WINTER NEWSLETTER 2005

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All About Injectable Fillers

What Are Injectable Fillers?
Pharmaceutical fillers are medical compounds or implants, not drugs, that work by replacing lost volume. Soft-tissue fillers are generally considered temporary, semipermanent or partially permanent since the results of treatment will diminish over time. Your face is always changing as the result of aging and weight fluctuation, so while the notion of a permanent filler may seem attractive, it is often not desirable or appropriate for the long term.

• Collagen Based
• Hyaluronic Acid Based
• Synthetic Temporary Fillers
• Partially Permanent
• Semipermanent Fillers

Collagen Based:

Used to fill wrinkles, moderate creases and depressed scars. Also effective for plumping lips

• Zyderm
• Zyplast

Derived from bovine collagen

1. Requires allergy testing prior to injection
2. Anesthetic added to minimize pain
3. No downtime
4. Requires overfilling to achieve desired result
   (excess fluid is absorbed by the body over the first few days)

Results last from 2-3 months
Cost up to $600 per area treated.

• Cosmoderm - for fine lines
• Cosmoplast - for moderate to deep lines and to restore the lip border

Derived from human collagen

Treats frown lines, forehead lines, crow's feet, smile lines, lip borders & marionette lines

1. No allergy testing required
2. Anesthetic added to minimize pain
3. No downtime
4. Requires overfilling

Results last from 2-3 months
Cost up to $600 per area treated

Hyaluronic Acid Based:

Decrease appearance of fine lines, creases and depressed scars... Also effective for plumping lips.

Hyaluronic acid is a natural compound found in human skin that binds moisture

• Restylane

1. Non-animal hyaluronic acid
2. No allergy testing required
3. Topical anesthetic applied prior to injection
4. Post-treatment swelling/bruising is expected and can last for up to a week

Results last six months or more
Cost up to $1,000 per area treated

• Hylaform - to restore plumpness
• Hylaform Plus - for deep wrinkle correction and facial contouring
  Hyaluronic acid derived from rooster combs

Treats frown lines between the eyes, smile lines above the lip, smile lines between the nose and mouth & corners of the mouth

1. No allergy testing required
2. Topical anesthetic applied prior to injection
3. Tell your doctor if you are allergic to certain types of water fowl

Results last up to 6 months
Cost up to $1,000 per area treated

• Juvederm (not yet FDA approved)

Non-animal hyaluronic acid

Approved for use in Canada, there are three formulations of Juvederm ranging in use for fine lines to deeper creases

Synthetic Temporary Fillers:

For deeper creases and wrinkles as well as sculpting the face. These are not intended for high-movement areas like the lips.

• Sculptra

Completely lab-manufactured. Claim to induce the body to produce it's own collagen

Microscopic particles of polylactic acid (PLLA)

1. Approved to treat loss of facial fact in HIV patients, used off-label for cosmetic purposes
2. Local anesthesia required
3. Requires a series of treatments at intervals of a few weeks to a month
4. Legnth of treatments depends on desired results

Annual touch-ups may be necessary
Cost up to $2,400 per session

Partially Permanent:

Fill frown lines, crows feet and smile lines; provide definition to cheeks and chin; fill depressed scars.

• Fat Injections

Transfer your own fat from one part of your body to another

1. Donor and treatment sites require local anesthetic
2. Overfilling may be necessary
3. Minimal downtime when small amounts of fat are injected to limited areas of the face

Three to four treatments may be necessary for long-lasting results which can endure from several months to permanently

$2,000 + for harvesting and injecting

Semipermanent Fillers:

For deeper creases and wrinkles as well as sculpting the face. These are not intended for high-movement areas like the lips.

These fillers (some have tiny synthetic beads added) are injected either just beneath or deep in the dermis

• Radiance (also known as Radiesse)

Calcium hydroxyapatite microspheres suspended in polysaccharicle gel

1. Newly marketed as Radiesse for cosmetic use
2. Requires local anesthesia of anesthetic block
3. Swelling and/or bruising can last for up to two weeks after treatment
4. Possible side effects include clumping and filler migration (both require surgery to correct)

Results last from three to five years
Cost up to $2,000 per treatment unit

• Artecoll

Microscopic synthetic acrylate beads suspended in a collagen-based injectable pending FDA approval. Results and risks are similar to Radiance (Radiesse)