What are dermal fillers?

Instant gratification!  Patients love to walk into the office bothered by her wrinkles or scars and leave the office with a more youthful appearance.  By definition, dermal fillers are products injected into the dermis. They are used to correct wrinkles.
There are several dermal fillers on the market today and each has its own unique claim to fame.  The perfect dermal filler would be one that is inexpensive, safe, painless, hypoallergenic, consistent, predictable, and long lasting.  There are multiple options on the market to meet the growing demand for these products.  Here, I will review a few of the FDA approved products available in our office.

A. Hyaluronic acids: Hyaluronic acid is a naturally occurring substance in the skin that helps the skin maintain elasticy and fullness. As we age, the skin loses hyaluronic acid and, subsequently, the skin loses volume and becomes more susceptible to the formation of wrinkles. The water loving molecules in hyaluronic acid molecules are capable of binding significant amounts of water as the molecules break down and this process allows for longer lasting results:

1. Restylane and Perlane are hyaluronic acids and the injection of these products is well tolerated. Restylane was approved by the FDA in 2003 for the treatment of nasolabial folds. Perlane gained FDA approval in 2007. Perlane is made of a gel larger particle and is intended to be injected deeper into the skin, thus, these products may have different indications.
2. Juvaderm is a smooth consistency gel composed of hyaluronic acid. Juvederm is approved by the FDA to last up to one year and it was the first FDA approved hyaluronic acid that has demonstrated effectiveness and safety in women and men of color.

Are hyaluronic acids safe?

These products have demonstrated an excellent safety profile in the properly chosen patient. Though they are considered very safe, there are some issues to consider.

• Patients with severe allergies, especially those with multiple allergies, should avoid the use of these products.
• Patients who use substances that prolong bleeding may experience bleeding and increased bleeding at the injection site.
• Patients on immunosuppressive therapy should use these products cautiously as there may be an increased risk of infection.
• Safety and effectiveness in pregnant patients has not been established.

B. Radiesse is an unique filler composed of calcium hydroxyapatite microspheres suspended in a water-based gel carrier.  After injection into the skin, the microspheres act as a filler and provide immediate increase in facial volume.  Over time, the body will reabsorb the gel carrier while the tiny microspheres remain and the body is stimulated to produce new collagen. Therefore, the results are natural looking and long lasting. 

These same fillers can be used to fill the back of the hands and reduced the signs of aging in this way as well.