What are the dermal fillers different types?
Dermal fillers tend to be broadly classified as being either non-permanent or permanent in their effect by both manufacturers and practitioners using these products.
Non-permanent or resorbable dermal fillers
In 1981, Collagen was the first filler approved in the U.S. for soft-tissue filling by injection. It is made from bovine (derived from cows’ skin) collagen and is currently known in the U.K. as Collagen Instant Therapy.
The collagen is taken from the cow and then purified to such a degree that it resembles the collagen which occurs naturally in our own skin. It is necessary to have a skin test before this treatment, however, as some patients may be allergic to bovine collagen.
Collagen instant therapy comes in different thicknesses, depending on the depth of your wrinkles or loss of firmness in your skin. You will sometimes hear Collagen Instant Therapy called by the brand names Zyderm® and Zyplast®. Unfortunately due to a decrease in popularity these brands were discontinued in 2010.
Evolence®, a porcine (derived from pigs) based collagen product was available in the UK from 2005 to 2009 when it was discontinued for commercial not safety reasons.
Other collagen only based fillers include Cymetra, collagen derived from human skin. This is rarely used these days.
The leading dermal filler used by most UK practitioners is a hyaluronic acid based product. This particular brand is manufactured using bacteria. Again, this product comes in different thicknesses and is called Restylane®.
Hyaluronic acid is a naturally occurring substance found in the spaces between the cells of body tissues in all animals. It has already been used widely in general medicine to help eye surgeons perform cataract operations, and for injection into arthritic joints to aid movement. It is estimated that 30 million patients around the world have been treated with some form of hyaluronic acid. Hyaluronic acid has now largely replaced collagen as the favourite filler of U.K. cosmetic experts. This is because it is more likely to be compatible with our bodies than collagen, and so people are less likely to be allergic to it and do not require a test prior to use.
Other hyaluronic acid only based products include:
Hylaform® and Hylaform Plus® – Manufactured from cockerel combs. This is being discontinued by the manufacturer in favour of other products.
Juvederm® ULTRA, Belotero®, Teosyal®, Matridur® and Hydrafill are examples of other Hyaluronic acid based brands derived from non-animal sources.
A newer filler using polylactic acid is promoted under the brand name Sculptra® (formerly New-Fill®). According to the manufacturer, Sculptra®, as the name suggests, is used more as a sculpting agent rather than just a wrinkle filler and larger areas can be treated with a longer lasting result.
Another product new to the UK market in 2004 is calcium hydroxylapatite, the key component of Radiesse™. Calcium hydroxylapatite has been safely used in the body for many reasons including dental applications where bone build-up is needed for reconstruction and also in block form for cosmetic applications such as cheek, jaw, cranial and chin implants.
Radiesse is marketed as a long lasting dermal filler and facial sculpting agent where results can last for 2 years or longer.
Most of the ingredients of available non-permanent or temporary fillers have been widely used and clinically tested for safety and effectiveness.
Permanent or non-resorbable dermal fillers
These are fillers that can give a longer lasting effect, or even a permanent effect, and may be recommended in some cases by a practitioner.
These products are currently not widely used, but include the following brands:
Artecoll® – Rounded PMMA beads in bovine collagen.
Aquamid™ – Polyacrylamide.
Matridex® – Hyaluronic acid with Dextran microspheres.