Wrinkle Fillers

Collagen and other injectable wrinkle fillers give skin a plumper, smoother appearance. Although collagen is the best known wrinkle filler, there are many other substances doctors can use to plump up your skin, including fat from your own body and synthetic materials. Take a look at how collagen and other injectable wrinkle fillers your doctor may recommend work.

What Is Collagen?

Collagen is a key part of your skin's structure. It forms a network of fibers within your skin that acts like a framework.

In young skin, the collagen framework is intact and the skin remains moisturized and elastic. Over time, the support structure weakens and the skin loses its elasticity. The skin begins to lose its tone as the collagen support wears down.

Using your facial muscles -- smiling, frowning, or squinting, for instance -- is part of expressing yourself. That's normal, but it does stress the collagen in your skin. Over time, that stress adds up and contributes to facial lines and wrinkles.

 

Can Collagen Creams Smooth Wrinkles?

Collagen creams work only on the skin surface and, like other moisturizers, mainly slow the rate of water loss from the skin and help keep the skin supple. A moisturizer with or without collagen cannot penetrate the skin and is not designed to be absorbed. No moisturizer can undo the effect of collagen loss and make wrinkles disappear.

How Do Collagen Injections Fight Wrinkles?

Collagen injections replenish the skin's natural collagen. By supplementing your skin's own collagen, injections help smooth facial lines and some types of scars. The natural beauty of your skin is enhanced as the contour of the support structure is restored. These products can come from cows (bovine) or human cells.

Collagen injections include the following brands: Bellafill and Fibrel

 

Are There Other Injectable Wrinkle Fillers?

Yes. They include:

  • Botulinum toxin (Botox Cosmetic, Xeomin and Dysport) is not an actual wrinkle filler. Rather, botulinum toxin is injected into facial muscles to immobilize the underlying cause of lines and wrinkles. Botulinum toxin may improve eyebrow furrows, crow's feet, and forehead creases.
  • Calcium hydroxylapatite (Radiesse) is a semi-permanent wrinkle filler that's suspended in an aqueous gel and used to increase soft tissue. This is a collagen stimulator to improve the surface texture of your skin as well as stimulate your own collagen to enable the product to last longer.
  • Fat from your own thighs or abdomen can be also be injected. There's no risk of allergic reaction, and most people achieve semi-permanent results. Several injections may be required to get the most benefit.
  • Hyaluronic acid  (Juvederm, Restylane, Perlane, Prevelle Silk, Elevess, Belotero) is a substance normally made by the body that gives your skin its volume and fullness. Hyaluronic acid injections fill the space between collagen and elastin fibers within the skin, which replenishes the natural volume lost with aging. There's no risk of infection, but you will need repeated treatments to maintain the result. Hyaluronic acid also attracts and binds water, which helps maintain fullness where it's injected. Some hyaluronic acid materials are thicker and can add significant volume and structure. Others are smoother and thinner and have the ability to flow more consistently. Juvederm may last longer, maintaining the appearance for up to 12 months with less tissue injury and inflammation.
  • Poly-L-lactic acid (Sculptra) is an injectable filler used to replace lost facial fat. This synthetic polymer has been used for many years in dissolvable stitches and bone screws. This product stimulates the body’s own collagen for better skin texture and a more long lasting result.
  • Polymethylmethacrylate beads (PMMA microspheres) are tiny round, smooth plastic particles. Your body doesn't absorb them. PMMA microspheres in natural sources are used to add volume. Synthetic PMMA microspheres collagen made from cows (Bellafill) are used to improve skin folds such as those around the nose and lips.

 

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How Do I Know I'm a Candidate for Wrinkle Fillers?

Before you get a wrinkle filler, you and your doctor will discuss your goals. You'll also discuss your medical history, the areas you want treated, and what results you can expect.

Injections are not appropriate for certain lines and scars. Certain medical conditions also make them inappropriate. It is very important to have realistic expectations about what the results may be. For instance, one treatment may not remove every line on your face.

With your doctor, you can decide which facial areas are most important to you and discuss how many treatments you may need. You should also discuss cost. Keep in mind health insurance doesn't pay for cosmetic procedures. So be sure you're clear on what you'll need to pay for and what your payment options are.

What Can I Expect With Wrinkle Filler Injections?

If you and your doctor decide injections are right for you, your doctor may start by giving you a skin test on your forearm to make sure you aren't sensitive to the substance being used. You'll need to watch the area carefully for four weeks. Most men and women tested show no reaction to the skin test and can proceed with the injections.

When you're ready for your wrinkle filler injection, you'll first get a shot of local anesthesia to numb the area being treated. It's possible the area may bruise, and you may get puffiness, redness, and tenderness around the treated site.

Depending on the substance injected, you will likely need more treatments to maintain the effect.

 

How Many Wrinkle Filler Injections Will I Need?

That depends on which wrinkle filler you use.

Just like natural collagen, collagen replacements begin to lose form. That means they will eventually wear down. Treatment may require collagen injections two to four times a year to maintain the smoothing effects. The “softer” hyaluronic acid fillers like Restylane and Juvederm last three to nine months or longer depending on the product and where it is placed. Other fillers last longer:

  • Juvederm Voluma and Perlane last up to one year or longer
  • Radiesse up to one and a half years
  • Sculptra stays up to two years
  • Bellafill is a permanent filler.

 

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on June 13, 2015

Sources

SOURCES:

American Academy of Dermatology: "Soft Tissue Fillers."

American Society for Dermatologic Surgery: "Do's and don'ts when considering cosmetic procedures in a spa or salon."

American Society of Plastic Surgeons: "Injectable Fillers."

MedlinePlus: "Plastic and Cosmetic Surgery."

Wise J.B. Greco T.  Facial Plastic Surgery, May 2006.

Kelly P.E. Facial Plastic Surgery, February 2007.

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