Facial wrinkles are a new phenomenon. Until a few centuries ago, humans didn’t live long enough to become wrinkled. In fact, the presence of wrinkles foretells aging. A healthy, youthful appearance wanes with advancing years. Every glance into the mirror reminds us of our mortality.
Attempts to correct wrinkles by inflation with fillers began as early as 1902. Paraffin (wax), silk, celluloid, latex, and Vaseline were injected into the face. These procedures were abandoned twenty years later because of disastrous complications. One surgeon actually combined various ingredients in a vegetable grinder and injected them into the face.
Surgeons have long searched for the ideal filling material—one that was simple to use, inexpensive, lasted a long time, and had no complications. Until Restylane was introduced in Europe in 1996 only one wrinkle filler was in common use. For two decades collagen was the only choice. And until 2003, it was the sole filler in the United States. Now many fillers are in use around the world and more are on the way. Only time will tell which are useful and which are dangerous. As Peter McKinney, M.D., C.M., professor of plastic surgery at both Northwestern and Rush medical schools, says, ‘‘The one that lasts longer with fewer problems wins.’’
In 2005, there were 40,000 Radiesse injections, 221,000 collagen injections, 1,194,000 hyaluronic acid injections, and 35,000 Sculptra injections in the United States alone.
Some fillers are designed to be placed in the skin and some belong underneath the skin, in the fat. Fine-wrinkle filling requires different materials than deep folds. After deciding on the depth of the material, we consider how long the material lasts and its cost.
While no surgeon wants to be the last to perform a new procedure, it is not wise to be the first, either. New fillers need to last for a long enough time to be cost-effective but not cause short- or long-term problems. Consumers should be sure that their physician purchases fillers from approved sources within his own country. If a product is brought in from outside the country, there is no way to be sure the product is genuine.
Fillers are not just used for filling wrinkles or folds. Innovative plastic surgeons are now using fillers to reshape noses, chins, jawlines, and virtually every area of the face.
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