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Injectable Fillers


Injectable fillers are used to round out wrinkles, lines, and scars, or to give the face a more desirable shape. Fillers are made from a variety of different substances, including collagen, hyaluronic acid (e.g., Restylane®), and poly-L-lactic acid (e.g., Sculptra® Aesthetic). A qualified physician can determine which filler is best.

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In this procedure, the treatment area is cleansed, an anesthetic is applied, if necessary, and the filler is injected under the skin using a tiny needle. Patients may feel some discomfort or pain during the injections. Side effects, which include bleeding, pain, swelling, bruising, and infection, may be treated using ice packs or medications. Most patients require multiple treatments over time, as the results of injectable fillers are usually temporary.

Many patients feel that collagen injections are less painful than other types of injectable fillers. Side effects include redness, bruising, swelling, or stinging and burning at the injection sites, but many patients do not experience side effects. Following treatment, most recover within 3 hours. Collagen treatments usually are effective for 3 to 6 months.

There are risks involved with collagen treatments. Collagen can come from two sources—humans and cows. Approximately 3% of patients are allergic to collagen from cows and physicians normally perform skin tests before the actual procedure to make sure the patient is not allergic.

Patients who have a condition that affects the immune system (e.g., lupus, rheumatoid arthritis) should not receive collagen injections. Other risks include infection and unsatisfactory results (e.g., problems with the shape of the face).

Hyaluronic acid often is used to improve the contour of the skin and to enlarge the lips. The procedure used is similar to the procedure used for collagen injections. However, results generally last longer (about 6 months) and fewer patients experience allergic reactions.

One popular brand of hyaluronic acid, Restylane®, was approved by the Food and Drug Administration (FDA) in 2003 and is commonly used to improve lines near the nose and lips. Complications (e.g., swelling, bruising) usually are minor and resolve quickly. The injections may be painful and some patients may require an anesthetic prior to treatment.

Sculptra® Aesthetic is the brand name of an injectable filler that contains poly-L-lactic acid, which comes from corn. This filler often is used in patients who have HIV and experience facial fat loss. It takes some time for the full effects of Sculptra® to be noticeable, but once treatments are complete, the results can last 2 years.

Due to the risk for an allergic reaction to ingredients in the filler, the patient's medical history should be reviewed thoroughly before Sculptra® treatments. Patients who have been treated with Sculptra® may develop small bumps beneath the skin of the treatment area, often 6 months to a year after treatment. Although these bumps may disappear by themselves, it is recommended that patients who experience them see a dermatologist to rule out infection.

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Original Date of Publication: 27 Jul 2006
Reviewed by: Under Construction
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