Temporary Fillers

Collagen – is a protein that makes up a large component of your skin. As you age, the collagen in your skin decreases in amount, and changes in quality. The thinning of your skin is one of the reasons that skin sags and forms wrinkles. Doctors can inject collagen into wrinkles in your forehead and around your mouth and lips to make you look younger. Collagen is the least expensive filler and last for 3-5 months.

There are different kinds of collagen. Zyplast/Zyderm are produced from cow skin. As a result, there is a contaminating protein that may result in a skin allergy in 10% of patients. It is for this reason that an allergy test is required for all patients receiving cow derived collagen for the first time. Cosmoplast/cosmoderm is human derived collagen. This type of collagen does not last any longer than zyplast or zyderm, but does not have the potential for allergy that the cow related collagen does. This type of collagen is a little more costly.

Although the benefits are short-lived, doctors have had the most experience with collagen and have many happy patients.

Hyaluronic acid – is a molecule of sugars and proteins that is the second largest component of your skin. Due to its unique structure, HA holds on to water making your skin thicker, firmer and more hydrated. As a filler, it serves a similar purpose to collagen. It can be used to fill fine wrinkles of the face, augment the lips, as well as fill the deeper folds around the mouth. In contrast to collagen, HA lasts 5-9 months and feels softer under the skin. It is also more expensive than collagen. HA is marketed under the names Restylane, Perlane, Captique and Juvaderm.

Calcium Hydroxyapatite – this is a gelatinous form of bony granules. Small pieces of bone-like material are injected into the deeper folds and contour irregularities around the mouth and face. It lasts for 1-2 years and costs more than either collagen or HA. This substance cannot be used in the lips or in the more fine lines. This product is marketed under the name Radiesse FN.

Silicone – liquid silicone has been injected into the face and lips for many years. The allure of permanent facial correction, must be tempered with the fact that no face is permanent. As we all age, are face sags and permanent fillers may not move like the rest of you. If the permanent filler is left behind, you may be left with unnatural or displaced lumps under the skin. Silicone is also known to form an inflammatory reaction under the skin forming lumps and scars under the skin. It is for these reasons that I advise my own patients to stay away from liquid silicone injections!

Autologous Fat Injections – this is where fat from some other part of your body is harvested and then processed to be injected in some part of your face. Because of the relatively large size of the fat globules, it is used for correction of deep folds around the mouth, lip augmentation and augmentation to the lower eyelids, cheeks and hands. Although this is under the temporary filler heading, many physicians believe that when harvested under the proper conditions, with the right techniques, that fat transfers can be permanent. In contrast to the warnings I previously made regarding permanent fillers such as silicone, fat has all the typical features of all the rest of the fat in your face, so as you age, the fat transfer will age with you. With regard to the proper processing and handling of fat, Dr. Freund has several patents for his techniques of fat harvesting and transfer, that result in excellent survival of the fat grafts.

Botox –  botox is not a filler per se, but actually a neurotoxin (poison) that when given in extremely small doses can paralyze muscles in your face that leave behind unwanted wrinkles. Botox is ideal for the wrinkles between your eyes, on your forehead and crows feet. Other less satisfactory uses include limiting the wrinkles around your mouth and limiting the look of those folds of skin on your neck.. Botox should last for 3-6 months.

Where can fillers be used?

Temporary fillers can be used to remove fine wrinkles of the forehead, crow’s feet, upper and lower lip. They are also useful to fill the deeper folds under the eyes (nasojugal groove), deep folds between the nose and mouth (nasolabial folds) and at the corner of the mouth (marionette lines). They are also great to plump up the lips. A word of warning when plumping up the lips – the upper lip should always be slightly smaller than the lower lip, otherwise you will look unnatural.