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. Here's a detailed explanation of how collagen works, followed by a discussion of other injectable wrinkle fillers your doctor may recommend.

What is collagen?

To understand collagen, you must first understand your skin.

Skin consists of three layers: epidermis, dermis, and subcutaneous tissue (hypodermis). The uppermost layer, known as the epidermis, controls the loss of water from cells and tissue. Without this protective barrier, the body would quickly dehydrate.

Just below the epidermis lies the second layer, the dermis. The dermis, although it contains blood vessels, nerves, and hair follicles, is primarily made up of a protein called "collagen." This protein forms a network of fibers that provide a framework for the growth of cells and blood vessels. Because it is the primary component of the dermis, collagen acts as the support structure for the skin.

The hypodermis is a layer of fat and connective tissue that contains larger blood vessels and nerves. It also hosts sweat glands, and fat and collagen cells. The hypodermis is responsible for conserving your body's heat and protecting your vital inner organs.

Why do fine lines and wrinkles appear with aging?

In young skin, the collagen framework is intact and the skin remains moisturized and elastic. Young skin is resilient to the many facial expressions we adopt as well as everyday environmental exposure. But 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. Every time you smile, frown or squint, you put stress on the collagen in your skin. The effect of these facial expressions is cumulative and facial lines and wrinkles begin to appear.

Can't collagen creams smooth out fine lines and wrinkles?

Collagen creams work only on the skin surface and, like other moisturizers, primarily 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 cumulative effect of collagen loss and make wrinkles disappear.

How do collagen injections work as wrinkle fillers?

Collagen injections replenish the skin's natural collagen. The natural beauty of your skin is enhanced as the contour of the support structure is restored.

Zyderm and Zyplast are bovine-derived collagen products that can replace the collagen your skin loses over time. Zyderm and Zyplast are placed in the skin -- in the dermis where the body readily accepts it as its own.

CosmoDerm and CosmoPlast are bioengineered human collagen products that are used for similar indications as Zyderm and Zyplast; they have the advantage of not requiring a skin test prior to the first treatment. Other human-based collagen products include Autologen, Cymetra, and Fascian.

Collagen should be injected into your skin only by a trained health care professional. By supplementing your skin's own collagen, collagen replacement therapy helps smooth facial lines as well as some types of scars.