Dermal Fillers In Caldecott

Dermal fillers tend to be broadly classified as being either non-permanent or permanent in their effect by both manufacturers and practitioners using these products.

Non-permanent or resorbable dermal fillers

In 1981, Collagen was the first filler approved in the U.S. for soft-tissue filling by injection. It is made from bovine (derived from cows’ skin) collagen and is currently known in the U.K. as Collagen Instant Therapy.

The collagen is taken from the cow and then purified to such a degree that it resembles the collagen which occurs naturally in our own skin. It is necessary to have a skin test before this treatment, however, as some patients may be allergic to bovine collagen.

Collagen instant therapy comes in different thicknesses, depending on the depth of your wrinkles or loss of firmness in your skin. You will sometimes hear Collagen Instant Therapy called by the brand names Zyderm® and Zyplast®. Unfortunately due to a decrease in popularity these brands were discontinued in 2010.

Evolence®, a porcine (derived from pigs) based collagen product was available in the UK from 2005 to 2009 when it was discontinued for commercial not safety reasons.

Other collagen only based fillers include Cymetra, collagen derived from human skin. This is rarely used these days.

The leading dermal filler used by most UK practitioners is a hyaluronic acid based product. This particular brand is manufactured using bacteria. Again, this product comes in different thicknesses and is called Restylane®.

Hyaluronic acid is a naturally occurring substance found in the spaces between the cells of body tissues in all animals. It has already been used widely in general medicine to help eye surgeons perform cataract operations, and for injection into arthritic joints to aid movement. It is estimated that 30 million patients around the world have been treated with some form of hyaluronic acid. Hyaluronic acid has now largely replaced collagen as the favourite filler of U.K. cosmetic experts. This is because it is more likely to be compatible with our bodies than collagen, and so people are less likely to be allergic to it and do not require a test prior to use.

Other hyaluronic acid only based products include:

Hylaform® and Hylaform Plus® - Manufactured from cockerel combs. This is being discontinued by the manufacturer in favour of other products.

Juvederm® ULTRA, Belotero®, Teosyal®, Matridur® and Hydrafill are examples of other Hyaluronic acid based brands derived from non-animal sources.

A newer filler using polylactic acid is promoted under the brand name Sculptra® (formerly New-Fill®). According to the manufacturer, Sculptra®, as the name suggests, is used more as a sculpting agent rather than just a wrinkle filler (see injectable tissue stimulators) and larger areas can be treated with a longer lasting result.

Another product new to the UK market in 2004 is calcium hydroxylapatite, the key component of Radiesse™. Calcium hydroxylapatite has been safely used in the body for many reasons including dental applications where bone build-up is needed for reconstruction and also in block form for cosmetic applications such as cheek, jaw, cranial and chin implants.

Radiesse is marketed as a long lasting dermal filler and facial sculpting agent where results can last for 2 years or longer.

Most of the ingredients of available non-permanent or temporary fillers have been widely used and clinically tested for safety and effectiveness.

Permanent or non-resorbable dermal fillers

These are fillers that can give a longer lasting effect, or even a permanent effect, and may be recommended in some cases by a practitioner.

These products are currently not widely used, but include the following brands:

Artecoll® - Rounded PMMA beads in bovine collagen.

Aquamid™ - Polyacrylamide.

Matridex® - Hyaluronic acid with Dextran microspheres.

As in any treatment to the skin, injections should be avoided in areas where the skin is swollen or where infections are present – e.g. active acne. This will reduce the risk of infection at the injection site after the treatment.

If you have even the slightest allergic reaction to a particular filler, it cannot be used and you will need to use a different brand. Dermal fillers have not been tested in pregnant women, so their use would normally be not advised by practitioners if you are expecting a child.

If you have suffered from a disease of the auto-immune system, you are likely to be allergic to bovine collagen and so it cannot be used. You need to give your doctor a detailed medical history to avoid such outcomes. Conditions which are not suited to the use of bovine collagen include: rheumatoid arthritis; psoriatic arthritis; systemic or discoid lupus erythematosus; or polymyositis.

Costs vary depending mostly on the type of dermal filler used and the degree of filling to the skin required.

Generally prices for dermal fillers are based upon the estimated number of syringes needed to obtain the required result.

Deeper lines and wrinkles tend to require more filler than shallow lines.

In addition, fillers used more for facial sculpting, contouring and addition of volume will tend to me more expensive than those just used for treating single lines.
 
A combination of fillers may also be recommended, and for certain areas additional treatments with other agents such as botulinum toxin (Botox®) may also be suggested, (especially for lines in the upper part of the face).

In addition, differnt filler brands such as Restylane, Perlane, Radiesse and Juvederm differ in price to clinics and practioners who purchase them from the respective manufacturers.

Hence, overall prices may vary from £150 to over £750 per treatment session.

Remember, using less filler than is actually required to fill out a line or improve the contour of the face properly will generally produce a less pleasing and less long lasting effect than opting for a proper (and more expensive) treatment.