No skin care products can do the job, but Botox and dermal fillers can.
That’s not to say that a good skin care regime doesn’t make a lot of difference, because it certainly does. But the effects of age, moving your muscles, loss of fat as well as sun damage and gravity contribute to a face that starts looking noticeably older around age 40 to 45. If nothing is done, it’s all downhill from there.
Dermal fillers are one way to take charge of your appearance and regain some youthfulness. In fact, when you see celebrities, models and others in their 40s who have skin that looks plump, smooth and young, dermal fillers are almost certainly the reason.
All you have to do is get over any fear of needles, then stop wasting your money on lifting creams or wrinkle serums that don’t work and turn to safe and effective dermal fillers. Once you’ve made the decision to have this kind of corrective treatment, the next choice is deciding in consultation with your practitioner what kind of dermal filler is best for your situation (practitioners see our course on how to offer dermal fillers legally). Here’s some information and advice that may help.
Dermal fillers perform a very specific function that’s unlike what other corrective medical procedures do. When a natural or synthetic material is injected directly into an area like frown lines, lines at the corner of the nose or mouth, depressions along the jaw line or even sunken spots under the eyes or other hollow areas, wrinkles or lines are immediately filled in and the skin is immediately plumper than before, eliminating the problem completely in many cases. This improvement can be effective for 3 months to up to 2 years or more, depending on the filler that’s used, how your aging progresses and how you maintain your skin and overall health.
Take note this is something different from Botox. Although Botox also involves simple and relatively painless injections, it’s usually used around the eyes, on the forehead and in other locations where it’s desirable to stop muscle movement that causes wrinkles. There’s no plumping or smoothing involved with Botox. A lot of people choose to have both kinds of injections for the best possible results.
Many different kinds of dermal fillers are used, and when administered by people with proper training, all can be effective in certain circumstances. And all have risks, though complications are rare. Which filler is right for you depends on how the practitioner does the injections, how skilled they are, how much experience they have, what you need done and how tolerant you are of potential risks. Forget the headlines in the media and which company advertises the most and choose the filler that makes the most sense for you.
Dermal fillers once showcased have fallen out of favor through the last couple decades, so headlines aren’t necessarily what determine how good a filler is.
Dermal fillers can be divided generally into naturally derived fillers and synthetic ones.
Natural fillers include the widely know hyaluronic acid and others that have small risks of allergic reaction. They provide immediate results that last from three to 18 months or longer, but they break down eventually. When this starts to happen, you can go back to get more filler injected to maintain the positive results. Most people get at least one follow-up injection within the first year.
Risks from natural fillers include the occasional allergic reaction as well as lumping and migration of the material. But side effects go away as the filler’s effects wear off.
Synthetic fillers can last a lot longer and are often semi-permanent in nature. Some might call them permanent because they don’t dissipate. Wrinkles come back only as you continue to age, get additional sun damage or don’t take good care of your skin.
Side effects are similar to natural fillers, but since results are permanent or at least semi-permanent, any problems you encounter or undesirable outcomes can last forever as well and are difficult to correct without other procedures.
There are many different specific dermal filler products, including even ones harvested from your body or someone else’s. Each filler choice has its own list of pros and cons. Given the relatively small chance of complications and the potential reward of a more youthful appearance, you may decide that using a dermal filler is an easy choice for you.
Keep in mind that your practitioner may recommend using more than one product type in your case since there’s no filler that can take care of every possible concern. Be open to the suggestions of your practitioner, but before your visit you should be educated about these products:
Alloderm is a processed version of human cadaver tissue prepared so that it retains its structure but cannot cause rejection. It has been shown to be effective in a variety of reconstructive surgical procedures when tissue has been lost to disease or injury. It can also be used for wrinkles and can last for 1 to 2 years, although there are really no studies to substantiate this anecdotal evidence. (Cymetra is an micronized version of Alloderm that’s rehydrated in the doctor’s office right before injection and may be less painful.)
Artefill is made of a synthetic ingredient called polymethyl methacrylate or PMMA mixed with animal-source collagen. Results can be semi-permanent to permanent, so great skill and proper training must be used to inject it. Risks include lumps, inflammation, hardening, grainy nodules at the injection site and migration of the material. Any problems that happen do not dissipate in most cases and must be removed, which isn’t easy. These long-term side effects are a tradeoff of the long-term results. In addition, maintenance injections aren’t usually required as they are with naturally derived fillers.
Fat grafting or autololgous fat is taken from one part of the body by liposuction, and no allergy testing is needed since the material comes from your own body. The complicated process of harvesting fat is often done in the doctor’s office. While there’s no consensus on how long results will last, injections can be effective for filling wrinkles for 12 months or perhaps up to 24 months. Migration is a very real risk, and the material can clump or bunch up in one area, causing a bumpy appearance. This can be difficult to correct.
Belotero Balance is another filler made with a basis of hyaluronic acid and is positioned in the industry as a multi-purpose filler because it can adapt and change within the skin for even correction. Softer and more malleable than some products, it’s good for nasolabial folds — or so-called smile lines — as well as vertical lines around the lips and at the mouth corners. Marionette lines — which run from the corners of the lips down to beside the chin — can also be treated effectively with this dermal filler. It’s used off-label in some cases for acne scar filling and on forehead lines. For deep lines, this filler may not be the best choice because there are thicker products with more crosslinking that can provide better results in these cases. Results from Belotero Balance can last up to 8 months, and some reports indicate results lasting as much as twice as long.
CosmoDerm 1 and 2 and CosmoPlast are products made from human collagen and widely considered safer than those made from cow collagen. CosmoDerm is best for shallow, superficial wrinkles while CosmoPlast is used for deep wrinkles. With this product, overcorrection is usually necessary for the best results, and touch-ups are required. Results from both products last from 3 to 9 months, a relatively short time. That means these fillers aren’t used as much as they once were.
Juvederm Ultra and Juvederm Ultra Plus are made from hyaluronic acid created in a lab. The Ultra Plus product is intended for deeper folds of skin while the Ultra product plumps and improves the look of fine surface lines. Both fillers last from 6 months to perhaps 2 years. Similar products Juvederm Ultra XC and Juvederm Ultra Plus XC include the addition of lidocaine to reduce the pain involve in having the injections.
Juvederm Voluma XC is yet another similar product but differs from the Ultra product because it contains a much thicker hyaluronic acid gel. It is used for filling volume loss in the cheekbones and chin caused by aging. It is not intended for use on the lips, in frown lines or around the eyes. Results can remain for up to 18 months, and your practitioner can help you decide if the product is right for you.
Perlane, a sister product of Restylane, is a transparent hyaluronic acid that is made in a lab from bacteria. Sometimes injected just under the skin, this product can also be used for adding volume. It can smooth wrinkles and folds and is especially helpful around the mouth, nose and under the edges of the mouth in the oral commissures. Because this product has a large particle size, it is better than Restylane for deep wrinkles and depressions. It can last from 6 months up to a year.
Radiesse is a synthetic dermal filler made from 30 percent calcium hydroxyapatite in a 70 percent cellulose gel carrier. Calcium hydroxyapatite is also used as a bone cement and has been used for a long time to correct skeletal defects. The material is stable, easy to use and had adapted well to use as a dermal filler. Because this product is thick, it’s perfect for use with deep wrinkles and not appropriate for finer lines. The results are semi-permanent.
Restylane, another hyaluronic acid filler derived from bacteria, is a smart choice for some superficial wrinkles, but research has proven that it can also work well as an overall filler for deep wrinkles and in cases where building up volume is desired. Sister product Perlane is intended for deep wrinkles. Results can last from 6 months to perhaps a year, and whether Perlane or Restylane is used is a choice your dermal filler practitioner will have to make.
Sculptra can’t technically be called a filler because it stimulates collagen production rather than adding volume where injected, but it still needs to be mentioned here. This synthetic filler is made from poly-L-lactic acid or PLLA and is related in some ways to alpha hydroxy acids or AHAs. The product can be used for indentations and wrinkles, ice-pick scars from acne and for general facial depression improvements where fat loss is an issue. Results don’t happen immediately and require multiple treatments every two weeks for the best results and then routine maintenance after that.
Zyderm I, Zyderm II, and Zyplast are all cow collagen products that deserve a mention. Zyderm holds the distinction of being the first injectable filler to gain FDA approval and has been used for over two decades, so the techniques and training for using this product have been perfected. Overcorrection is needed because the materials are absorbable, and results only last from 3 to 9 months. About 5 percent of patients experience hypersensitivity, so allergy testing is mandatory before use.
Perhaps the biggest problem with dermal fillers is longevity. After that, it’s important to mitigate risks like migration and lumping, but a skilled practitioner with the right training can use the right amount of filler in the precise places for the very best results. No matter which material is used, there is a learning curve involved in injecting it correctly and understanding how the product interacts with the human body and impacts the skin. That’s why it’s always best to choose someone who has been injecting dermal fillers for a while and who has experience with more than one kind of product.
If you have visible signs of aging, there’s every good reason to consider using dermal fillers to correct them. When used along with well-made skin care products and proper skin protection in the form of sunscreen, hats and proper clothing, dermal fillers can be a sensible part of the anti-aging process and can contribute to keeping skin looking better and younger for many years to come.
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