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Laurence O’Halloran MD
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Cosmetic facial fillers


The simplest and least expensive method of facial contouring is by the use of a temporary, injectable filler. The injection of temporary fillers is performed in the office, with or without a topical anesthetic or nerve block, and the procedure takes about 5 to 15 minutes. Collagen is the old favorite, with Zyderm and Zyplast being the most commonly used brand of collagen. This product typically lasts from 2 to 4 months. A skin test is required prior to injection of collagen since about 4% of the population will have an allergic rection to the bovine (cow) collagen.

Restylane and its thicker counterpart, Perlane are both made from hyaluronic acid, a substance that naturally creates volume in the skin. Since this product does not involve the use of foreign substances, allergies are extremely rare and a skin test is not required. Additionally, the results last about twice as long as collagen, and in some instances, Restylane and Perlane can last for up to 12 months. As an alternative to injecting a substance that your body will eventually absorb, another class of fillers involves injection of a permanent substance. Once this foreign substance is injected, your body will naturally form scar tissue around it to protect it from entering other areas of the body. This scar is made of collagen, which as we know is a filler all by itself. However, since the foreign substance is not biodegradable, it will stay in your body presumably forever. Although this may seem like an ideal permanent solution to facial contouring, your body’s reaction to the foreign material is unpredictable and some of these products can be toxic. While many people will do fine with injection of a foreign, non-biodegradable filler, some people will form excessive scars, creating firmness, lumpiness, inflammation, and migration of the substance. And since it is permanent, it is very difficult to remove if problems do arise. There are nearly 20 types of permanent injectable fillers, but the most commonly used are Silicone and Artecoll (made from the same chemical as plexiglas), neither one of which is legal in the United States.