Want longer lasting facial fillers?

by Courtney Caplin, Md, DMA
Cosmetic Surgery Columnist

At Cosmetic Surgery Affiliates, performing cosmetic surgery is what we do. However, many of our patients are also very interested in less invasive options, especially as the holidays are approaching.

Many patients ask about fillers for their face for an immediate result without the downtime so they can be ready for their holiday pictures.

With a different medi-spa popping up on every corner, facial fillers have become extremely popular. Medical spas make their money by patients returning at regular intervals for more product, so they almost exclusively only use temporary products. When the product wears off, the patient returns and purchases more.

The most commonly used temporary fillers are made of hyaluronic acid. Hyaluronic acid is naturally in our skin, so you cannot be allergic to it. It holds roughly 1,000 times its size in water, as it naturally plumps the skin. As it dissolves, it turns back into water and the body absorbs it.

I love hyaluronic products and use them frequently in my practice, especially for first-time filler patients.

Once patients know what they love, I often graduate them to a permanent or semi-permanent product. As surgeons, surgery is our livelihood; not injecting filler.

I have two favorite longer lasting filler products: Silikon 1000 and Bellafill. Silikon 1000 is free silicone. It was originally FDA approved for restoring volume to orbital globes (aka eyeballs!). It was found to be a great permanent filler that the body did not dissolve.

Just as Viagra was originally used as a heart medication, physicians quickly found other uses.

Silikon 1000 has been used successfully for lip augmentation. What’s most interesting is that although the silicone itself is permanent, how it works is not just as a filler. It is injected in micro-droplets. These micro-droplets act as stimulants which cause the body to “grow” more collagen around it. Due to this effect, injecting silicone into the lips should be thought of as more of a treatment.

Once injected, the lips will then be stimulated to grow for up to eight weeks. As no one wants lips that are overdone, and we cannot predict the exact growth, only small amounts are injected at a time (usually 0.5ml/treatment).

The average patient needs three to four treatments to get the desired size, even though each session they are growing slightly larger. Silikon 1000 works wonderfully for the lips; however, I will not inject it in the skin because the skin does not respond favorably and created too much scar tissue around it.

For the skin, I prefer to use Bellafill for a more permanent option. Similar to Silikon 1000, Bellafill has a specific place for it to be used, which is the skin. It should not be used around round constrictor muscles, such as the eyes or mouth.

Bellafill is made out of a mixture of poly-methyl-methacrylate (PMMA) and bovine (cow) collagen. Due to the cow collagen, there is a possibility to be allergic to it, so I do regularly allergy test my patients. PMMA is what is used for cataract surgery and is very biocompatible, and the body does not break it down. The body does absorb the cow collagen and is then stimulated to build more of its collagen around the PMMA spheres.

The company promotes this product for lasting up to five years because it found roughly an 83 percent satisfaction rate after five years. Personally, I believe they saw how well it worked after five years and decided to stop studying it and start selling it. Since your own body is building more of its own collagen, I believe it could last even longer.

As the holidays approach, and you or someone you know may be interested in non-invasive cosmetic treatment, be informed about the various products on the market and what is best fits your needs. I love temporary products, and often start my patients with these, but I always want them to know that other more permanent options exist.

Copyright The Gayly – December 10, 2018 @ 9:50 a.m. CST.