Facial Rejuvenation Without Surgery

Christopher R. Hove, M.D.

Due to work limitations or fear of drastic surgery and general anesthesia, many people desire improvement of facial “trouble spots” with little or no recovery time.  Soft tissue fillers, or injectables, are an ideal solution under these circumstances.  These materials can be injected into the skin to fill, or in essence inflate, any unwanted depressions, wrinkles or unevenness in skin texture.

Since there are over 40 different injectable materials available on the world market today, which one is best?  Each filler has its own benefits and drawbacks and what works well for one person may not work well for another.  A discussion of each of these fillers would be tedious, so only those currently cleared by the FDA bear mention.

Collagen (ZyplastÔ and ZydermÔ) has been in widespread use since the 1970s, and has been considered the gold standard of fillers.  It excels at softening fine facial lines and plumping the lips with a natural look and feel.   The first versions, Zyplast and Zyderm require pre-treatment skin testing to make sure the patient does not have an immune reaction.  The newer versions, Cosmoplast and Cosmoderm, do not require skin testing, but still only lasts 3-5 months.

A longer acting injectible filler is hyaluronic acid, marketed under several different names: RestylaneÒ, HylaformÒ, and Captique™.  As hyaluronic acid is normally found in the human body, these products are biocompatible, do not require skin testing, and last from 6-12 months, depending on where they are injected.  Like collagen, they are also superb for filling fine lines and creating longer lasting full lips.

Radiesse™ (formerly named Radiance FN) is the latest injectable material being enjoyed nationwide by patients for non-surgical facial rejuvenation.  It is also a completely natural material (hydroxylapetite), and not derived from another living being (reducing likelihood of allergic or inflammatory reaction).  Interestingly, the same amount of Radiesse will treat almost twice as many areas as the same amount of collagen, but unlike collagen it is not ideal for very fine, well-demarcated facial lines.  Radiesse works well for deep cheek creases (melolabial folds) and marionette lines (corner of the mouth). Most recent long-term studies reveal that the injection is not permanent, with the effects capable of lasting over 1 year as the material is slowly resorbed.

Injections take usually 30 minutes to perform in a comfortable medical office setting. Local anesthesia is often used to numb the area injected.  Mild swelling and redness may occur for the first 24-48 hours, but no special dressings are necessary. Patients are thrilled that results are noticeable before they leave the office, and that they may use makeup and return to their daily activities immediately.