The liquid face lift is currently all the rage among Hollywood's elite, and its popularity is understandable. It promises a more youthful appearance with no downtime, no anesthesia, and no going under the knife. There are even house parties devoted to facial treatments that utilize injectables for facial rejuvenation (though they are not recommended). The most popular and well-known of these injectables is of course Botox. However, Botox isn't even half the story when it comes to injectables. More and more youth-seekers are using Botox in conjunction with dermal fillers to plump up, fill in, and re-contour the face.
It is important to know that not all injectable dermal fillers are created equal, and each has specific purposes for which it is best suited. The list below is not exhaustive, but does represent the most widely used dermal filler available for use in the United States.
Juvederm is a dermal filler used to fill and smooth moderate to severe facial wrinkles and folds. It is available in modified versions which are useful for adding volume to lift and contour the face. Juvederm is made of hyaluronic acid, a natural substance in the body that helps maintain skin volume and hydration as well as joint lubrication and cushioning. Hyaluronic acid retains moisture, absorbing more than 1,000 times its weight in water. It also binds with collagen and elastin, transporting essential nutrients to these fibers which make up much of the support structure of the skin. The hyaluronic acid in Juvederm and the other dermal fillers listed here is not derived from animal sources.
Restylane is also made from hyaluronic acid, but is used mostly for moderate facial lines and wrinkles as opposed to lifting and contouring purposes. Restylane is often used in conjunction with Botox to enhance and extend the life of results.
Perlane is made by the same company (and from the same hyaluronic acid) as Restylane. The difference is that the gel particles are larger and, therefore, Perlane is more effective at filling in deeper folds and achieving increases in facial fullness. Perlane is also often used to augment lips and other areas of the face that could benefit from a restoration of youthful volume.
Rather than hyaluronic acid, Radiesse is made from calcium-based microspheres suspended in a water-based gel. Radiesse provides both immediate and extended results because it stimulates production of collagen and encourages tissue regeneration. It is most commonly used for the smoothing of nasolabial folds and marionette lines, for cheek augmentation, and to plump up sunken areas below the eyes.
Artefill is the first and only non-reabsorbable dermal filler to be approved by the FDA. Its claim to fame is that it provides a permanent support structure for lasting wrinkle correction, which means that its effects are both immediate and long-term. Artefill is made of polymethylmethacrylate (PMMA) microspheres, a material that has been used for years in surgical implants. However, since it is not a natural substance, there is a risk of allergic reaction. Because the results are considered to be permanent, physicians using Artefill generally prefer to under-fill on the first treatment, adding more at a subsequent appointment, if needed. Generally, full results are seen within six months of the procedure.
Sculptra is generally used as a treatment for facial lipoatrophy, the loss of fat beneath the skin that sometimes causes sunken cheeks, indentations, and hollow eyes. The main component of Sculptra is poly-L-lactic acid, a bio-compatible substance that does not cause damage to surrounding tissues. Unlike other dermal fillers, Sculptra does not produce immediate results. It works by stimulating collagen production, so results appear gradually over a period of a few months. Three to five treatments are usually required, and results can last up to two years or more.
Autologous fat is simply fat harvested from one’s own body. Its use eliminates the risks of allergic reaction or rejection by the body, since it is one’s own tissue. However, not all of the live fat cells survive when transplanted into the new site, so a fairly high rate of re-absorption is to be expected. Because of this, the physician will usually overfill the area being treated, which can leave the patient with a result that may look -- at least temporarily -- abnormal.
Sources: Dermal Fillers, Consumer Information Sheet, American College of Osteopathic Dermatology; http://www.aocd.org/skin/dermatologic_diseases/dermal-fillers.html
Product Information Sheet on Brand-Name Dermal Fillers, Liquid Face Lift Association; http://www.liquidfacelift.com/liquidfaceliftproducts.asp
Dermal Fillers, Consumer Information Sheet, American College of Osteopathic Dermatology; http://www.aocd.org/skin/dermatologic_diseases/dermal-fillers.html