Dermal fillers have been used for over a hundred years. Originally autologous fat was removed from elsewhere in the patient and inserted in to the face. This process has been refined over the years and is still available today. Despite this it is not the most reliable of treatments and results can be disappointing.
Recently collagen extracted from bovine or poultry sources has been used very successfully in refilling facial lines. One disadvantage of collagen is that its animal origin makes allergic reactions to the product more common and so a test patch of treatment has been required to ensure a safe treatment.
More recently the Hyaluronic Acids have been developed which require no prior testing. Hyaluronic Acid is a natural component of the skin. Approximately 87% of the upper layers of your own skin is Hyaluronic Acid. Manufacturers in Sweden have simply trained some bacteria to manufacture Hyaluronic Acid in large volumes which are made into a gel which is then sterilised and safe to inject into the face. Often termed “Polyfilla for the face” these Hyaluronic Acids are extremely safe. Not all hyaluronics readily available today are made from bacterial sources, however the best ones are. The most popular by far is the Restylane range.
Restylane is fundamentally a Non Animal Stabilised Hyaluronic Acid or NASHA. It comes in several forms and it is most important to choose the right form for the right problem. Your doctor is best placed to advise you about which form is most appropriate for you and many people require several different types dependent on the lines they present with.
These
products are most frequently used to reduce lines in the lower parts
of the face especially Nasolabial Folds and Oral Commissures. They are
also frequently used to enhance lips shape and to build up cheek bones.
Even more recently a new version of collagen has been developed called Evolence. This has two advantages over the previous versions. Firstly it has been washed of most of its antigenicity and so it no longer requires a test patch to be performed prior to treatment. Secondly it has been wrapped in a “dextrose monomer” which makes it last considerably longer. Evolence does sting rather more than Restylane at the time of injection but it certainly appears to last roughly twice as long for less than twice the cost