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Injectables At-A-Glance

 
Injectable  Description  Purpose  Possible Side Effects/Risks  Results  Regulatory Status
Zyderm/ Zyplast Collagen injection made from purified cow skin. Fills wrinkles, lines and scars on face and around lips. Allergic reaction. Requires skin test prior to procedure. Immediate, lasts up to 6 months. FDA Approved
           
           

Human Tissue Derived Collagen

A group of human-derived collagen products are currently available in the United States. The tissue, harvested using sterile techniques from donors or grown in a laboratory, are processed to form an injectable human collagen matrix.

Injectable  Description  Purpose Possible Side Effects/ Risks  Results  Regulatory Status
Cymetra (Micronized Alloderm)  Injectable human tissue collagen matrix derived from cadaver tissue, screened for contami-nation. Filler for lips, nasolabial folds, deep wrinkles and lines. Bruising Multiple treatments needed; lasts 2 months FDA Approved
CosmoDerm/ CosmoPlast  Derived from human tissue that has been purified and grown in a laboratory. Doesn't need a skin test. Approved for frown lines, crow's feet, forehead lines, smile lines, vertical lip lines, marionette lines, lip border and for certain scars. Cosmoderm is used for superficial lines, while Cosmoplast is used for more pronounced wrinkles. Bruising Immediate,  
Fascian  Injectable derived from donor-fascia (connective tissue made of collagen) of the thigh muscle. Stimulates collagen formation, adds bulk. Bruising Lasts up to 6 months FDA Approved
Autologen Injectable collagen prepared from the patient's skin. Small pieces of skin are harvested from the patient, processed and prepared for injection or frozen for later use. An alternative to traditional collagen injections. Bruising, time consuming and expensive 2 or 3 treatments over a 6 to 8 week period to produce collagen; not permanent Not required
Human Derived Product
Injectable  Description  Purpose  Possible Side Effects/ Risks  Results  Regulatory Status
Plasmagel  Plasma emulsion (protein) made of patient's blood and Vitamin C complex. Soft tissue filler to add volume. Bruising Lasts up to 3 months Not required

Fat

Fat injections have been used for years to add volume, fill wrinkles, lines and enhance the lips. Fat injections involve taking fat from one part of the patient’s body (abdomen, thighs or buttocks) and reinjecting it beneath the facial skin. Unlike bovine collagen, allergic reaction is not a factor as the fat is harvested from the patient’s own body. Results are variable, but can be permanent. More than 52,000 fat injection procedures were performed in 2006, according to the ASPS.

           

Botulinum toxins

First used to treat eye disorders, botulinum toxins have been used for neck spasms, cranial nerve disorders and eye spasms. For cosmetic purposes, the bacteria is used for the temporary improvement of moderate to severe wrinkles in the glabellar region. When injected into facial muscles, botulinum toxins block nerve impulses, temporarily paralyzing muscles and smoothing wrinkles. Currently Botox® is the only form of botulinum toxin approved by the FDA for cosmetic purposes in the glabellar region, but two others, MyoblocTM and Dysport®, are under FDA review for cosmetic use.

More than 4 million Botox® injections were performed in 2006, according to ASPS. Botox injections were the most popular minimally-invasive cosmetic procedure in 2006. Sixty-five percent of all Botox® procedures were performed on people between the ages of 30 –55.

Injectable  Description  Purpose  Possible Side Effects/ Risks  Results  Regulatory Status
Botox Botulinum toxin type A Smoothes wrinkles, reduces hyperhydrosis Bruising, numbness, droopy eyelids, body may become immune Can begin to take effect 5-7 days, maximum effect in two to four weeks FDA approved for use in the glabellar region.
           
All other use considered off label.
Myobloc  Botulinum toxin type B; Requires larger dose than Botox but takes effect more quickly. Myobloc has a longer shelf life than Botox. May serve as alternative to patients resistant to botulinum toxin type A. Smoothes wrinkles Bruising, numbness, droopy eyelids, body may become immune Can take effect in 4-6 hours, maximum effect in 2 weeks  
In use outside U.S.
Injectable  Description  Purpose  Possible Side Effects/ Risks  Results  Regulatory Status
Dysport  Botulinum toxin type A; Requires larger dose than Botox but manufacturer claims injections are stronger and last longer with patients returning twice a year rather than four treatments with Botox. Smoothes wrinkles Bruising, numbness, droopy eyelids, body may become immune Can begin to take effect 5-7 days, maximum effect in two weeks In use outside the U.S. FDA decision pending. FDA approved only for cervical dystonias.

Hyaluronic Acid

Hyaluronic acid exists naturally in all living organisms and is a natural component of connective tissues, including the skin. Hyaluronic acid has been used to treat joint pain. Restylane® is a soft tissue filler made of hyaluronic acid, manufactured by recombinent technology which adds volume to minimize wrinkles and lines. As the substance naturally occurs in humans and all animals, allergic reactions are rare. According to the ASPS, more than 770,000 hyaluronic acid injection procedures were performed in 2006. Captique™ is another soft tissue filler made of hyaluronic acid which received FDA approval in 2004. Hylaform® and Hylaform Plus® are soft tissue fillers composed of hyaluronic acid extracted from rooster combs - both received FDA approval in 2004. Two additional tissue fillers composed of hyaluronic acid, Perlane® and Restylane® Fine Line, are used outside the United States but are not approved by the FDA.

Injectable  Description  Purpose  Possible Side Effects/ Risks  Results  Regulatory Status
Juvederm (24HV, 30, 30HV) Hyaluronic acid gel Temporarily corrects moderate to severe facial wrinkles and folds Temporary redness, pain/tenderness, firmness, swelling, and bruising at injection site; should not be used in patients with severe allergies, particularly allergies to bacterial proteins Immediate; corrects facial wrinkles of folds for up to six months or longer FDA approved
Restylane  Non-animal derived hyaluronic acid. Soft tissue filler that adds volume to wrinkles around the nose and mouth. Redness, bruising, tenderness, swelling, pain, itching    
Restylane Fine-lines  Non-animal derived hyaluronic acid. Soft tissue filler that adds volume. Redness, swelling, tenderness, especially at sight of injection; acne-like formations are rare Immediate, may last up to 1 year In use outside U.S.
           
Not FDA approved for any use in the U.S.
Injectable  Description  Purpose  Possible Side Effects/ Risks  Results  Regulatory Status
Perlane  Non-animal derived hyaluronic acid. Soft tissue filler that adds volume to wrinkles and folds in deep layers of skin. Pain, redness, swelling, itching, discoloration, and tenderness at the point of injection Immediate; lasts six months to one year; subsequent injections may require less Perlane FDA approved for the correction of moderate to severe facial folds and wrinkles.
Captique Non-animal derived hyaluronic acid. Soft tissue filler that adds volume. Bruising, swelling, rare allergic reaction Immediate, may last up to 1 year FDA approved for filling moderate to sever facial wrinkles and folds around the nose and mouth
Hylaform Hyaluronic acid extracted from rooster combs. Soft tissue filler that adds volume. Redness, swelling, people with sensitivities to avian products may have an allergic reaction Vary, may last up to 6 months FDA approved for filling moderate to severe wrinkles around the nose and mouth.
Hylaform Plus  Hyaluronic acid extracted from rooster combs. Contains large hyaluronic gel acid particles. Soft tissue filler that adds volume. Redness, swelling, people with sensitivities to avian products may have an allergic reaction Vary, may last longer than 4-6 months FDA approved for filling moderate to severe wrinkles around the nose and mouth.
           

Semi-permanent Fillers

Two additional soft tissue fillers being used for their wrinkle reducing and volume-adding qualities are Sculptra®  and Radiesse® (formerly RadianceTM). Radiesse® - received FDA approval for cosmetic applications in Decemeber 2006 - is composed of calcium hydroxylapatite, which has been used in the body for multiple applications including cheek and chin implants. Radiesse® is injected into the face adding volume through microspheres that are suspended in polysaccharide carriers until encapsulation occurs. Sculptra®, which is made of synthetic polylactic acid contained in microspheres, is approved by the FDA for restoration and/or correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus. Any other use is considered off-label. 

Injectable  Description  Purpose  Possible Side Effects/ Risks  Results  Regulatory Status
Radiesse (Bioform)  Microspheres of calcium hydro-xylapatite suspended in an aqueous gel carrier. Reported to last 1-2 years. The body forms collagen around the micro-spheres that adds bulk. According to manu-facturer, clumping, lumping, and nodules can appear when injected into the lips. Little risk of allergic reaction. Immediate, according to the manu-facturer. FDA approved for correction of moderate to severe wrinkles and folds.
Sculptra  Synthetic polylactic acid contained in micro-spheres. Restores lost facial volume in people with HIV. The body forms collagen around the micro-spheres. Redness, bruising, lumping and granulomas Immediate, and typically last two years according to manu-facturer. Approved by FDA for restoration and/or correction of lipoatrophy in HIV patients.
In use outside the U.S. as New Fill, to fill wrinkles. Non-resorbable/"Permanent" Filler
Injectable  Description  Purpose  Possible Side Effects/ Risks  Results  Regulatory Status
ArteFill  Contains 20% tiny, round, non resorbable, smooth particles (polymethyl methacrylate microspheres) and 80% purified bovine collagen gel with 0.3% lidocaine. Microspheres not absorbed by the body; provide support for wrinkle correction Indicated for the correction of nasolabial folds (a.k.a. smile lines) Skin test required Unlike other dermal fillers that eventually become absorbed by the body, ArteFill® is the first injectable to provide a permanent support solution to fill wrinkles and prevent further wrinkling.  

 

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Disclaimer.Disclaimer.Disclaimer. Information on this web site was gathered from many sources in public domain such as published books, articles, studies and web sites. It is not intended to treat, diagnose, cure or prevent any disease. Please discuss your health conditions and treatments with your personal physician.

 

 

 

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