Dermal Fillers

Semi-permanent and permanent injectable

Semi-permanent and permanent injectable fillers are used to correct deeper facial creases and restore volume in large areas. They injected deep within the soft tissue for more long-lasting and large volume correction.

Semi-permanent fillers

• Radiesse (Radiance) • Sculptra (NewFill)

Radiesse is a white, paste-like suspension of calcium hydroxylapetite FDA approved to treat nasolabial folds. Radiesse is also frequently used off-label to add volume to the cheeks. Results from Radiesse injections typically last about 1-2 years, Sculptra is FDA approved for aesthetic use on facial wrinkles, although it was originally created to treat lipoatrophy in HIV patients. Sculptra is a suspension of microspheres composed of poly-L-lactic acid (PLLA), the same substance as some absorbable sutures, suspended in methylcellulose.

The PLLA microparticles injected during Sculptra treatment may last upto 2 years, but Sculptra may have a more permanent result, as it can promote new collagen production even after it has been absorbed by the body.

Permanent fillers

• Artefill (Artecoll)
• Silicone injections
• Aquamid

Artefill is a gel filler consisting of millions of synthetic microspheres (polymethylmethacrylate or PMMA) suspended in purified bovine (cow) collagen. The company that produced Artefill filed bankruptcy in 2008.

Silikon 1000 and other types of silicone injections are not FDA approved for aesthetic use and may cause contour irregularity, dimpling, infection, migration, nodules, granulomas, inflammatory reaction, and deformity.

Aquamid is another permanent filler, not FDA approved for use in the U.S. Aquamid is a hydrogel consisting of water and cross-linked polyacrylamide gel (PAG). Aquamid injections may carry high risk of infection.

Injectable filler side effects

Common injectable filler side effects may include:

• Bruising
• Swelling
• Hematoma
• An unsatisfactory outcome

Infection and necrosis are also potential side effects, although less common. Fillers may also migrate, or move to areas where their effects are not desired. Improper injection technique may cause temporary injectable fillers to be visible, palpable, and in some cases, to form small lumps that will dissipate with time.

Semi-permanent and permanent fillers may also carry a risk of inflammatory reaction, which causes the formation of granulomas, or lumps, that can be felt or seen beneath the skin. Injection of an anti-inflammatory may help to improve minor lumps or swelling, however, surgery is often needed to fully resolve permanent filler side effects.

The greatest risk occurs when injectable fillers are injected by a practitioner who is not properly qualified to perform cosmetic injections.

What about getting Collagen fillers?

Along with the rise in demand for hyaluronic acid, fillers has come a decline in collagen injections. Since collagen injections are typically made of collagen derived from cows (bovine) or pigs (porcine), an allergy test is required before collagen fillers may be injected. This inconvenience and relatively shorter lifespan reduced consumer demand for collagen. Brands you may still encounter include Evolence (now off the market), Cosmoderm, Cosmoplast, Zyderm, and Zyplast. Note that despite the name, collagen injections do not increase your rate of collagen generation.