Surgical Procedures
Facial Surgery
Fillers
Concept - Fillers
are agents that are injected into depressions of the skin, either
in the dermis or deeper structures. These are mainly used for
wrinkles in the aging face, but may also be used for acne pock
marks and depressed scars. There are several fillers on the
market at this time. Each has certain advantages and disadvantages.
The most commonly utilized filler is collagen. The original
collagen was bovine collagen (Zyderm /Zyplast).
This agent has been popular in the past. It has had the disadvantage
of requiring a test dose to avoid allergic reactions and its
short duration of activity. Some patients still may have a localized
reaction even in the face of a negative test dose.
Recently, a human-derived collagen has been made available
(Cosmoderm/Cosmoplast). The advantage of the
human collagen is that it does not need a test dose. Localized
allergic reactions are of a much lower incidence. This form
of collagen may last longer than the bovine collagen (up to
4 mo.)
Restylane is an injectable form of hyaluronic
acid. It has been popularized in Sweden and more recently in
Canada. It has just entered the United States and seems to have
good acceptance.
Radiance made of a micronized hydroxyapetite.
This agent is placed in the deeper layers. It has the advantages
of lasting up to 1 to 2 years. This is a good choice for those
patients who like the results of collagen, but who are seeking
a more lasting result. Dr. Dabb believes that a patient should
experiment with collagen first, before committing to this filler.
Permanent fillers, such as silicone, are discouraged in Dr.
Dabb’s practice. The long-term results may actually become a
problem as a patient ages. Risk of extrusion and chronic infections
outweigh any advantage of longevity.
Dr. Dabb recently incorporated collagen with his Botox package.
This provides a complimentary injection of wrinkles with human
collagen with the 8 dose package. This combination of treatment
seems more effective than when either agent is used alone.
