injection, but your skin does slowly thicken as collagen production increases.
Initially approved by the FDA to correct sagging skin caused by HIV-related facial volume loss (also known as lipoatrophy), Sculptra® Aesthetic is used to correct nasolabial folds, chin wrinkles, and marionette lines. The patient typically sees desired results within weeks or months, at which point the poly-L-lactic acid is naturally metabolized into CO2 or incorporated into glucose by your body. Effects should last up to two years as the body continues to produce more collagen.
Radiesse®
Radiesse® uses calcium hydroxylapatite (CaHA) microspheres, a biodegradable material similar to a compound found in your bones, in a gel substance to treat patients with deepening nasolabial folds, marionette lines, chin wrinkles, and the pre-jowl area. Radiesse® is also used to treat lipoatrophy associated with HIV.
Radiesse® provides immediate volume after injection, which continues as the CaHA microspheres keep stimulating natural collagen production for up to a year in the treatment area until the injectable is dissolved. While it lasts longer than hyaluronic acid fillers, Radiesse® can be difficult to remove if there is an adverse reaction, so it is up to your physician to not overfill the treated area.
Artefill
Artefill is a permanent dermal filler composed of tiny plastic microspheres wrapped in bovine collagen, which will eventually degrade, causing the body to produce its own collagen to wrap around the microspheres. Because Artefill contains collagen from an animal source, patients are required to undergo an allergy test prior to injection to minimize adverse reactions.
Since Artefill is thicker, it is typically used for deeper creases, like nasolabial folds. Unfortunately, it’s permanent, so it is difficult to fix if you are unhappy with the results. See only an experienced Artefill injector.
LAVIV®
LAVIV® is one of the newer treatments available, but it has been studied extensively by the FDA for the past nine years. LAVIV® is different because it’s crafted from your very own cells; a small sample of skin is taken from behind your ear and then taken to a lab to isolate your fibroblasts, the cells that create collagen. The whole process takes about six weeks overall. Because it’s grafted from your own cells, there’s little risk for rejection or an allergic reaction.
The resulting liquid isn’t thick enough to act as a cheek filler itself, but LAVIV® has shown results in treating marionette lines, nasolabial folds, and under eye hollows. Some doctors have reported that the treatment areas have shown improved pores, pigmentation, and skin texture over time. Typically, results last up to two years, but can cost upwards of $3000.Â
Zyplast®
One of the first injectables used in aesthetic procedures, Zyplast® is a purified form of bovine collagen, so, like Artefill, it requires allergy testing before injection. Because it is a form of collagen, Zyplast® works to supplement the weakening collagen structure in your skin. While this type of filler has typically gone out of style in favor of hyaluronic acid, Zyplast® is still used by some doctors for lip injections.
Belotero Balance®
This is the newest hyaluronic acid gel filler, and is included here because we did not discuss it last week. Belotero marketing claims state that it is more malleable in your skin, which allows it to integrate into your skin and mold to facial contours more easily than other HA fillers. It can be injected more superficially than Restylane® or Juvéderm®, and the company claims a reduced risk of creating the Tyndall Effect, a bluish area that occurs when a clear gel is injected too superficially and can be seen through the skin. Belotero can treat both nasolabial folds and vertical lip lines, leading to instant results that should last about six months.
Bottom Line
Dermal fillers are great if you’re looking to correct lost facial volume associated with aging, and the wide variety of options available lets patients and doctors choose from many different products to suit the patient’s individual needs. As always, discuss options with your board-certified dermatologist to figure out the best method for your desired results.