RESTYLANE, PERLANE, JUVEDERM, AND JUVEDERM XC are the most well known brands and are all HYALURONIC ACID - This transparent viscous (like thick syrup) material, which occurs naturally in the body, is available from several manufacturers. It is useful either to fill in shallow skin wrinkles and lines or to go under the skin to fill out broad depressions like the nasolabial folds ("smile lines"). It is also very useful to plump up the lips. More recently it is proving helpful to fill in hollows and grooves in the region between the cheeks and the lower eyelids. Dr. Cedars has been using hyaluronic acid for filling since it became available in 2003.
RADIESSE consists of Hydroxyapatite, another synthetically-made but also naturally occurring material. The material is thicker and denser than even Perlane. Therefore it is injected below the skin and is usually used where the skin is relatively thick. Because it is denser it will resist spreading out. Lifting of deep folds is enhanced because the subcutaneous tissue can hold more material in one location than the skin can. These two factors make Radiesse the agent for individuals with very deep smile lines. Radiesse can also be used to add volume in the chin and mid-cheeks areas. It is not as effective for treating finer skin creases as hyaluronic acid agents, which are injected directly into the skin. Radiesse will also feel firmer after injection, but as long as it is injected under thick skin it will be felt and not seen. If Radiesse is injected where the skin is thin such as the eyelids and lips, visible lumps are possible. Radiesse typically lasts about nine months but can persist up to two years.
SCULPTRA - Unlike hyaluronic acid, this product is very watery when it is injected deep to the skin. It is actually a suspension of fine particles in local anesthetic and water and prior to injection needs to be shaken up, looking rather like a child's snow globe. The material itself is the same as that used for several decades in one of the most common surgical sutures. The manufacturer claims that it stimulates the body to produce collagen. As a result the fullness produced by SculptraĻ builds up gradually over several months. Several injections, usually at one-month intervals, are required to produce the desired effect. Once achieved the fullness lasts, according to the manufacturer, 2 years or longer.
- Dermal fillers are often used in an "off-label" manner. Off-label use is not only legal, but usually represents an appropriate physician standard of care.
- What does "off label" mean? When an approved product is used in a different location or for a purpose not described in the FDA's official approval of the product, such use is considered to be off-label.
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