As we age, collagen, the protein scaffolding that maintains skin firmness, gradually disappears and the dermis loses moisture. While Botox Cosmetic is the treatment of choice for dynamic wrinkles of the upper face, dermal fillers add volume that time has taken away. The process, known as soft tissue augmentation uses injectable filler materials to treat fine to deep wrinkles, nasolabial folds, smile lines, oral commissures and scars. In addition, lips can be augmented and the face can be contoured.

Today, most cosmetic physicians are introducing hyaluronic acid-based fillers into their practices. These fillers are showing a distinct advantage over collagen-based fillers as they are non-animal based and as such do not carry the increased risk of antigenicity and immunogenicity. Hyaluronic acid is a synthetic polysaccharide that appears to last longer than collagen. It is a physiologic constituent of dermal tissue which maintains local moisture content and is gradually reabsorbed with time. Restylane and Juvederm are two of the more popular injectable fillers used widely throughout Europe and Canada. These fillers are increasing in popularity due to their safety profile and ease of use. They typically last 6 to 12 months.

Cosmetic Injectable Fillers have numerous indications and when injected by a skilled practitioner, yield natural results. The following list outlines the many applications of injectable fillers:

facial folds and wrinkles
subcutaneous skin defects
lip augmentation
augmentation of cheekbones, chin, bridge of nose
irregularities of nose
small facial or hand bone defects
augmentation of nipple
acne scars

There are many factors that determine the length of time a filler material will remain in a patient's dermis. These include the patient's age, the depth of the wrinkle, the volume of injected product, the injection technique and the patient's skin quality.

Regardless of the filler material used, adverse reactions are possible but extremely rare. The most common reactions include erythema of the injected area, edema, hypersensitivity, allergenicity and blanching. Short term potential side effects include slight swelling, bruising, itchiness, redness for 1 - 2 days, ridging and/or blanching if the injection is too superficial, nodule formation (can be treated with intralesional injections of triamcinolone) and granulomas (less than 0.01%).

There are very few absolute contraindications for injectable fillers. They include known hypersensitivity or allergy to the active ingredient, diseases affecting the immune system, pregnancy or lactation or a positive skin test.

Visit www.canderm.com or www.juvederm.ca for more information.