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Fill 'er Up!: Facial Rejuvenation and Contouring Using Cosmetic
Fillers
(Continued from previous
page)
Some filler implants and injectables are derived from
human tissue. Once the material is harvested, it is tested and processed
to remove any substance that could cause an allergic or infectious
response. Longevity of these human-derived products varies widely,
as does the cost. The more popular ones are Alloderm (implanted),
Fascian (injected), and Cymetra (an injectable form
of Alloderm). Interestingly enough, though not yet available in
the United States, another set of fillers named Cosmoderm
and Cosmoplast are derived from the removed foreskin of the
owner's son of the company that makes it!
Instead of injecting a filler through a needle, a
minor surgical procedure can be performed in the office operating
room to place a permanent implant. (These filler implants are not
to be confused with facial
implants used for cheek, chin, jaw, or midface augmentation).
Filler implants are most commonly used for lip augmentation, but
can sometimes be used to fill in the naso-labial grooves around
the mouth. They can be shaped like tiny threads or strands, hollow
tubes, or flat sheets of material that are trimmed to fit. The more
commonly used filler implants are Gore-Tex and Softform.
The procedure to place the implant is performed with local anesthesia,
and swelling may be evident for several days. These implants can
usually be removed if you decide you don't like the look, but otherwise
they are permanent.
The final class of fillers comes directly from your
own body, so there is no chance of rejection. Fat
Transfer (also known as fat grafting, fat transplantation,
or fat injection) involves suctioning small amounts of fat, usually
from the abdomen or flanks, processing it in a centrifuge to separate
the fat from other substances, and then injecting the fat into the
face for the desired effect. This is done in a minor surgical procedure,
in the office operating room with local anesthesia. Longevity varies
from several months to forever, and depends greatly on the surgeon's
skill, the location of the injections, the amount of movement in
that area, and your own body's response. The cost ranges from about
$2000 to $4500.
Other autologous (self-derived) options are Isolagen
(not yet available in the US) and Autologen. Both of these
are grown from your own skin that has been removed surgically and
then sent to a lab for processing and replication before surgical
re-implantation several months later. Because of the work involved
by the lab for storage and processing, this option costs several
thousand dollars. As with all self-derived fillers, there is no
risk of allergy or rejection, and no skin test is required. Longevity
of these products varies from 6 months to several years or more.
From injectables to implants, the options for facial
contouring with fillers are seemingly endless. While there are well
over 50 options for cosmetic fillers, the most common have been
mentioned above. My choice of a quick-fix, temporary filler (not
requiring surgery) will be Restylane
and Perlane, once
it is FDA-approved for use in the United States. It is safe, does
not use animal sources, does not require a skin test, and the results
typically last twice as long as collagen. For a more permanent solution,
Fat Transfer using
your own tissue avoids the risk of allergy and rejection, provides
longer lasting (if not permanent) natural appearing results, and
is safe and reliable in the hands of a surgeon experienced with
fat transplantation.
Danya B. Hoenig, PA-C is a licensed and certified Physician Assistant
specializing in the field of plastic and reconstructive surgery.
Her husband, Dr. Jonathan Hoenig practices in Los Angeles, California
where he provides the most advanced and innovative techniques in
facial plastic surgery and facial rejuvenation today. To learn more
about facial plastic and reconstructive surgery, visit us on the
web at http://www.la-plastic-surgery.com,
email info@drhoenig.com,
or phone toll free 866-HOENIG9.
dr. hoenig
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