COSMETIC FILLERS - WHAT'S NEW AND IMPROVED?

By Dr. John Goldhar

Part of the natural aging process involves the normal loss of cells - a process called apoptosis. This occurs in our bones, our brain and, in fact, in all of our organs including the largest one, the skin.

In the skin this loss can be manifest by the appearance of brown spots, blood vessels, and easy bruising, one of the more obvious signs is tissue volume loss which shows up as deepening of the lines between the sides of the nose and the sides of the mouth-known as the "nasal labial folds."

The prominence of the cheek bones, drooping of the brow, loss of fullness around the chin and the appearance of vertical lines at the lower sides of the mouth (marionette lines) are further signs of the tissue volume loss due to the disappearance and damage to the main building blocks of the skin-collagen, elastin and hyaluronic acid.

Many attempts have been made at replacing this volume loss. Surgical implants, for one, have an important role in correcting this volume loss but further surgical procedures are required as the face ages. Fat transfers have been used with variable effectiveness and duration and the very early use of filler substances such as paraffin led to horrendous disfiguring complications.

The introduction of Collagen in the late 1970s was a tremendous advancement, but about 10-15% of recipients developed allergies to this bovine derived substance. With the recent development of non-animal sourced products, that can be slowly metabolized by the body, we now have a safe, relatively long lasting material that can be injected without the fear of severe reactions. Furthermore, as the face ages, simple top-up treatments can easily address the evolving aging process.

WHAT'S NEW AND WHY IT'S MORE EFFECTIVE

The newest development in the use of fillers is technique related. One of the main problems with the use of fillers in the last 25 years was the surface textural change that was present due to the filler. This appearance was due to the physical presence of the filler in the second layer of the skin (the dermis) and resulted is slight lumpiness. In the last year however, a new development in filler injection has greatly reduced the visibility of the fillers and has markedly improved the appearance after injections. The technique involves the placement of fillers directly onto the surface of underlying bone. This deep placement creates a mound of filler that acts as a pillar for the overlying re-draped skin. This effectively replaces the volume loss without giving distortions on the skin surface. Furthermore, since there is a deep placement of a more concentrated amount of filler, the injected material can last for several years, rather than the few months that was previously the norm. The technique is less painful than previous treatment methods and gives a more natural appearance. In most cases the treatment takes less than half-and-hour and there is generally no down time. Occasionally there can be a small bruise that can be covered with concealer.

The deep placement technique can be used to correct a weak chin, rebuild youthful looking cheek bones, raise the brow and repair the nasal labial and marionette regions. It is often used in combination with Botox ™ and fractionated laser re-surfacing procedures to reduce the environmentally induced aging changes and can cut a decade or more off a person's appearance.

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Find out what Dr. Goldhar has to say about Hyperpigmentation

Dr. Goldhar, is a fellow of the Royal College of Physicians and Surgeons of Canada and a board-certified dermatologist with over 31 years of experience. He has been working in the cosmetic dermatology field since 1981. More at CosMedix MD