A Guide to Fillers
Posted: Thursday 13 May 2010 10:32am
Plumping lips, filling wrinkles and smoothing furrows and flaws are all possible with a range of injectable dermal fillers.
Dermal fillers are injected into the skin in tiny amounts to add volume and fullness to the face, cheekbones, lips and eyes.
> VIDEO: Dermal fillers to treat under-eye hollows
“In the last two years the range of dermal fillers has expanded rapidly,” says Dr Peter Bakaric, of The Collagen Face Centre, Bondi Junction.
“For the first time ever, fillers pose a real alternative to surgery, but for good results we generally use several different fillers to smooth wrinkles, volumise and lift.”
Dr Bakaric says fillers are particularly popular as they are a true lunchtime procedure, there is no down time, and they are cost effective.
“In reality no one tells anybody that they are having filler treatments – many women don’t tell their husbands – and they can get away with it because they are so minimally invasive, and any bruising or redness can be covered with make-up.”
We give you a rundown on what’s on the market so you can decide what’s best for you, in alphabetical order:
COLLAGEN
What is it: The first filler to hit the market, collagen has lost most of its popularity due to other longer lasting fillers becoming available. The latest range of collagen fillers are made from a highly purified form of animal collagen (usually bovine) and still require an allergy test beforehand.
Best for: Treating fine lines around the eyes and for plumping lips
Who’s it for: Usually favoured by older women who’ve been having these injections since the ‘80s and don’t want to change or try anything new. “These days collagen is used very rarely, and it’s really only asked for by die-hard patients who like to stick with what they know.”
What’s involved: Some collagen products contain an anaesthetic, but they still sting when injected so a local anaesthetic cream may be required before hand. The areas to be treated are injected gradually with the collagen.
Downtime: You may be a little red and swollen afterwards. Bruising may occur.
Risks and side effects: In rare cases you may have an allergic reaction to the collagen.
Treatments required: Every four to six months
Optimal results: Results are immediate, but better when any swelling subsides within 48 hours.
Ballpark cost: $350 to $500
ESTHELIS
What is it: This gel is made from hyaluronic acid, which is a naturally occurring substance in the skin. There are two types of Esthelis – basic and soft
Best for: Esthelis Basic can be used for frown lines, nasolabial folds, lips, furrows and depressions. Esthelis Soft is better for fine lines around the eyes and mouth and lip borders
What’s involved: Numbing cream is used first, and then Esthelis is injected into the required areas. “It is extremely easy to work with and produces great results,” says Dr Bakaric.
Downtime: None
Risks and side effects: Bruising is the most common, slight swelling, redness.
Preparations: Don’t take any medication such as Aspirin, Nurofen, Omega 3 fish oils, or vitamin E beforehand.
Treatments required: Six monthly. “I like to give patients their first treatment and then boost this four to six weeks later for more lasting results,” says Dr Bakaric.
Complications: None.
Optimal results: One week later when bruising and swelling has settled.
Ballpark cost: $550 to $600 per 1ml treatment.
FORTELIS
What is it: A gel made from hyaluronic acid, which is a naturally occurring substance in the skin. It is related to Esthelis, but a thicker, more long-lasting formulation.
Who’s it for: Those with deep wrinkles, creases and folds, chin and cheek augmentation, facial revolumisation. “It is generally used for deeper placement in the skin,” says Dr Bakaric. “It has good lifting properties and it restores structure to sagging skin.”
What’s involved: Numbing cream is used first, and then Fortelis is injected into the required areas.
Downtime: None, although you could be swollen and red.
Risks and side effects: More likelihood of bruising, swelling and redness afterwards as the needle is a larger calibre.
Preparations: Don’t take any medication such as Aspirin, Nurofen, Omega 3 fish oils, or vitamin E beforehand.
Treatments required: Every 12 to 18 months. “I usually use Fortelis in a two to three stage process. The client has one treatment, then it is topped up one month later, and again another month later.”
Complications: “The product could be placed too superficially in the face, and that could cause lumpiness,” says Dr Bakaric. “As the needle is larger, there is more of a risk of haematomas, and an increased risk of infection.”
Optimal results: Two to three weeks later.
Ballpark cost: $650 per 1ml
JUVEDERM
What is it: This gel is made from hyaluronic acid, which is a naturally occurring substance in the skin. There are two types of Juvederm – Ultra and Plus. Ultra is used on superficial lines, while Plus, is a thicker version and used on deeper lines. In contains an anaesthetic.
Who’s it for: “Great for anyone 18 to 90 years, who wants to plump lips, fill wrinkles, deep furrows, mouth creases, marionette lines,” says Dr Bakaric.
What’s involved: A numbing cream may be used first if using ultra, then the product is injected into the lines or problem areas.
Downtime: None
Risks and side effects: Bruising is the most common, slight swelling, redness.
Preparations: Don’t take any medication such as Aspirin, Nurofen, Omega 3 fish oils, or vitamin E beforehand.
Treatments required: Every six months
Complications: None
Optimal results: One week later
Ballpark cost: $550 to $600 per 1ml treatment.
RESTYLANE
What is it: Made from stabilised hyaluronic acid, Restylane comes in the form of a clear gel that after injection, instantly adds volume to skin folds and creases. “This is an old favourite, as it was the first hyaluronic acid filler to hit the market, offering our first alternative to collagen,” says Dr Bakaric. Restylane Kiss is great for lip plumping while Restylane Sub Q works well for cheekbone enhancement and lifting.
Who’s it for: Treating deep wrinkles and creases, remodeling folds and depressions, cheek and chin augmentation. “It’s particularly good for lips,” says Dr Bakaric.
What’s involved: A numbing cream may be applied beforehand, and then the product is injected into the wrinkles, lines or areas to be treated.
Downtime: None
Risks and side effects: Bruising is the most common, slight swelling, redness
Preparations: Don’t take any medication such as Aspirin, Nurofen, Omega 3 fish oils, or vitamin E beforehand.
Treatments required: Every four to six months
Complications: None
Optimal results: One week later
Ballpark cost: $550 to $600 per 1ml treatment
PERLANE
What is it: A soft tissue filler related to Restylane, made from naturally occurring hyaluronic acid, Perlane is thicker and used to create greater volume.
Best for: Reshaping chins and augmenting lips and cheeks. “Perlane is not a superficial treatment and treats deeper wrinkles and rehapes lips,” says Dr Bakaric.
What’s involved: Anaesthetic cream may be applied and then the product is injected into the skin.
Downtime: None
Risks and side effects: Bruising is the most common, slight swelling, redness
Preparations: Don’t take any medication such as Aspirin, Nurofen, Omega 3 fish oils, or vitamin E beforehand.
Treatments required: Every six to 12 months.
Complications: “If the product is placed too superficially in the skin, it is more prone to lumpiness,” says Dr Bakaric.
Optimal results: One week later.
Ballpark cost: $600 to $650 for 1ml treatment
NEW-FILL
What is it: A poly-L-lactic acid that that helps stimulate the body’s own natural production of collagen. This is a synthetic substance so no allergy test is required, however some people can have a reaction to the foreign substance in their body. New-fill has virtually been replaced by Sculptra.
Who’s it for: Those who want to volumise their face and increase collagen production.
What’s involved: A numbing cream is applied and the product is injected in the lines and wrinkles or areas requiring more collagen stimulation. Can also be used for the hollow cheek appearance exhibited in patients with HIV.
Downtime: Up to one week
Risks and side effects: Bruising is the most common, slight swelling, redness
Preparations: Don’t take any medication such as Aspirin, Nurofen, Omega 3 fish oils, or vitamin E beforehand.
Treatments required: Up to four treatments recommended. Then topped up every 18 months to two years
Complications: “As it is a foreign substance, some people can have a reaction to the product which causes granulomas or lumpiness in the skin,” says Dr Bakaric.
Optimal results: One to three months after treatment.
Ballpark cost: $1,000 per 1ml treatment
SCULPTRA
What is it: The product is a synthetic polymer from the alpha-hydroxy acid family, containing a poly-L-lactic acid base. It is a long lasting volume generator.
Who’s it for: Replacing volume in the face, typically in jaws, cheeks, temples, and marionette lines, nasolabial folds, eyes,
What’s involved: After numbing cream is applied to the face, the gel is injected deeply into the skin. Afterwards, you need to massage the skin for around seven days to stimulate collagen and to avoid any lumps.
Downtime: Up to one week.
Risks and side effects: Bruising is the most common, slight swelling, redness
Preparations: Don’t take any medication such as Aspirin, Nurofen, Omega 3 fish oils, or vitamin E beforehand
Treatments required: Up to four treatments recommended, then treatments every 18 months to two years
Complications: Some patients will notice lumps and granulomas forming under their skin.
Optimal results: Results are immediate, but results improve over time.
Ballpark cost: $1,000 per 1ml treatment
RADIESSE
What is it: Radiesse is a filler comprised of calcium-based microspheres suspended in a water-based gel. It immediately adds volume, but over time encourages collagen growth.
Who’s it for: Those with volume loss and facial wrinkles and folds.
What’s involved: Anesthetic cream is applied to the face, and then the skin is injected in areas that need volumising.
Downtime: None
Risks and side effects: Bruising is the most common, slight swelling, redness
Preparations: Don’t take any medication such as Aspirin, Nurofen, Omega 3 fish oils, or vitamin E beforehand
Treatments required: Every year to 18 months.
Complications: Foreign body reaction, leading to lumps and bumps forming.
Optimal results: You’ll see immediate results, but as this product stimulates more collagen growth, you’ll continue to see results for months.
Ballpark cost: $550 to $1,300 per treatment, depending on the area.
AQUAMID
What is it: The product is made from protein and water, but because the major ingredient is water (97.5%) and the rest is cross linked polyacrimide, the gel is soft and uniform. “Basically this is a permanent filler, which is very attractive to cost-conscious people,” says Dr Bakaric.
Best for: lip augmentation, nasolabial folds, deep wrinkle treatment, remodeling cheeks, chin clefts, acne scarring, nasal irregularities
What’s involved: After numbing cream is used, the product is placed deeply into the skin to volumise cheeks, correct furrows and flaws, resculpt noses and fill scars.
Downtime: None
Risks and side effects: Bruising is the most common, slight swelling, redness
Preparations: Don’t take any medication such as Aspirin, Nurofen, Omega 3 fish oils, or vitamin E beforehand.
Treatments required: Every 10 years
Complications: As this is a long-lasting product, if you don’t like the results, you’ll have to live with it for a long time. “Some people may suffer from a foreign body reaction, granulomas and lumps,” says Dr Bakaric.
Optimal results: You’ll see results instantly, but it’s best one week later.
Ballpark cost: $800 per 1ml treatment