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The Latest Advances in Nonsurgical Facial Restoration

By: Nicholas Daniello, MD
Posted: June 13, 2008

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Bovine collagen was the first filler, featuring results that last two to three months. Its major disadvantage is that the patient has to be skin tested twice for allergic reactions throughout a two-month period before use. Side effects include redness and bruising at the injection site.

Human cadaver dermis and fascia were the next available fillers. These last a little longer, but few patients want cadaver skin to be injected into their faces. Side effects include redness and bruising at the injection site.

Next came fat injections. The patient’s own fat is harvested from their abdomen or hip area, and injected into the face. This lasts between six and 12 months. Side effects include redness, calcium deposition, bruising and fat breakdown at the injection site.

The most recent filler is hyaluronic acid. This is a natural skin component made from bacterial cultures that is hydroscopic and attracts water to the area, resulting in a skin-plumping effect. This lasts from six to nine months, and side effects include redness, bruising, swelling and pain at the injection site.

There are two semipermanent fillers available: calcium hydroxylapatite and poly-l-lactic acid, which last one to two years. Side effects include temporary redness, bruising and nodules at the injection site. Recent studies suggest that a combination of hyaluronic acid and calcium hydroxylapatite works better than the individual products alone.