Injectable fillers have been on the market since the Collagen Corporation brought out the first collagen injection, Zyderm, in the early 1980s. A large number of things have changed since then including the acquisition of the Collagen Corporation and collagen being supplanted by the hyaluronic acids like Juvederm and Restylane. As the treatments have evolved some patients may wish for longer lasting injectable fillers and these have become available in the last few years. These longer lasting fillers are not hyaluronic acid based and are completely different from each other with the unifying characteristic that they are injected less than once per year.
Sculptra is derived from a sugar polymer that has been used in surgical suture since the 1970s. It is injected as a powder suspension and it stimulates the body to form collagen in the areas where it is injected. Unlike other injectables the volume increases for months after the injection and the improvement lasts for at least 2 years and possibly longer.
There can be rare nodule formation but the material has a decades long record and there is no doubt about its safety.
Radiesse is made from the same material as the body makes bones from, calcium hydroxyappetite. This is the mineral part of a bone and is found in every bone in every body so the safety is assured. The material is also not derived from bones but is synthesized in a lab so that is a further safety factor. The powdered material is suspended in a gel and is injected with a hypodermic needle like all the other fillers. It’s approved life span is approximately 18 months.
Artefille is the only permanent filler of these three and only 20% of its total volume is permanent. The permanent part is microscopic beads made of methyl methacrylate which is more familiar as the main component of dentures, hard contact lenses and plexiglass. It has been used in the body for decades to cement hip replacements in place and to replace parts of skulls as the surgical product Cranioplast. The microscopic beads are suspended in a matrix of collagen for injection and a test of the patients’ reactions to collagen must be done one month prior to the injection. Only one fifth or 20% of the total volume remains permanently so a series of injections are required to get to the desired lever of correction because over correcting is contraindicated.
Nothing is perfect and the one drawback that all of these new injectables have in common is that they cannot be injected into the lips. Anything new takes some familiarization and we have no intention of abandoning the tried and true like Juvederm, Restylane and Perlane. If you’re one of those patients who want a longer respite between injection sessions or who are looking for permanent corrections these new products might be for you.
