Derma Filler Treatment
Facial Augmentation in Aesthetics
Facial augmentation has had a long and varied history. For centuries, techniques that were developed for reconstruction have been repurposed in the pursuit of a youthful appearance. While the idea of fat transplanting has been around since the 19th century, the first injectable dermal filler per se (which we know about) – was paraffin. It’s an unnerving notion which was shelved when paraffin granules were found to migrate around the body, ultimately causing embolism. Silicon was the next breakthrough – hailed for decades before similar migration issues came to light, it’s fall from grace in the early 90s was spectacular and precipitated a quest for a more ‘natural’ alternative. Biologically derived substances followed like bovine collagen, marketed as Zyderm & Zyplast, and eventually came the advent of hyaluronic acid based filling agents – a longer lasting (and hydrating) gel simulation of a naturally occurring polysaccharide.
The first filler substance specifically approved for cosmetic use was bovine collagen (collagen derived from cows) in 1981 (FDA, USA). Testing throughout the seventies meant several animal based collagens were deemed suitable for humans by the 1980s – and the cow variety, developed at Stanford University, became a game-changer for the cosmeceutical industry. Despite some swelling and difficulties associated with introducing a foreign substance into the body, these animal derived collagens were an improvement and generally well-tolerated.
A finessing of the collagen based approach came with the arrival of Cosmoderm & Cosmoplast – similar to their bovine counterpart, but developed from human collagen. A nearer biological match meant no foreign protein, so pre-treatment testing could be scrapped. Success rates, already good, rose further but the lifespan of the aesthetic effect improved only marginally.
Hyaluronic Acid Fillers
A breakthrough came with the trialling of hyaluronic acid. HA is a sugar molecule found throughout the human body, particularly in connective tissue and the skin, which, among other things, provides a profound source of hydration – each molecule of hyaluronic acid can retain 1000 times its weight in water. As we age our hyaluronic store is depleted, making hyaluronic filler more ‘top up’ than foreign agent. Restylane was introduced in the early 2000s, followed by Juvederm by Allergan. Lab produced HA is received well by the body and and will typically last twice as long as collagen, longer if combined with synthetic hydroxyapatite, as is the case with Radiesse, a popular, thicker filler used in particular facial areas.
Administering technology has also guided the evolution of dermal fillers. The very concept was born with the invention of the syringe in the 1800s, and even today new refinements are made, such as the introduction of the blunt flexible cannula and the mixing of local anaesthetic with filling agent to smooth the process further. As it stands, a long lasting hyaluronic based gel is the most recommended filling agent but animal based collagen filler/implants remain a plausible option. As the procedure has evolved fillers have increasingly mimicked naturally occurring substances and treatment longevity has increased. Further discoveries are no doubt in store – we can’t wait to see what’s next.
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