The modern era began with FDA approval of Zyban in (bovine collagen) 1981. Since then, numerous products from different source materials including bovine, porcine, human, avian and bio-engineered products have come to the market. Today over 60 different materials are in use throughout the world. The need and demand are driving the market. Many products are claiming permanency or significant longevity.

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 Juvéderm 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 4 to 8 months.

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%).

Restylane/Juvéderm

These fillers are made from hyaluronic acid, a substance that occurs in most living organisms. Because of this it does not cause allergic reactions. Hyaluronic acid is the elastic frame underlying the skin. When it is restored it hold water and softens wrinkles. It can be used in the same places as collagen and should last for 4-8 months. Swelling can occur post procedure that would last 1-2 days. Cost is $600 for the first syringe, $500 for the second syringe and $400 for subsequent syringes.

Juvéderm

As we age, our skin changes. Over time, the natural volume of youthful skin begins to diminish as wrinkles and folds form. But, with Juvéderm injectable gel, you don't have to just sit back and let it happen! Recently approved by the FDA, Juvéderm injectable gel is a next-generation dermal filler. The smooth consistency gel helps to instantly restore your skin's volume and smooth away facial wrinkles and folds, like your "smile lines" or "parentheses" (nasolabial folds, the creases that run from the bottom of your nose to the corners of your mouth).

Juvéderm is a smooth consistency gel made of hyaluronic acid a naturally-occurring substance in your skin that helps to add volume and hydration. Your healthcare professional eases Juvéderm injectable gel under the skin to provide a smooth, natural look and feel so everyone will notice (but no one will know)! In fact, studies show superior results of Juvéderm compared to a collagen-based dermal filler.* And, almost 90% of all study volunteers who were treated with both Juvéderm injectable gel and another dermal filler* preferred Juvéderm! In addition, Juvéderm injectable gel is the first FDA-approved hyaluronic acid dermal filler that is proven to be safe and effective for persons of color.