Injectables

Definition: Injectables consist of two groups: cosmetic fillers and cosmetic injectable drugs. These products treat wrinkles and volume loss in the face. Injectables and fillers include a variety of materials, which last for different lengths of time and have different effects and uses. [1]

Overview of Types of Injectables
Provided below is a table of common injectables for referance. Not all providers will offer all of these treatments. Ultimately your doctor will let you know how to best achieve your cosmetic goals based on the area you wish to treat and the severity of the wrinkling or volume loss. [1]

Botox vs Dysport
Botox and Dysport and both made from the same neurotoxic protein (Clostridium botulinim toxin type A) and do the same thing, treat wrinkles and lines of movement. These dynamic wrinkles have been shown to be effectively treated with both Botox & Dysport. Some research indicates Dysport may last a bit longer than Botox, and that it may also spread farther from the injection site. Ulltimately they are very similar and which is right for you should be discussed with your doctor during your consultation.[1]

Restylane vs Juvederm
Both these products are often used for plumping the lips and filling lines and wrinkles. Both last up to 9 months between injections and are made of hyaluronic acid. While there are some differences (such as molecule size and consistency) the decision as to which ought to be used should be made by your doctor. [1]

Human-Based Collagen Fillers
Human-based collagen is used under brand names such as CosmoDerm, CosmoPlast, Cymetra, Autologen, and Fascian to build volume in facial areas including the lip area (such as for lip augmentation), above and below the eyes, crow's feet, the nasolabial fold area (the grooves from your nose to your mouth), and frown lines.

Human-based collagen fillers are biocompatible and produce results that may last for four or more months. But as collagen treatments continue over time, more and more of the collagen remains, and results may last longer, in some cases forever. It is important to note that the treatment area is typically overfilled initially, because up to 40% of the collagen dissipates within a short time. [2]

Human-Based Collagen Fillers
The brand names of bovine-based collagen fillers include Zyderm and Zyplast. This form of collagen is derived from cows and may be used to add volume to facial areas such as the lip area, above and below the eye, crow's feet, the nasolabial fold area, and frown lines. Because some people are allergic to bovine-based collagen, your doctor will perform an allergy test.

Results may last for four or more months, but as with human-based collagen, if you continue to have treatments over time, some of the collagen will remain, and results may last a lifetime. Also, ArteFill (described below) uses a bovine collagen product to suspend polymethylmethacrylate (PMMA, a type of plastic) microspheres that lodge into the treatment area after the collagen dissipates, with the goal of providing a more permanent benefit. Since up to 40% of bovine-based collagen soon dissipates, the treatment area is typically overfilled at first.

Both human-based and bovine-based collagen are FDA-approved for cosmetic uses. [2]

Off Label Treatments
In many medical treatment areas, including cosmetic injectables and fillers, you will often hear the term "off-label." When the FDA approves a substance for medical or cosmetic purposes, it is for a very specific use. That FDA-specific use is printed on the label. But the FDA also allows physicians to use their own judgment. Physicians are allowed to prescribe fillers for newly discovered uses that were not originally included in the FDA-approval specification (although certain controlled drugs such as opiates are excluded from off-label use).

For example, Botox is FDA-approved for cosmetic use for lines between the eyes, but is commonly prescribed off-label for other areas of the face. Sculptra is FDA-approved for certain non-cosmetic uses, but is commonly prescribed for a number of cosmetic uses.

Cosmetic fillers are commonly used off-label, as many new applications are constantly being found. Doctors may also use a combination of fillers customized to fit the facial conditions of each patient. The fact that physicians can prescribe treatments off-label is a good reason to choose a qualified, trained, and experienced dermatologist or a board-certified plastic surgeon who has extensive expertise in the specific treatment you are receiving.

Injectables Costs
There are a wide range of costs for various dermal fillers. Some last longer and are therefore more expensive. Others are used for different purposes and have their own unique price as a result. Many times the price is determined by "units" or "vials" used for the procedure. The price of dermal fillers may also be determined by the area of the country you live in and who you go to for treatment. Certain physicians may charge more because they have more experience performing the treatment. It’s advisable to seek treatment with an experienced physician, as they are the most likely to provide you with a satisfactory result. Price should not be your main consideration when deciding on treatment. [1]

References

1. Dermal Fillers. The Patient’s Guide. http://www.dermalfiller.net/comparison.aspx